4 Amphetamine is a central nervous system stimulant. A patient who is administered anesthesia may have difficulty breathing due to respiratory depression. To prevent discomfort and provide relief from breathing difficulty, amphetamine must be administered to the patient. Adrenergic drugs such as dobutamine may cause vasoconstriction, but may not help prevent respiratory depression. Barbiturates such as phenobarbital and benzodiazepines such as diazepam are central nervous system depressants. Therefore they should not be administered because they aggravate respiratory depression.

The nurse is assessing a patient who has been administered anesthesia. The nurse finds that the patient has difficulty breathing. Which drug does the nurse anticipate to be administered to the patient to provide relief from breathing difficulty? 1 Diazepam 2 Dobutamine 3 Phenobarbital 4 Amphetamine More test answers on https://studyhippo.com/pharmacology-chapter-17-substance-abuse/

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We've found 12 Central Nervous System Depressants tests

Central Nervous System Depressants Illicit Drug Use Long Term Effect Motor Vehicle Crashes

Health Exam Cards Ch. 10 – Flashcards 50 terms

Livia Baldwin

50 terms

Preview

Health Exam Cards Ch. 10 – Flashcards

question

The percentage of people in the United States who do NOT use illicit drugs is

answer

91.1%

question

About 75 percent of people aged 12 or older have used an illicit drug during their lifetime.

answer

false

question

A drug is any substance, natural or artificial, other than food, intended to affect the structure or function of the body through its chemical action.

answer

true

question

Drugs are called pharmaceutical drugs when they are developed

answer

medical use

question

Which of the following routes of drug administration is the fastest way for a drug to reach the brain?

answer

through the nose

question

If a person's biochemical state is already altered by another drug, the effect of a drug can be changed.

answer

true

question

Which type of drug has effects similar to the response evoked during the fight-or-flight reaction?

answer

stimulants

question

Which of the following is a demand reduction strategy in the war on drugs?

answer

treatment

question

People who abuse heroin are at higher risk for all of the following health conditions EXCEPT

answer

colon cancer

question

Ativan is an anti-anxiety drug.

answer

true

question

Compared to other routes of administration, ___________________ is the most complicated way for a drug to enter the bloodstream.

answer

oral consumption.

question

Which of the following statements about the effects of drugs on the brain is FALSE?

answer

Parts of the brain involved in rational thought are not affected.

question

Paco has come to depend on heroin to be able to function normally. A few weeks ago, he attempted to cut himself off, but he experienced severe diarrhea. Paco's case illustrates which of the following concepts?

answer

withdrawal syndrome.

question

One indicator of physiological dependence is the development of

answer

tolerance

question

Neuroscientists have found that many addictive drugs, such as cocaine, marijuana, opiates, alcohol, and nicotine, affect a pleasure and reward circuit lying deep inside the brain.

answer

true

question

Drug abuse rates are lower among college graduates than among those with a high school diploma.

answer

true

question

Sheena is engaging in drug misuse when she

answer

ingests her brothers ritalin

question

Psychoactive drugs are substances that are used only for recreational purposes.

answer

false

question

Most drugs are taken

answer

orally

question

The route of administration may have a profound effect on the speed and efficiency with which a drug acts.

answer

true

question

Probably the most popular psychoactive drug is

answer

caffeine

question

Amphetamines fall under which category of drugs?

answer

stimulants

question

The majority of federal funds directed toward fighting the war on drugs is spent on

answer

domestic law enforcement.

question

Most experts agree that drug treatment should be a one-time, short-term process without relapses.

answer

false

question

Dependence on barbiturates and hypnotics is common among middle-aged and older adults who use these sedatives as sleep aids.

answer

true

question

Smoking or orally consuming marijuana gives you the munchies.

answer

fact

question

Drinking alcohol does in fact kill brain cells in an adult.

answer

myth

question

Drinking alcohol does warm you up a little bit.

answer

myth

question

Which of the following statements is TRUE about cocaine?

answer

Cocaine's effects appear almost immediately after a single dose and disappear within a few minutes.

question

Which of the following combinations/associations is NOT correct

answer

methamphetamine/panic attacks.

question

Which of the following is a possible long-term effect of marijuana?

answer

development of chronic bronchitis

question

LSD does not produce compulsive drug-seeking behaviors, and physiological withdrawal symptoms do not occur when use is stopped.

answer

true

question

Users can develop a tolerance to stimulants and experience serious withdrawal effects without becoming physically dependent on them.

answer

true

question

Which of the following, by definition, is(are) a drug(s)?

answer

nicotine, aspirin, and caffeine.

question

Which of the following is a term used to refer to a substance that causes changes in brain chemistry and alters consciousness, perception, mood, and thought?

answer

psychoactive drug.

question

When choosing an over-the-counter medication, it is best to choose a medication with a single ingredient targeted at your symptoms rather than a combination of ingredients.

answer

true

question

It is not necessarily safe to consume food or beverages containing grapefruit juice with any medication; grapefruit juice contains an enzyme that can raise levels of some medications in the blood.

answer

true

question

The FDA does have the power to remove an herbal remedy from the market if it has proven harmful.

answer

true

question

Although close, which of the following geographic regions in the U.S. does the text's graph report as having the highest rate of recent illicit drug use?

answer

the West

question

Surprisingly, the data in the text reports that "completely rural counties" in the U.S. have a higher recent percentage of illicit drug use.

answer

false

question

Which of the following is NOT considered a harm reduction strategy?

answer

incarceration

question

The most effective approaches to drug abuse prevention on college campuses include all of the following strategies, EXCEPT

answer

engaging the media.

question

More than half of the people in jail have been incarcerated for drug offenses.

answer

true

question

While most of the funding has been for supply reduction efforts, most of the data suggest that treatment is a more effective and cost-effective approach for reducing drug use.

answer

true

question

Harm reduction strategies are based on the same set of assumptions as supply and demand reduction strategies in the war on drugs

answer

false

question

What is the most commonly used illicit drug among persons aged 12 and older?

answer

marijuana

question

The highest rates of illicit drug use occur among adults aged.

answer

18-20

question

Abuse of which of the following genres of prescription medications jumped by 343 percent from 1993-2005?

answer

pain relievers.

question

In the United States, drug use is most prevalent in _______, while the lowest occurs in

answer

large metropolitan areas; completely rural counties.

question

Which of the following drugs has seen a dramatic increase in abuse by college students?

answer

perscription drugs

STUDY

Central Nervous System Depressants Nursing Pharmacology Primary Health Care Primary Health Care Provider

Chapter 36, 37 – Flashcards 20 terms

Suzette Hendon

20 terms

Preview

Chapter 36, 37 – Flashcards

question

Which antihistamine causes sedation an adverse drug effect?

answer

Diphenhydramine

question

Which condition is characterized by enlargement of air spaces caused by the destruction of the alveolar walls?

answer

Emphysema

question

The nurse observes that a patient has moon face, acne, an increase in fat pads, and swelling. After checking the patient history, the nurse finds that the patient is taking methylprednisolone for bronchospastic disorder. What will the nurse infer from the assessment?

answer

The patient has Cushing's syndrome.

question

The nurse is teaching a patient who has asthma about the frequency of inhalation of salmeterol. Which statement by the patient indicates effective learning?

answer

"I will inhale it twice a day approximately 12 hours apart."

question

A patient reports to the nurse that after taking guaifenesin for 1 week, the productive cough still persists. What advice should the nurse give to the patient?

answer

"Consult your primary health care provider."

question

What interaction can occur when an asthmatic patient consumes rifampin along with xanthine derivatives?

answer

Theophylline levels are decreased. Xanthine derivatives are used as bronchodilators in asthmatic patients. Administration of rifampin along with xanthine derivatives causes increased metabolism of theophylline, which results in decreased levels of theophylline. Additive cardiac and central nervous system stimulation is produced when caffeine is administered along with theophylline.

question

A patient is prescribed tiotropium for the treatment of chronic obstructive pulmonary disease (COPD). How can the absorption of tiotropium be improved?

answer

By waiting for 1 to 2 minutes before inhaling the second dose

question

The nurse is teaching a patient about the use of an expectorant. What is the most important instruction for the nurse to include in the patient teaching?

answer

"Increase your fluid intake to decrease viscosity of secretions."

question

A patient is prescribed diphenhydramine for the treatment of an allergic disorder. After reviewing the patient's history, the nurse finds that the patient drinks alcohol. Why should the nurse instruct the patient to stop alcohol consumption?

answer

Alcohol increases central nervous system depression.

