The nurse is teaching a client about the initiation of a prescribed abstinence therapy using disulfiram. Which information should the client provide to acknowledge understanding?

Attend monthly meetings of Alcoholics Anonymous.

Remain alcohol free for 12 hours prior to the first dose.

Admit to others that he is a substance abuser.

Completely abstain from heroin or cocaine use.

Answer and Explanation

The Correct Answer is B

Choice A reason: Attending Alcoholics Anonymous supports recovery but is not specific to disulfiram’s mechanism or initiation requirements. Remaining alcohol-free for 12 hours prevents adverse reactions, directly relating to disulfiram’s use, making this incorrect for demonstrating understanding of the medication’s requirements.

Choice B reason: Disulfiram causes severe reactions if alcohol is consumed, so remaining alcohol-free for 12 hours before the first dose is critical to avoid adverse effects. This demonstrates understanding of safe initiation, aligning with pharmacotherapy guidelines, making it the correct choice for client education.

Choice C reason: Admitting substance abuse is part of recovery but unrelated to disulfiram’s pharmacological requirements. Avoiding alcohol for 12 hours before starting is essential for safety, making this incorrect, as it does not reflect understanding of disulfiram’s specific administration protocol.

Choice D reason: Abstaining from heroin or cocaine is irrelevant to disulfiram, which targets alcohol use. Remaining alcohol-free for 12 hours addresses disulfiram’s alcohol-specific reaction, making this incorrect, as it does not demonstrate understanding of the medication’s purpose or initiation requirements.

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Correct Answer is ["A","C","E"]

Explanation

Choice A reason: Inviting the client for a walk channels high energy during mania into a safe, physical activity, reducing agitation and inappropriate behaviors. This intervention aligns with bipolar disorder management by redirecting energy constructively, supported by psychiatric nursing evidence, making it appropriate for the care plan.

Choice B reason: Suspenseful television programs may overstimulate a manic client, increasing agitation and inappropriate behaviors. Calming, structured interventions like walking or clear directions are more effective. This choice risks escalating symptoms, making it incorrect for managing a client with bipolar disorder’s manic behaviors.

Choice C reason: Concise, firm directions for hygiene and dressing provide structure, helping the manic client focus on essential tasks despite distractibility. This reduces inappropriate behaviors by setting clear expectations, aligning with therapeutic strategies for mania, making it a key intervention for the bipolar care plan.

Choice D reason: Competitive activities may escalate agitation and impulsivity in a manic client, worsening behaviors like sexual comments. Non-competitive, calming interventions like walking are safer. This choice is inappropriate, as it risks increasing mania-related disruption, making it incorrect for the care plan.

Choice E reason: Assigning a single room reduces stimuli and potential conflicts with others, providing a calmer environment for a manic client. This supports safety and minimizes inappropriate interactions, aligning with inpatient psychiatric care principles for bipolar disorder, making it an appropriate intervention for the care plan.

A. "May I sit with you for a while?" B. "Come into the recreation area. We have your favorite card game and I will play it with you." C. "I know you are sad about not seeing your family as often, but they are visiting as much as they can." D. "Why do you want to stay in your room today?"

Correct Answer is A

Explanation

Choice A reason: Offering to sit with the client provides empathetic presence, addressing the isolation of depression without pressuring activity. This fosters connection and support, critical for a reclusive, depressed client, aligning with psychiatric nursing principles for building therapeutic rapport in chronic depression, making it the most helpful comment.

Choice B reason: Inviting the client to the recreation area may feel coercive to a depressed, reclusive client, increasing withdrawal. Offering quiet companionship respects his current state and encourages engagement gently, making this less helpful and incorrect for addressing his immediate emotional needs effectively.

Choice C reason: Acknowledging family absence may validate sadness but risks dismissing the client’s feelings by justifying the situation. Sitting with him offers direct support, fostering connection. This comment is less therapeutic, as it may not address his isolation, making it incorrect for immediate support.

Choice D reason: Asking why he stays in his room may seem confrontational to a depressed client, potentially increasing withdrawal. Offering to sit with him builds trust without demanding explanation, aligning with supportive care for depression. This question is less helpful, making it incorrect for fostering engagement.

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The nurse is teaching a client about the initiation of a prescribed abstinence therapy using disulfiram. Which information should the client provide to acknowledge understanding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is planning the care for a client who is hospitalized with a bipolar disorder. The client wanders the hallways, talks excessively, and makes sexual comments about the staff. Which intervention(s) should the nurse include in the plan of care? (Select all that apply)

Correct Answer is ["A","C","E"]

Explanation

Correct Answer is A

Explanation

The mother of an infant with profound mental and physical disabilities tells the nurse how depressed she is because she realizes that her child will never achieve normal growth and development milestones. How should the nurse respond to this mother?

A client at the mental health center reports difficulty concentrating at work, feeling very tired during the day, and sleeping 4 to 5 hours at night. To further assess for depression, which question is most important for the nurse to ask?

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