The nurse is caring for a client and family member who are distressed about not having a concrete medical diagnosis. The client states, "I have been through a lot of tests, and I still know nothing." When confirming a psychobiologic diagnosis, the nurse is most accurate to state which of the following?

"Confirmation is achieved by ruling out other diseases that manifest similar symptoms."

Diagnosis takes time to consult the specialist and to get those reports."

"We should have the conclusion of the tests soon. Hang in there."

"Psychotherapy will provide the best data to make a diagnosis."

Answer and Explanation

The Correct Answer is A

A. "Confirmation is achieved by ruling out other diseases that manifest similar symptoms.": Psychobiologic diagnoses are often made through exclusion since many medical and psychiatric conditions present with overlapping symptoms. This explanation is medically accurate and helps the client understand the diagnostic process.
B. "Diagnosis takes time to consult the specialist and to get those reports.": While this may be true, it lacks specific detail about the diagnostic process. It may come across as vague or dismissive rather than informative and supportive during a stressful time.
C. "We should have the conclusion of the tests soon. Hang in there.": This is a supportive statement but provides no meaningful information. It does not validate the client’s frustration or explain the nature of psychobiologic diagnosis.
D. "Psychotherapy will provide the best data to make a diagnosis.": Psychotherapy is primarily used for treatment, not diagnosis. While it may help reveal symptoms, the diagnostic process relies more on clinical assessment and the exclusion of medical conditions.

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Correct Answer is D

Explanation

A. Administer the medications and then notify the health care provider: Administering digoxin with a heart rate below 60 bpm can worsen bradycardia and lead to complications like heart block. The drug should be withheld first.
B. Administer atropine to speed the heart rate and then administer the digoxin: Atropine is not given prophylactically without a provider's order. It is used in emergency settings for symptomatic bradycardia, not as a pre-treatment for digoxin.
C. Administer the medication and inform the charge nurse about the rate: This does not follow safe medication guidelines. Administering digoxin without addressing the low heart rate may lead to serious adverse effects.
D. Withhold the medication and notify the health care provider of the heart rate: This is the safest and most appropriate action. Digoxin should be withheld if the apical pulse is below 60 bpm, and the provider must be informed for further evaluation.

A. Suggest a consultation with a psychiatrist to treat the client's addiction. B. Inform the client that they will not be able to receive more medication than the health care provider has prescribed. C. Tell the client the nurse will ask the health care provider to prescribe a non-narcotic analgesic. D. Consult with the prescriber regarding the need for an increased dose of the drug and not to reduce the frequency of administration.

Correct Answer is D

Explanation

A. Suggest a consultation with a psychiatrist to treat the client's addiction: Tolerance is a physiological response to long-term opioid use, not necessarily a sign of addiction. Labeling the client as addicted without behavioral signs of misuse is inappropriate and stigmatizing.
B. Inform the client that they will not be able to receive more medication than the health care provider has prescribed: This response dismisses the client's need for adequate pain control. Tolerance may require dose adjustment, and concerns should be communicated compassionately to the prescriber.
C. Tell the client the nurse will ask the health care provider to prescribe a non-narcotic analgesic:
Switching to a non-narcotic medication may not provide effective relief for someone with a chronic condition and established tolerance. Medication adjustments should be based on the client’s needs and pain response.
D. Consult with the prescriber regarding the need for an increased dose of the drug and not to reduce the frequency of administration: Tolerance may require a dose increase to maintain pain relief. The nurse’s role includes advocating for appropriate pain management and collaborating with the provider for safe and effective adjustments.

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Naxlex Comprehensive Predictor Exams

The nurse is preparing to administer digoxin to a client with heart failure. The nurse obtains an apical pulse rate for 1 minute and determines a rate of 52 beats/minute. What is the first action by the nurse?

Correct Answer is D

Explanation

The nurse is caring for a client in the hospital who has been taking an analgesic for pain related to a chronic illness and has developed a tolerance to the medication. What is the appropriate action by the nurse?

Correct Answer is D

Explanation

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