question

A patient is prescribed inhaled corticosteroids. Why should the nurse ask the patient to rinse the mouth after each dose?

answer

To prevent the development of oral candidiasis It is recommended that patients rinse their mouth immediately after use of the inhaler or nebulizer dosage forms of corticosteroids. It helps to prevent overgrowth of oral fungi and subsequent development of oral candidiasis (thrush). Dry mouth, nasal congestion, and sore throat are not side effects of corticosteroid inhaler use

question

Which anticholinergic effect is seen in a patient who takes brompheniramine?

answer

Dry mouth

question

Which drug will the primary health care provider prescribe for a patient who has nighttime insomnia and motion sickness?

answer

Diphenhydramine

question

What are the adverse effects of ipratropium and tiotropium therapy? Select all that apply.

answer

Headache Dry mouth Nasal congestion

question

A patient is prescribed disulfiram for alcohol abuse. During the assessment, the nurse finds that the patient is also taking echinacea for wound healing. What should the nurse instruct the patient to do?

answer

"Stop using echinacea."

question

Which antiasthmatic drugs work by preventing the inflammation commonly provoked by the substances released from mast cells?

answer

Corticosteroids

question

A patient taking an oral theophylline drug is due for the next dose and has a blood pressure of 100/50 mm Hg and a heart rate of 110 beats/min. The patient is irritable. What is the nurse's best action?

answer

Hold the next dose of theophylline and assess the patient.

question

Which antiasthmatic, available only for oral use, is approved for use in children 2 years of age and older?

answer

Montelukast

question

A patient presenting with cough is prescribed diphenhydramine. The nurse instructs the patient to avoid consuming alcohol. Which consequence of drug interaction with alcohol would be prevented if the patient follows the nurse's instructions?

answer

Central nervous system (CNS) depression

question

A patient complains of worsening nasal congestion despite the use of oxymetazoline nasal spray every 2 hours. What is the nurse's most appropriate response?

answer

"Overuse of nasal decongestants results in rebound congestion."

question

The nurse is assessing a patient with asthma. Which symptoms should the nurse expect to find in the patient? Select all that apply.

answer

Wheezing Chest tightness Shortness of breath

STUDY

Central Nervous System Central Nervous System Depressants Central Nervous System Stimulant Grade Point Average Illicit Drug Use Poor Self Esteem

Personal Health Final #3 – Flashcards 120 terms

Daniel Thompson

120 terms

Preview

Personal Health Final #3 – Flashcards

question

Carl's biggest health risk from his current pattern of drug use is

answer

Respiratory depression

question

Which drug is mostly associated with flashbacks

answer

LSD

question

All of the following are signs that a persons life may be centered on drugs, EXCEPT

answer

increased social activity

question

Small doses of amphetamines result in all of the following, EXCEPT

answer

improved complex motor skills

question

Ice is an

answer

amphetamine

question

Which of the following statements is false regarding drugs and crime?

answer

people under the influence of drugs are less likely to commit violent crimes than people who do not use drugs

question

Consequences of heavy marijuana use may include all of the following, EXCEPT

answer

increased progesterone levels

question

All of the following are depressants, EXCEPT

answer

methedrine

question

Bill has just taken ephedrine. He can expect

answer

all of these choices

question

Caffeine use

answer

counters fatigue

question

The term used by the American psychiatric association to refer to what is commonly called addiction is

answer

substance dependence

question

According to the text, the best solution to drug abuse is

answer

prevention

question

The ___ is the physical and social environment surrounding an individuals drug use

answer

setting

question

The most widely used illegal drug in the United States is

answer

marijuana

question

For someone to be diagnosed as drug dependent according to the American psychiatric association criteria, how many clusters of symptoms must they demonstrate in a one year timeframe

answer

question

Carl is showing signs of

answer

alcohol tolerance

question

Which of the following is NOT a CNS stimulant

answer

alcohol

question

What is the estimated annual cost of illegal drug use in the united states

answer

500billion

question

Which of the following could marijuana possible be used to treat

answer

side effects of chemotherapy

question

Amphetamines can do all of the following, EXCEPT

answer

improve complex thinking

question

Sudden death from cocaine may result from of all of the following, EXCEPT

answer

depressed central nervous system

question

In terms of drug use, setting means the

answer

social environment

question

Which of the following would not be considered a psychoactive drug

answer

aspirin

question

The time action function Is the relationship between

answer

when a drug is taken and the intensity of its effect

question

Which of the following drugs is an opioid

answer

codeine

question

Which of the following best describes the phenomenon known as state dependence

answer

information learned in a drug induced state is difficult to recall when not under the influence of the drug

question

When tomas does not drink alcohol, he has tremors and shakes. He is experiencing

answer

withdrawal

question

Which characteristic of addictive behavior indicates that an individual needs more and more of a particular substance

answer

escalation

question

A psychological risk factor for drug dependence is

answer

difficulty controlling impulses

question

Which of the following is not a risk factor for experimenting with drugs

answer

being an independent thinker

question

One reason that females usually become intoxicated more quickly than males because

answer

the stomach enzyme that metabolizes alcohol is less active in women than in men

question

Among college students , frequent binge drinkers are ___ times more likely to engage in unplanned sexual activity, drive after drinking, or get injured than non binge drinkers

answer

3-7

question

Which of the following is an effect of environmental tobacco smoke

answer

all of these choiced

question

Even though Rodney has not successfully quit smoking in the past, he would like to quit before he and lisa get married. All of the following strategies might help him quit, EXCEPT

answer

substituting spit tobacco for cigarettes

question

Which of the following is associated with cirrhosis

answer

replacement of liver cells with scar tissue

question

Initial effects of low concentrations of alcohol include all of the following, EXCEPT

answer

sleepiness

question

What percentage of pregnant women are binge drinkers during their pregnancy

answer

10 percent

question

A component of tobacco smoke that seriously limits the body's ability to use oxygen is

answer

carbon monoxide

question

Which of the following is the most accurate description of the safe limit of alcohol consumption during pregnancy

answer

one drink per week during the first trimester

question

People who quit smoking suddenly may have all of the following symptoms. EXCEPT

answer

increased attentiveness

question

Which of the following statements is true concerning alcohol use

answer

Health benefits from alcohol are negated by heavy

question

The main site of alcohol metabolism is in the

answer

liver

question

Cardiovascular benefits from moderate alcohol consumption may be due

answer

increased levels of HDL cholesterol

question

Which of the following statements is FLASE

answer

nicotine is considered a powerful depressant

question

A 20 proof beverage is ___ percent alcohol

answer

question

On average, a regular user of tobacco can go how long between dosages of nicotine

answer

no more than 40 minutes

question

Which of the following statements is FALSE regarding coronary heart disease and smoking

answer

smokers have a death rate from CHD that is 25 percent higher than non smokers

question

Which of the following statements about alcohol related pancreatitis is TRUE

answer

Jaundice is an early sign of pancreatitis

question

Which of the following lingers in the bloodstream for 5 hours after exposure to environmental tobacco smoke

answer

carbon monoxide

question

At what blood alcohol concentration is pain perception significantly impaired

answer

0.15-0.30 percent

question

The effects of fetal alcohol syndrome are

answer

both physical and mental impairments

question

Lynette has quit smoking. She can expect all of the following changes to occur, EXCEPT

answer

a lack of improvement in circulation

question

Negative consequences associated with binge drinking include

answer

all of the above choices

question

A heart attack is also called

answer

a myocardial infarction

question

What would be the estimated blood alcohol concentration for a person who is experiencing emotional instability with exaggerated feelings and behavior

answer

0.05-0.10 percent

question

What role does ammonia play in cigarettes

answer

it boosts the amount of nicotine they deliver

question

Which of the following is not a major form of spit tobacco

answer

cloves

question

What are the estimated hours required to metabolize a BAC of .05 percent

answer

4-6 hours

question

Respiratory cilia

answer

keep air passages free of dust and soot

question

Which of the following would probably not be a sign of impending alcohol abuse

answer

drinking moderate amounts with most evening meals

question

Jonas is having severe chest pains with shortness of breath that has not subsided within the last ten minutes. He should

answer

have someone take him to the nearest emergency room

question

Western medicine traditionally relies on the use of ___ to treat and cure diseases

answer

pharmaceuticals

question

You should always consult with a doctor before taking an over the counter medication if you

answer

are pregnant

question

The most commonly used form of manual healing is

answer

chiropractic

question

Biofield therapies are based around energy fields thought to originate from the

answer

body of the patient

question

Which of the following types of health insurance requires a primary care physician

answer

health maintenance organization

question

Which of the following Is not a purpose or condition for which consumers are likely to turn to complementary and alternative medicine

answer

bone fractures

question

Which of the following is a guideline for sale self medication

answer

when buying a medication for the first time, buy the brand name version

question

Reiki is an example of which of the following domains of complementary and alternative medicine practice

answer

energy therapy

question

Which of the following describes the process of drug development

answer

it may take 12 years or more

question

Which of the following is true of managed care plans

answer

they restrict which physicians patients may use

question

What over the counter medication should you not give to children with flu like symptoms

answer

aspirin

question

Which of the following best describes symptoms you should check with a physician about

answer

recurrent

question

Which of the following is a product of Western medicines belief that illness is caused by outside factors

answer

the scientific method

question

A government health insurance program for americans over age 65 is

answer

medicare

question

Which of the following best describes generic drugs

answer

they generally cost much less brand name drugs

question

Why should consumers exercise caution when choosing a CAM therapy

answer

not all CAM practices have been scientifically evaluated for safety

question

In traditional Chinese medicine, the life force contained in all living things is called

answer

question

Which of the following herbals may have severe interactions with nonsteroidal anti inflammatory drugs or anticoagulants

answer

ginkgo

question

Fatima has had a cough for several weeks. Which of the following is likely to be Fatima best option for addressing this symptom

answer

calling her physician

question

Western researchers might explain the effects of acupuncture as being the result of

answer

releasing hormone and neurotransmitters

question

Which of the following describes data based on evidence gathered by the senses and via systematic observations

answer

empirical

question

Which of the following best describes homeopathy

answer

its remedies have not been shown to have serious adverse effects

question

The purpose of bioelectromagnetic based therapies is to help patients

answer

manage pain

question

The CAM therapy that involves the use of highly diluted extracts is

answer

homeopathy

question

Marc has had a fever for two days. Which of the following is likely to be marcs best option for addressing this symptom

answer

treating the illness himself

question

If cara consults a physician based on her insurance plan she should contact

answer

the primary care physician assigned by her health maintenance organization

question

Which of the following is a sign that an online pharmacy may not be safe to purchase medication from

answer

it sells medications that have not been approved by the fda

question

Which of the following describes the state of health care in the united states

answer

as many as 50 million Americans to not have health insurance

question

Which of the following is listed first on an fda drug label

answer

active ingredients

question

The most common form of elder abuse is

answer

financial exploitation

question

Which of the following is a societal risk factor for interpersonal violence

answer

availability of firearms

question

Which of the following is a strategy for preventing fire injuries

answer

take short, shallow breaths, preferably through a wet cloth

question

Which of the following is a way to reduce the risk of motorcycle and motorized scooter injuries

answer

choose a helmet with a faceshield

question

Which of the following is not one of the four major classes of unintentional injuries

answer

private

question

The most common motivating bias in hate crimes is

answer

ethnicity

question

Which of the following is an effective way to avoid being stalked on the internet

answer

using a fake name in a chat room

question

Unintentional injuries are the leading cause of death of americans

answer

under age 45

question

Marias best friend was raped just hours ago. what advice should maria give her

answer

write down everything you remember and call the police

question

Which of the following statements best describes air bags

answer

They come standard on all new vehicles

question

What government entity deals with sexual harassment complaints

answer

equal employment opportunity commision

question

Which of the following is a safe cycling strategy

answer

using lights and reflectors, especially at night or in dark areas

question

Which of the following is not a recommendation for safe lifting

answer

bend at the waist

question

Which of the following is the best strategy for avoiding data range drugs

answer

getting a new drink after leaving the old one unattended

question

Firearms are used in ___ % of workplace homicides

answer

more than 80

question

The Heimlich maneuver helps to

answer

clear the airway

question

Women ages ___ have higher rates of nonfatal injuries than men in the same age range

answer

75-84

question

Which of the following is the only type of automobile crash in which front air bags provide substantial protection

answer

Head on collision

question

The use of electronic communications to repeatedly harass or threaten another person is known as

answer

cyberstalking

question

Salome thinks she is being sexually harassed at work. She should

answer

confront the harasser in person

question

Which of the following is not a factor that contributes to date rape

answer

androgynous view of sexually

question

Which of the following is the most likely explanation for the colleges low incidence of reported date rape

answer

most cases of date rape are not reported

question

Which of the following is a benefit of safety belt use

answer

prevention of being thrown from the car

question

Prevents who abuse their children tend to

answer

believe in physical forms of punishment

question

Which of the following is not a strategy for preventing motor vehicular injuries

answer

avoiding interstate highways

question

The recommended minimum age for front seat passengers in vehicles with air bags is

answer

13 years

question

What percentage of schools report no incidents of serious violence

answer

90%

question

Which of the following is the first step in providing emergency care

answer

Check to see if the situation is safe for you and the injured person

question

Which of the following workers is most likely to suffer a work related injury

answer

laborer

question

Which of the following substances has the least potential to impair driving

answer

vitamin supplements

STUDY

Central Nervous System Depressants Deep Breathing Exercises Mental Health Nurse Nursing Psychology Selective Serotonin Reuptake Inhibitors

PrepU Chapter 14, PrepU Chapter 14 combo – Flashcards 173 terms

August Dunbar

173 terms

Preview

PrepU Chapter 14, PrepU Chapter 14 combo – Flashcards

question

Increased blood pressure

answer

The nurse is assessing a client and finds two enlarged supraclavicular lymph nodes. The nurse asks the client how long these enlarged nodes have been there. The client states, "I can't remember. A long time I think. Do I have cancer?" The nurse is aware that that body responds to stress. Which is an immediate physiologic response to stress the nurse would expect to see in this client? Vasodilation of peripheral blood vessels Increased blood pressure Decrease in blood glucose levels Pupil constriction

question

Providing the client with a comforting touch

answer

A nursing instructor is describing the care of a client with acute anxiety to a class of nursing students. The instructor determines that more education is necessary when the students identify which intervention as appropriate? Providing the client with a comforting touch Providing the client with a safe, quiet, and private place Encouraging the client to verbalize feelings and concerns Approaching the client in a calm, confident manner

question

Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback

answer

A nurse is preparing a plan of care for a client with anxiety. Which would the nurse likely include? Select all that apply. Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback Using restraint when panic develops

question

assessing the client's ability to implement stress management techniques effectively

answer

Which nursing intervention is focused on the primary goal of anxiety management and treatment? assessing the client's ability to implement stress management techniques effectively helping the client identify ways to eliminate all sources of stress in his or her daily life educating the client concerning the use of medications to manage anxiety disorders assessing the client for possible symptoms of panic disorder

question

selective mutism is associated with social anxiety

answer

A school health nurse is meeting with the parents of a 6-year-old child who has been selectively mute. The nurse is offering the parents education regarding this problem. The nurse can tell the parents that what is true about selective mutism? selective mutism is associated with social anxiety parenting does not play a role in selective mutism selective mutism arises from child abuse children with selective mutism should be home-schooled.

question

Deep breathing

answer

A client comes in for a therapy session and begins to have a panic attack. The therapist asks the client to relax in the chair and then gently asks the client to imagine the client in a very safe and calm place. This technique, often useful in anxiety disorders, is called what? Cognitive therapy Deep breathing Desensitization Problem-solving

question

"What kind of relationship do you have with your parents?"

answer

The client reports that the client feels anxious when interacting socially with others and "never seems to know what to say." Which question indicates the nurse has a sound understanding of interpersonal theory as it relates to anxiety? "What kind of relationship do you have with your parents?" "Do other members of your family have similar problems?" "How long have you experienced these problems?" "What have you tried to help manage your feelings and discomfort?"

question

Compulsion

answer

A client spends hours stacking and unstacking towels. The client is repeatedly checking to make sure that the towels are in order of color. What term is used to identify this behavior? Compulsion Phobia Obsession Derealization

question

Client will adapt relaxation techniques to reduce stress.

answer

The nurse walks into the client's room and finds the client sobbing uncontrollably. When the nurse asks what the problem is, the client responds, "I am so scared. I have never known anyone who goes into a hospital and comes out alive." On this client's care plan the nurse notes a nursing diagnosis of ineffective coping related to stress. What is the best outcome to be expected for this client? Client will adapt relaxation techniques to reduce stress. Client will be stress free. Client will avoid stressful situations. Client will start antianxiety agent.

question

"The client taps her fingers very rapidly when she is feeling anxious."

answer

Which statement by the nurse demonstrates an understanding of the role automatisms have in a panic attack? "The client taps her fingers very rapidly when she is feeling anxious." "I discourage her finger tapping since it serves to increase her anxiety level." "She knows that if she taps her fingers she will be able to lessen her anxiety." "I can tell that the more she taps, the less anxiety she is actually feeling."

question

6 months

answer

Anxiety disorder is considered chronic and generalized when excessive anxiety and worry about two or more life circumstances exist for at least ... 6 months 2 months 12 months 4 months

question

Stay with the client, emphasizing that the client is safe and that the nurse will remain with the client.

answer

The nurse is caring for a client who is being treated in the emergency department for a panic attack. Which nursing intervention would be most appropriate? Demonstrate empathy for the client by trying to mimic the client's state of anxiety. Tell the client that the nurse must leave to go report the client's symptoms to the psychiatrist on duty. Tell the client this is an acute exacerbation with a positive prognosis and low morbidity. Stay with the client, emphasizing that the client is safe and that the nurse will remain with the client.

question

The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations

answer

The nurse at the student health center is seeing a group of nursing students who are interested in reducing their stress level. The nurse identifies guided imagery as an appropriate intervention. What does guided imagery involve? The use of progressive tensing and relaxing of muscles to release tension in each muscle group Using a positive self-image to increase and intensify physical workouts in the gym, which decreases stress The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations The use of music and humor to create a calm and relaxed demeanor, which allows escape from stressful situations

question

The client would have an enhanced sense of security.

answer

A nurse is caring for a client who has panic attack. The nurse takes the client in a small, isolated room. How would this intervention benefit the client? Choose the best answer. The client would return to rational thought. The client would have an enhanced sense of security. The client would be able to demonstrate relaxation techniques. The client would be able to understand what the nurse is saying.

question

Staying with the client and speaking in short sentences

answer

Which would be an appropriate intervention of a client experiencing a panic attack? Staying with the client and speaking in short sentences Turning on the lights and opening the windows so that the client does not feel crowded Leaving the client alone Turning on stereo music loudly

question

"Has something changed at work that is causing you to worry?"

answer

A client with generalized anxiety disorder states that the client is worried about the client's job. The client never feels like the client has control over the client's responsibilities, even though the client puts in extra hours. The client adds that the client is afraid the client will be fired. Which response by the nurse is most therapeutic? "It sounds to me like you're doing a good job." "Your worries are a feature of your anxiety disorder. Tell yourself that you have nothing to worry about." "Has something changed at work that is causing you to worry?" "Why do you think you'll be fired?"

question

Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first

answer

Which assessment question is most likely to allow the nurse to differentiate between anxiety disorder due to a general medical condition and psychological factors affecting a medical condition? Reviewing the client's previous medication administration record and the client's current list of medications Questioning the client about the clinician who first diagnosed the medical problem Asking the client to provide a detailed explanation of his or her medical problem to determine if the presentation is typical of the problem Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first

question

Assisting the client with deep-breathing exercises

answer

A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest? Leaving the client's door open so the client can see into the hallway Assisting the client with deep-breathing exercises Offering the client a cup of tea Encouraging the client to take prescribed sedatives daily

question

Adaptation

answer

What is the term for the change that takes place in response to a stressor? Rehabilitation Adaptation Positive movement Negative movement

question

Specific phobia

answer

Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger? Specific phobia Posttraumatic stress disorder Obsessive-compulsive disorder Generalized anxiety disorder

question

Concomitant use of alcohol

answer

Clients taking benzodiazepines need education about what? Avoiding cheeses and smoked meats Interactions with monoamine oxidase inhibitors (MAOIs) Avoiding spending too much time in the sun Concomitant use of alcohol

question

Stay with the client while remaining calm.

answer

A client who has been diagnosed with panic disorder visits the clinic and experiences a panic attack. The client tells the nurse, "I'm so nervous. My hands are shaking, and I'm sweating. I feel as if I'm having a stroke right now." What would be the priority intervention at this time? Stay with the client while remaining calm. Move the client to a safe environment. Tell the client that the attack will soon pass. Teach the client deep breathing techniques to calm the client.

question

The client is nervous and agitated.

answer

The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety? The client is focused in an activity. The client is nervous and agitated. The client has impaired cognitive skills. The client is unable to communicate verbally.

question

depersonalization.

answer

A nurse is seeing a client who is having severe to panic level anxiety after a physical assault months previously. The client tells the nurse, "When the panic starts I feel like I am watching myself through a window." The nurse can most accurately describe this experience as: depersonalization. derealization. decatastrophizing. demonstrating automatisms.

question

"Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life."

answer

The nurse is providing care for a psychiatric-mental health client who has a diagnosis of anxiety. Which statement by the nurse is likely the most therapeutic intervention? "Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life." "With the development of more life skills and a demonstration of continued success in life, your anxiety will shrink and eventually disappear." "Every time you feel anxious, try to focus on how much easier your life would be if you didn't experience anxiety so often." "If you address the causes of your anxiety head-on, you will find that you can recover from it without medications or therapy."

question

Panic disorder

answer

The nurse has read in a client's admission record that the client has been taking propranolol for psychiatric, rather than medical, reasons. The nurse should recognize that the client likely has a history of which mental health condition? Obsessive-compulsive disorder (OCD) Panic disorder Acute stress disorder Nightmares

question

"When I have a problem, I just deny it until it goes away."

answer

Which statement, made by a client diagnosed with an anxiety disorder, should trigger the nurse's concern about the client's understanding of the use of defense mechanisms? "I'm thankful that I have a way to manage my problems." "Defense mechanisms provide a sense of control over the uncontrollable." "I'm not sure when I'm actually using a defense mechanism." "When I have a problem, I just deny it until it goes away."

question

Pacing and repeatedly asking staff what time the "doctor will be here."

answer

The nurse can document correctly that a client diagnosed with an anxiety disorder is experiencing moderate anxiety when the nurse observes the client doing what? Pacing and repeatedly asking staff what time the "doctor will be here." Reporting, "I just can't relax; I've got things to do." Telling another client that "there is nothing they can do for me; I just know it's really bad." Demonstrating difficulty actually verbalizing anxious feelings

question

Tearfulness and sadness

answer

All except which are considered clinical symptoms of anxiety? Palpitations Extreme restlessness Motor excitement Tearfulness and sadness

question

Selective serotonin reuptake inhibitors (SSRIs)

answer

Which medication classification has been used to treat social phobia? Selective serotonin reuptake inhibitors (SSRIs) Monoamine oxidase inhibitors (MAOIs) Tricyclic antidepressants (TCAs) Nonbenzodiazepines

question

The nurse should speak in short and simple sentences.

answer

In speaking with a client with moderate anxiety, the client becomes tangential discussing unrelated topics. To help the client's attention from wandering, which is an effective intervention? The nurse should speak in short and simple sentences. The nurse should remain with the client until the anxiety is reduced. The nurse should speak in a soft and calm voice. The nurse should take the client to a nonstimulating environment.

question

Allow the client to pace

answer

A client is currently experiencing panic. Which acation would be most appropriate for the nurse to do? Allow the client to pace Ask the client repeated questions about feelings Employ the use of negative self-talk Urge the client to engage in vigorous exercise

question

Determine the client's risk for self-harm or harm to others

answer

When assessing an elderly client who has newly been diagnosed with an anxiety disorder, the mental health nurse's priority is to carry out which task? Determine the client's risk for self-harm or harm to others Obtain a thorough history, focusing on the client's physiologic functioning Assess for physical conditions that may affect anxiety Determine the effects that culture has had on the client's anxiety issues

question

Mild

answer

A client reports the client is beginning a new job and is feeling anxious about the client's performance. The nurse can explain which type of anxiety can actually improve functioning? Mild Moderate Severe All anxiety decreases functioning

question

Anticipatory anxiety

answer

A client has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the client's young children. The client admits that the client will not normally let the client's children leave the client's sight for fear that they will be abducted, abused, or injured. The client is unable to function at work as a result of this anxiety. The nurse would recognize that this client experiences which condition? Signal anxiety Fear Derealization Anticipatory anxiety

question

Mild

answer

During which type of anxiety does a person's perceptual field actually increase? Mild Moderate Severe Panic

question

Establishing daily routines of meals and sleeping

answer

Nursing interventions for physical stress related illness should include what? Assessing the need for increased dose of benzodiazepines Attending group therapy Establishing daily routines of meals and sleeping Fostering use of a social support system

question

40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months

answer

The nurse recognizes that who is the client most likely experiencing generalized anxiety disorder (GAD)? 40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months 22-year-old soldier who served in the Middle East who "cannot sleep" and is facing criminal charges for hurting someone in a barroom brawl 70-year-old whose spouse died 1 year ago who has "no desire to leave my house" and reports severe fatigue 30-year-old business executive who reports being anxious about attending the meetings and social events that are the executive's job responsibilities

question

Antidepressants

answer

Which medication classification has been found to be effective in reducing or eliminating panic attacks? Antidepressants Anticholinergics Antipsychotics Antimanics

question

The client is often late to school and makes poor grades in most of the client's subjects.

answer

Which factor has the least influence on achieving mental health for the client who has anxiety disorder? The client's mother also suffered from an anxiety disorder. The client was raised in a household with high stress and frequent geographic moves. The client's mother often related to the client in ways that reflected the mother's high level of anxiety. The client is often late to school and makes poor grades in most of the client's subjects.

question

Tearfulness

answer

A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what? Palpitations Extreme restlessness Motor excitement Tearfulness

question

Women experience anxiety disorders more often than do men.

answer

A group of students is reviewing information about anxiety disorders in preparation for a class examination. The students demonstrate understanding of the material when they state what? Anxiety disorders rank second to depression in psychiatric illnesses being treated. Women experience anxiety disorders more often than do men. Most anxiety disorders tend to be short term with individuals achieving full recovery. Anxiety disorders are more common among children than among adolescents.

question

Dry mouth Blurred vision Constipation

answer

A client diagnosed with anxiety disorder has been prescribed benzodiazepine drugs. The nurse is explaining the possible side effects of the medications. Which side effects of the drug explained by the nurse is correct? Select all that apply. Agitation Dry mouth Blurred vision Constipation Vomiting

question

Moderate

answer

The mental health nurse is gathering a health history on a new client. The client is constantly pacing the floor and is concerned only with stating that the client is about to die. The nurse would classify this level of anxiety as what? Moderate Euphoria Mild Severe

question

Coping mechanisms

answer

Humans are able to adapt to physiological and psychological threats. Which is key to a person's adaptation to these situations? Coping mechanisms Ability to ignore symptoms Previous experience Communication skills

question

Mild

answer

Which level of anxiety helps the client focus the client's attention to learn, problem solve, think, act, feel, and protect himself or herself? Mild Moderate Severe Panic

question

Intense worry and stress about work or simple family life

answer

A group of students is reviewing information about the etiology of generalized anxiety disorder (GAD). The students demonstrate understanding of this information when they identify which as representing the bases for this disorder? Inaccurate environmental danger assessment Exposure to multiple stressful life events Kindling caused by overstimulation Intense worry and stress about work or simple family life

question

The client is aware and alert

answer

A nurse assesses a client and determines that the client is experiencing mild anxiety based on what? The client is selectively inattentive The client is aware and alert The client has focused attention on a small area The client voices feelings of unreality

question

In GAD, the person usually does not experience eruptions of acute anxiety.

answer

Which is one characteristic that differentiates generalized anxiety disorder (GAD) and panic disorder? In panic disorder, the person suffers from a chronic state of elevated anxiety. Panic disorders are more easily treated than GAD. In GAD, the person usually does not experience eruptions of acute anxiety. GAD is characterized by occasional, unexpected panic attacks.

question

Is conducive to concentration and problem solving

answer

An adolescent client reveals that she is about to take a math test from her tutor. Nursing assessment reveals mild anxiety. The nurse explains that this level of anxiety does what? Will interfere with her cognitive abilities Is conducive to concentration and problem solving May be transferred to her tutor and result in test anxiety Is pathologic and warrants postponing the test

question

Going to a crowded, outdoor market independently

answer

A 21-year-old client has been recently diagnosed with agoraphobia. Which situation is most likely to cause the client anxiety? Having a blood sample drawn and experiencing mild pain Going to a crowded, outdoor market independently Having the client's work performance closely scrutinized by a supervisor Gaining 5 pounds and being unable to exercise vigorously

question

Based in genetics with clinical symptoms being a result of chromosomal influence

answer

A biologic theory explains anxiety disorders in which way? Based in genetics with clinical symptoms being a result of chromosomal influence Rooted in episodes of physical or psychological abuse that occurred at times of developmental growth Originated from disappointments resulting from an exaggerated sense of self-worth Caused by substance abuse, particularly narcotics, resulting in damage to the brain's receptors

question

Imipramine

answer

Which is considered a tricyclic antidepressant (TCA) used in the treatment of clients with panic disorder? Imipramine Fluoxetine Sertraline Lorazepam

question

Sympathetic nervous system

answer

When a parent observes the parent's young child heading toward a busy road the parent becomes stressed, feeling the parent's heart pounding, breathing heavily, and hands becoming wet with perspiration. Which physiological system is activated with the parent's "fight or flight" reaction to this danger? Parasympathetic nervous system Sympathetic nervous system Motherly response system Central nervous system

question

Headache

answer

The nurse is assessing a client with anxiety. What symptom indicates that the the client has adopted a maladaptive behavior in response to stress? Tachycardia Dyspnea Headache Pedal edema

question

Individuals may believe they are having a heart attack when a panic attack occurs.

answer

The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which would the nurse include when describing panic disorder? Individuals may believe they are having a heart attack when a panic attack occurs. People with panic attacks often have fewer attacks if they also have agoraphobia. Typically, individuals experience this disorder after the age of 30 years. Persons rarely have an underlying comorbid condition of depression.

question

The client states, "I understand what I need to do, and I'm ready to do it so I'm back to normal."

answer

The nurse can be confident that the admitted client diagnosed with an anxiety disorder will respond well to treatment when the client which of the following conditions are present? The client states, "I understand what I need to do, and I'm ready to do it so I'm back to normal." The client has a family that is truly willing and capable of supporting him during the treatment The client readily agrees to immediately notify the mental health care team if symptoms reoccur after discharge The client has a no history of other psychiatric disorders

question

an Asian American client

answer

Which client, presenting with a report of vague physical symptoms, should be assessed for possible anxiety by the nurse? a Native American client a African American client an Asian American client an Arab American client

question

25%

answer

Nearly what percentage of adults are affected by anxiety disorders? 10% 25% 40% 55%

question

Antidepressants

answer

Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what? Antidepressants Anticonvulsants Antipsychotics Central nervous system depressants

question

"Do you have any problems going out alone to public places?"

answer

The nurse is assessing a client who recently experienced the client's first panic attack while at the grocery store. To identify complications of the disorder, the nurse should ask: "Do you have any problems going out alone to public places?" "What do you think is the origin of the panic you felt?" "Can you describe how you felt physically during the attack?" "Are you concerned there will be more panic attacks?"

question

Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes Fear results in objective, physical responses caused by real danger Anxiety is likely to result from an attempt to overcome stress

answer

When explaining the difference between anxiety and fear, the mental health nurse shares what? Select all that apply. Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes Fear results in objective, physical responses caused by real danger Anxiety is likely to result from an attempt to overcome stress People who experience anxiety tend to use maladaptive coping mechanisms Obsessive-compulsive behavior is often the result of abandonment

question

Systematic desensitization

answer

A client who experiences panic anxiety around dogs is sitting in a room with a dog and the client's nurse therapist. The nurse therapist is using which behavioral intervention for this type of anxiety? Systematic desensitization Implosion therapy Relaxation exercise Biofeedback

question

Safety

answer

Which is the primary concern for a client with panic-level anxiety? Safety Emotional needs Physiologic needs Social support

question

Compulsion

answer

question

"Anxiety is a sense of psychological distress."

answer

A 25-year-old client tells the nurse that the client has been worried and tearful lately because of pressures at work. The client states, "My partner tells me that it's 'stress' and 'anxiety,' but doesn't everyone have that? What is anxiety anyway?" Which response would be most appropriate for the nurse to provide about the nature of anxiety? "Anxiety is an abnormal response to everyday stress." "Anxiety is a sense of psychological distress." "Anxiety is a physiologic response to stress." "Anxiety is a normal response to everyday stress."

question

Concomitant use of alcohol

answer

question

A systematic way to replace a panic response with a relaxation response

answer

What does desensitization refer to? A systematic way to replace a panic response with a relaxation response A cognitive technique for replacing a worry with a positive statement Exposing the client to an anxiety-producing stimulus for 1 to 2 hours (flooding) Teaching the client to ignore or become immune to anxiety-producing situations

question

Medications

answer

When assessing a client with anxiety, the nurse should recognize that anxiety may often be a result of what? Cognitive deficits Organic brain changes Medications Fluid and electrolyte imbalances

question

Inform the client that the assessment can be postponed if the client is finding it overwhelming.

answer

During the admission assessment of a 27-year-old client who has been diagnosed with an anxiety disorder, the nurse observes that the client is becoming increasingly restless and agitated. How should the nurse respond to this development? Inform the client that the assessment can be postponed if the client is finding it overwhelming. Increase the speed of the assessment in order to ensure that it is completed sooner and inform the client that the nurse is doing so. Provide education regarding the level of anxiety that the client may be experiencing. Explain to the client that the client's current feelings of anxiety have the potential to foster better coping skills in the future.

question

Adaptive coping strategies

answer

The most important factor in the person's stress response is what? Strength of the immune system Supportive friends Relaxation techniques Adaptive coping strategies

question

To focus attention to learn To feel and think To motivate to make a change To engage in goal-directed activity

answer

The nurse is teaching shoulder exercises to a client recovering from a mastectomy. The nurse might view the client's mild anxiety during the session positively, because mild anxiety helps what? Select all that apply. To focus attention to learn To feel and think To motivate to make a change To engage in goal-directed activity To calm restlessness

question

There is evidence of a substantial familial predisposition to panic disorder

answer

A nurse is talking with a client who has experienced panic attacks. The client asks the nurse, "What causes these attacks?" Which information would the nurse most likely integrate into the response about the etiology of panic disorders? There is evidence of a substantial familial predisposition to panic disorder Neurologic abnormalities are a rare occurrence with panic disorder The link between panic disorders and neurotransmitters is lacking There is a strong evidence supporting a psychodynamic influence

question

assess for depression

answer

Which nursing assessment is most appropriate for an older client presenting with reports of generalized anxiety? assess for depression assess for panic attacks assess for elder abuse assess for dementia

question

assessing the client's ability to implement stress management techniques effectively

answer

question

Talk to the client in a comforting manner. Take the client to a quiet space. Reassure the client of being safe.

answer

A nurse is seeing a client prior to discharge after being admitted to hospital for suicidal ideation. As the nurse begins the discharge process, the client closes the eyes and begins rapid, shallow breathing. The client also begins to shake and perspire profusely. Which actions should the nurse take? Select all that apply. Talk to the client in a comforting manner. Take the client to a quiet space. Reassure the client of being safe. Ask the client to spend some time alone. Assess the client for suicidal ideation.

question

Introduction of appropriate coping skills Identification of alternate treatment modalities Involving family and support persons when appropriate Providing feedback to support the client

answer

A nursing role in providing client education regarding panic disorder includes which of the following? (Select all that apply.) Introduction of appropriate coping skills Identification of alternate treatment modalities Involving family and support persons when appropriate Providing feedback to support the client Adjustment of treatment plan when indicated

question

Excessive worry or anxiety lasting more than 6 months

answer

Generalized anxiety disorder (GAD) is characterized by what criteria? Excessive worry or anxiety lasting more than 6 months Flashbacks and feelings of unreality Fear of going outdoors Behavioral changes in response to panic attacks

question

The client has no adaptive coping mechanisms.

answer

A client reports the client has been experiencing increased stress at work. The client has been managing the stress by drinking 2-3 glasses of wine per evening. Despite the nurse recommending that drinking alcohol is not an effective way to manage the stress, the client reports it is unlikely that the client will be able to stop. Which statement explains why this will be difficult for the client? The client is probably physically dependent on alcohol. Drinking alcohol is more socially acceptable than taking medications. The client has no adaptive coping mechanisms. A few glasses of wine each night is not necessarily a problem.

question

Benzodiazepines

answer

Which medication classifications used in the treatment of panic disorder can cause physical dependence? Benzodiazepines Selective serotonin reuptake inhibitors (SSRIs) Tricyclic antidepressants (TCAs) Serotonin-norepinephrine reuptake inhibitors (SNRIs)

question

The client has heightened awareness.

answer

The nurse understands that a certain level of anxiety is required in a client for effective learning. Which anxiety-related symptom indicates the client may be able to learn effectively? The client is trembling. The client is speaking in a high-pitch voice. The client has heightened awareness. The client has increased muscle tension.

question

Resistance

answer

A client experiencing stress has tachycardia and tachypnea. On the basis of the physiological model of the general adaptation syndrome, in which stage is this client? Stress Alarm reaction Resistance Exhaustion

question

Touching the client in an attempt to comfort the client

answer

After teaching a group of mental health nursing students about the care of a client experiencing a panic attack, the instructor determines that additional education is required when the students identify which as an appropriate intervention? Touching the client in an attempt to comfort the client Providing the client with a safe, quiet, and private place Encouraging the client to verbalize feelings and concerns Approaching the client in a calm, confident manner

question

Social anxiety disorder

answer

A 30-year-old client who has been unemployed secondary to the client's anxiety disorder states that the client would like to have a job where the client is alone and no one needs to evaluate the client's work. The nurse interprets these comments as an indicator of what? Social anxiety disorder Agoraphobia Obsessive-compulsive disorder Panic disorder

question

Heart racing Hypertension

answer

A nurse is assessing a client with anxiety. Which signs and symptoms would the nurse attribute to sympathetic nervous stimulation? Select all that apply. Pressure to urinate Fainting Heart racing Hypertension Bradycardia

question

Administer the prescribed PRN anxiolytic medication.

answer

A client approaches the nurse on an inpatient psychiatric hospital unit crying, trembling, and feeling nauseous. The client states, "I've tried everything, I still feel so anxious." Which action by the nurse would be most appropriate? Direct the client to continue deep breathing. Take the client on a walk around the unit. Take the client to the dayroom as a distraction. Administer the prescribed PRN anxiolytic medication.

question

flooding

answer

A client with a specific phobia of spiders is seeing a therapist for the first session of treatment. The therapist hands the client a clear container with a large house spider inside. This activity is repeated continuously until the client's fear subsides. Which strategy is being used to treat the client's specific phobia? systematic desensitization flooding decatastrophizing assertiveness training

question

Staying with the client and speaking in short sentences

answer

Which would be an appropriate intervention for a client experiencing an anxiety attack? Staying with the client and speaking in short sentences Turning on the lights and opening the windows so that the client does not feel crowded Leaving the client alone Turning on stereo music

question

Touching the client in an attempt to comfort the client

answer

Which would not be an initial intervention for the client with acute anxiety? Touching the client in an attempt to comfort the client Use of open-ended communication techniques Encouraging the client to verbalize feelings and concerns Maintaining a nonstimulating environment

question

Phobic disorders

answer

Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger? Phobic disorders Posttraumatic stress disorder Obsessive-compulsive disorder Stress disorders

question

Coping mechanism

answer

A young parent tells the nurse, "I can't stop smoking. That is what I do to make myself feel better." What is the term used to describe this behavior? Defense mechanism Coping mechanism Caregiver burden Crisis

question

interpersonal

answer

A nurse is seeing a client who is experiencing symptoms of moderate anxiety. She tells the nurse she and her parents disagree over her sexual orientation. Which theory would best explain the course of the client's anxiety? interpersonal behavioral neurochemical genetic

question

Heart attack

answer

While conducting a class on anxiety and stress reduction, a nurse describes the symptoms of anxiety (including panic), informing the class that the physical symptoms of a panic attack can mimic what? Stroke Gastrointestinal flu Heart attack Appendicitis

question

Move the client to a quiet environment.

answer

When a client is experiencing panic, which is the priority intervention? Give the client medication immediately. Move the client to a quiet environment. Offer the client therapy to calm down. Physically restrain the client.

question

The client can sustain attention on a particular focus. The client verbally states, "For some reason, I am feeling anxious now."

answer

A client is experiencing moderate anxiety. Which manifestation would the nurse most likely observe? Select all that apply. The client can sustain attention on a particular focus. The client verbally states, "For some reason, I am feeling anxious now." The client has flights of ideas and confusion. The client makes distorted inferences because of inadequacy of observed data. The client may pace, run, or fight violently if asked to perform a task the client does not want to perform.

question

mild

answer

An adolescent who is seeing the school health nurse states, "I won't be able to hang out with my friends on Friday night because I have two essays due Monday." What level of anxiety is the adolescent experiencing? mild moderate severe panic

question

Severe

answer

A nurse determines that a client who is experiencing anxiety is using relief or primitive survival behaviors. The nurse determines that the client is experiencing which degree of anxiety? Mild Moderate Severe Panic

question

somatic symptoms.

answer

A nurse is seeing a client in the emergency department who repeatedly presents with gastrointestinal discomfort. Despite exhaustive medical investigations, there are no significant medical findings to explain the discomfort. The nurse should suspect: endocrine dysfunction. chronic obstructive pulmonary disease. heart disease. somatic symptoms.

question

"People with anxiety disorders generally find that the anxiety interferes with daily activities."

answer

A nurse is giving a presentation on mental health promotion to college students. One student asks the nurse to explain the difference between normal anxiety and an anxiety disorder. Which response is best? "People with anxiety disorders experience a fight-or-flight response when threatened." "People with anxiety disorders generally find that the anxiety interferes with daily activities." "Normal anxiety does not result in feelings of dread or restlessness." "Normal anxiety occurs in response to everyday stressors."

question

gastrointestinal upset.

answer

The nurse is assessing a client suffering from stress and anxiety. The most common physiologic response to stress and anxiety is: gastrointestinal upset. sedation. vertigo. skin rash.

question

Selective serotonin reuptake inhibitor (SSRI)

answer

A nurse is developing a plan of care for a client with panic disorder that will include pharmacologic therapy. Which would the nurse most likely expect to administer? Benzodiazepine Selective serotonin reuptake inhibitor (SSRI) Monoamine oxidase inhibitor (MAOI) Tricyclic antidepressant (TCA)

question

Tachycardia

answer

Which is a cardiovascular response of the sympathetic nervous system? Tachycardia Bradypnea Hypotension Bradycardia

question

Epinephrine

answer

A client states that the client has just had an argument with the client's spouse over the phone. What can the nurse expect that the client's sympathetic nervous system has stimulated the client's adrenal gland to release? Endorphins Dopamine Epinephrine Testosterone

question

Lorazepam

answer

A client diagnosed with panic disorder has been receiving medication therapy, which is being discontinued. A nurse would be alert for possible withdrawal symptoms if the client was receiving what? Lorazepam Duloxetine Escitalopram Fluvoxamine

question

"How do you feel about everything that is happening in your life right now?"

answer

Which question in the assessment of a client with anxiety is most clinically appropriate? "What can I give you to make you feel less anxious right now?" "Does your anxiety make you feel less valuable and competent as a person?" "Do you think that you're justified in feeling anxious right now?" "How do you feel about everything that is happening in your life right now?"

question

Coping mechanism

answer

A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor? Adaptation Homeostasis Coping mechanism Defense mechanism

question

Deep breathing

answer

question

Touching the client in an attempt to comfort the client

answer

Which would not be an initial intervention for the client with acute anxiety?

question

Social phobia

answer

A 30-year-old client who has been unemployed secondary to anxiety disorder states that the client would like to have a job where the client is alone and no one needs to evaluate the client's work. The nurse interprets these comments as an indicator of what?

question

"Has something changed at work that is causing you to worry?"

answer

question

Reduction of autonomic arousal

answer

Relaxation techniques help clients with anxiety disorders because they can promote what?

question

Is conducive to concentration and problem solving

answer

An adolescent client reveals that she is about to take a math test from her tutor. Nursing assessment reveals mild anxiety. The nurse explains that this level of anxiety does what?

question

Educate the client that this medication has a high risk for withdrawal symptoms, and the client should not discontinue without a doctor's supervision.

answer

In teaching a client who has been prescribed a benzodiazepine for panic disorder, the nurse must be certain to do what?

question

"How do you feel about everything that is happening in your life right now?"

answer

Which question in the assessment of a client with anxiety is most clinically appropriate?

question

Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first

answer

Which assessment question is most likely to allow the nurse to differentiate between anxiety disorder due to a general medical condition and psychological factors affecting a medical condition?

question

Benzodiazepines

answer

Which medication classifications used in the treatment of panic disorder can cause physical dependence?

question

The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations

answer

question

Coping mechanism

answer

A young parent tells the nurse, "I can't stop smoking. That is what I do to make myself feel better." What is the term used to describe this behavior?

question

The nurse should speak in short and simple sentences.

answer

In speaking with a client with moderate anxiety, the client becomes tangential discussing unrelated topics. To help the client's attention from wandering, which is an effective intervention?

question

Staying with the client and speaking in short sentences

answer

Which would be an appropriate intervention of a client experiencing a panic attack?

question

Touching the client in an attempt to comfort the client

answer

question

Social anxiety disorder

answer

question

Providing the client with a comforting touch

answer

question

Specific phobia

answer

Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger?

question

mild

answer

question

flooding

answer

question

Compulsion

answer

A client spends hours stacking and unstacking towels. The client is repeatedly checking to make sure that the towels are in order of color. What term is used to identify this behavior?

question

"People with anxiety disorders generally find that the anxiety interferes with daily activities."

answer

question

The client has no adaptive coping mechanisms.

answer

question

A woman who has been taking lorazepam for several months after witnessing a traumatic motor vehicle accident

answer

Which client is most likely to be at risk for drug dependence and difficulties with withdrawal?

question

"What did you experience just before and during the attack?"

answer

A client comes to the emergency department because the client thinks the client is having a heart attack. Further assessment determines that the client is not having a heart attack but is having a panic attack. When beginning to interview the client, which question would be most appropriate for the nurse to use?

question

Selective serotonin reuptake inhibitor (SSRI)

answer

A nurse is developing a plan of care for a client with panic disorder that will include pharmacologic therapy. Which would the nurse most likely expect to administer?

question

Increased blood pressure

answer

question

Epinephrine

answer

question

Client will adapt relaxation techniques to reduce stress.

answer

question

Assisting the client with deep-breathing exercises

answer

A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest?

question

Sympathetic nervous system

answer

question

Coping mechanism

answer

A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor?

question

Adaptive coping strategies

answer

The most important factor in the person's stress response is what?

question

Lorazepam

answer

A client diagnosed with panic disorder has been receiving medication therapy, which is being discontinued. A nurse would be alert for possible withdrawal symptoms if the client was receiving what?

question

Move the client to a quiet environment.

answer

When a client is experiencing panic, which is the priority intervention?

question

Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback

answer

A nurse is preparing a plan of care for a client with anxiety. Which would the nurse likely include? Select all that apply.

question

Antidepressants

answer

Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what?

question

"When I have a problem, I just deny it until it goes away."

answer

Which statement, made by a client diagnosed with an anxiety disorder, should trigger the nurse's concern about the client's understanding of the use of defense mechanisms?

question

interpersonal

answer

question

depersonalization.

answer

question

In GAD, the person usually does not experience eruptions of acute anxiety.

answer

Which is one characteristic that differentiates generalized anxiety disorder (GAD) and panic disorder?

question

Based in genetics with clinical symptoms being a result of chromosomal influence

answer

A biologic theory explains anxiety disorders in which way?

question

Mild

answer

Which level of anxiety helps the client focus the client's attention to learn, problem solve, think, act, feel, and protect himself or herself?

question

Antidepressants

answer

Which medication classification has been found to be effective in reducing or eliminating panic attacks?

question

Tachycardia

answer

Which is a cardiovascular response of the sympathetic nervous system?

question

"Anxiety is a sense of psychological distress."

answer

question

Concomitant use of alcohol

answer

Clients taking benzodiazepines need education about what?

question

The client is often late to school and makes poor grades in most of the client's subjects.

answer

Which factor has the least influence on achieving mental health for the client who has anxiety disorder?

question

Buspirone

answer

When discussing various types of anxiolytic medications with a client, the nurse recognizes that which medication has the lowest potential for abuse?

question

Individuals may believe they are having a heart attack when a panic attack occurs.

answer

The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which would the nurse include when describing panic disorder?

question

Coping mechanisms

answer

Humans are able to adapt to physiological and psychological threats. Which is key to a person's adaptation to these situations?

question

positive coping skills.

answer

The overall goals of care for individuals experiencing a stress response are to focus on interventions to develop ...

question

The client is nervous and agitated.

answer

The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety?

question

The client would have an enhanced sense of security.

answer

A nurse is caring for a client who has panic attack. The nurse takes the client in a small, isolated room. How would this intervention benefit the client? Choose the best answer.

question

To focus attention to learn To feel and think To motivate to make a change To engage in goal-directed activity

answer

question

Tearfulness

answer

A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what?

question

assessing the client's ability to implement stress management techniques effectively

answer

Which nursing intervention is focused on the primary goal of anxiety management and treatment?

question

"The client taps her fingers very rapidly when she is feeling anxious."

answer

Which statement by the nurse demonstrates an understanding of the role automatisms have in a panic attack?

question

Self-preservation

answer

A nurse is assessing the vital signs of a client in the cardiac clinic. The nurse observes the client's blood pressure and heart rate are higher than what is normally expected for this client. The client tells the nurse, "It makes me nervous to come into the clinic." What is the most likely explanation for the unexpected change in the client's vital signs.

question

separation anxiety disorder.

answer

A school health nurse is seeing a 7-year-old child. The mother of the child describes the child holding on to her leg and crying loudly when she attempts to leave the child at school each morning. The nurse should explain that the child is experiencing:

question

A systematic way to replace a panic response with a relaxation response

answer

What does desensitization refer to?

question

Tearfulness and sadness

answer

All except which are considered clinical symptoms of anxiety?

question

"Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life."

answer

The nurse is providing care for a psychiatric-mental health client who has a diagnosis of anxiety. Which statement by the nurse is likely the most therapeutic intervention?

question

Neurobiologic vulnerabilities and perception of psychosocial stress

answer

The causes of anxiety disorders can be best explained by what?

question

Dry mouth Blurred vision Constipation

answer

question

The client is aware and alert

answer

A nurse assesses a client and determines that the client is experiencing mild anxiety based on what?

question

25%

answer

Nearly what percentage of adults are affected by anxiety disorders?

STUDY

Abnormal Psychology Areas Of The Brain Central Nervous System Depressants Substance Use Disorders

Quiz 6 (Ch. 11-12) – Flashcards 10 terms

Stephen Sanchez

10 terms

Preview

Quiz 6 (Ch. 11-12) – Flashcards

question

Metabolic tolerance involves changes in _____________ while pharmacodynamic tolerance involves changes in _____________.

answer

enzymes / neurons

question

In recent years, the term addiction is being used to describe other kinds of impulsive behavior problems, including

answer

pathological gambling.

question

Tolerance and withdrawal are considered the __________ criteria included in the definition of alcohol use disorder.

answer

pharmacological

question

People suffering from gender dysphoria are likely to dress up in the clothing of the opposite sex because

answer

it helps them to adopt the role of the gender with which they identify.

question

One approach to the treatment of paraphilias involves drugs that

answer

reduce the levels of testosterone.

question

What point concerning sexual problems was highlighted by the case of Bill and Margaret described in your textbook?

answer

The thoughts people have about the meaning of sexual behavior are extremely important.

question

What is the rationale for sensate focus in sex therapy?

answer

Couples need to focus on erotic sensations rather than performance demands.

question

Why do psychologists consider sexual arousal to be a hypothetical construct?

answer

It cannot be measured directly.

question

What are the phases of the human sexual response cycle described by Masters and Johnson? Sexual sadism involves sexual arousal associated with

answer

excitement phase, orgasmic phase, resolution phase

question

Sexual sadism involves sexual arousal associated with

answer

being humiliated and feeling pain

STUDY

Advanced Pathophysiology Alcohol Withdrawal Symptoms Central Nervous System Depressants Pharmacology

Elsevier 321 Pharm Unit 2 – Flashcards 133 terms

Patricia Harrah

133 terms

Preview

Elsevier 321 Pharm Unit 2 – Flashcards

question

Which condition contraindicates barbiturates? 1 Drug allergy 2 Cardiac disease 3 Epileptic disease 4 Narrow-angle glaucoma

answer

Drug allergy

question

The nurse notes that a patient has taken an excessive dose of baclofen. Which action does the nurse implement immediately? 1 Comfort measures 2 Seizure precautions 3 Airway maintenance 4 Antidote preparation

answer

Airway maintenance

question

A patient is admitted to the emergency department after taking an overdose of a barbiturate 15 minutes before arrival. The nurse can anticipate that which drug will be prescribed? 1 Naloxone 2 Flumazenil 3 Ipecac syrup 4 Activated charcoal

answer

Activated charcoal

question

Which medication is beneficial for reducing presurgery anxiety and decreasing the patient's ability to remember an uncomfortable medical procedure? 1 Ramelteon 2 Midazolam 3 Alprazolam 4 Eszopiclone

answer

Midazolam

question

The nurse is teaching a group of nursing students about the stages of non-rapid eye movement (non-REM) sleep. Which is the third stage of sleep? 1 Dozing 2 Relaxation 3 Deep sleep 4 Sleepwalking

answer

Deep sleep

question

A patient is scheduled for a brief surgical procedure. Which drug does the nurse expect to be used during surgery? 1 Thiopental 2 Butabarbital 3 Pentobarbital 4 Phenobarbital

answer

Thiopental

question

Which drug is used as an antidote for overdose of oral benzodiazepine or excessive intravenous sedation? 1 Flumazenil 2 Olanzapine 3 Furosemide 4 Activated charcoal

answer

Flumazenil

question

While assessing a patient, the nurse finds that the patient is allergic to aspirin. Which medication in the prescription does the nurse question? 1 Baclofen 2 Zaleplon 3 Diazepam 4 Pentobarbital

answer

Zaleplon - If a patient is allergic to aspirin, there is a possibility that the patient is allergic to nonbenzodiazepines such as zaleplon, too.

question

A patient with epilepsy is prescribed barbiturates. On further assessment, the nurse finds that the patient has depression. What classes of antidepressants does the nurse expect the primary health care provider to avoid when prescribing to this patient? Select all that apply. 1 Tricyclic antidepressant 2 Monoamine oxidase inhibitor (MAOI) 3 Selective serotonin reuptake inhibitor (SSRI) 4 Reversible monoamine oxidase inhibitor (RMAOI) 5 Serotonin and noradrenaline reuptake inhibitor (SNRI)

answer

Tricyclic antidepressant Monoamine oxidase inhibitor (MAOI) Reversible monoamine oxidase inhibitor (RMAOI) - Tricyclic antidepressants, MAOIs, and RMAOIs interact with barbiturates. These drugs increase the activity of barbiturates and may lead to severe central nervous system depression.

question

A patient is brought to the trauma care unit for administration of activated charcoal via a nasogastric tube every 4 hours. What may be the reason for this? 1 The patient is experiencing a barbiturate overdose. 2 The patient is experiencing benzodiazepine toxicity. 3 The patient is experiencing a muscle relaxant overdose. 4 The patient was administered azole along with benzodiazepine.

answer

question

While teaching about a medication regimen, the nurse advises the patient to take the medication no later than midnight and at least 4 hours before the patient usually awakens. Which drug has been prescribed to the patient? 1 Zaleplon 2 Zolpidem 3 Diazepam 4 Midazolam

answer

Zaleplon

question

The nurse is assessing a child with attention deficit hyperactivity disorder (ADHD) who is prescribed amphetamine aspartate. The nurse instructs the parent to give medications 5 to 6 hours before bed. Why did the nurse give this instruction? 1 To prevent insomnia 2 To prevent gastric ulcer 3 To prevent hyperglycemia 4 To prevent nutrition deficiency

answer

To prevent insomnia

question

Which adverse effect does the nurse anticipate in a patient who uses analeptics at high doses? 1 Diarrhea 2 Reflex bradycardia 3 Decreased respiratory rate 4 Increased deep tendon reflexes

answer

Diarrhea

question

A patient is diagnosed with attention deficit hyperactivity disorder (ADHD). Which drug is suitable for treatment of this disorder? 1 Orlistat 2 Doxapram 3 Sumatriptan 4 Atomoxetine

answer

Atomoxetine

question

A 7-year-old child is highly impulsive and has not been attentive in school for the last 2 months. The child's parents are worried about the child's behavior. What will the nurse inform the child's parents? 1 "This is the normal behavior of a 7-year-old child." 2 "You should consult a child psychiatrist immediately." 3 "Your child has attention deficit hyperactivity disorder (ADHD)." 4 "You should continue to observe the child's behavior for 4 months."

answer

"You should continue to observe the child's behavior for 4 months."

question

The nurse prepares to collect the health history of a patient with narcolepsy. Which strategy should be used to complete this assessment? 1 Provide a structured form for the patient to complete in writing. 2 Seek information from significant others rather than the patient. 3 Use the patient's past medical records to locate important information. 4 Use short, focused interview sessions with active participation by the patient.

answer

Use short, focused interview sessions with active participation by the patient.

question

Which drug is used to treat attention deficit hyperactivity disorder (ADHD)? 1 Orlistat 2 Modafinil 3 Sumatriptan 4 Dextroamphetamine

answer

Dextroamphetamine

question

While caring for a patient, the nurse learns that the patient has dysfunctional rapid eye movement (REM) sleep. This finding is a symptom of which condition? 1 Diplopia 2 Glaucoma 3 Narcolepsy 4 Migraine headache

answer

Narcolepsy

question

A patient is diagnosed with narcolepsy. Which symptom does the nurse expect to find in the patient? 1 Hyperactivity 2 Pulsating headache 3 Skeletal muscle weakness 4 High body mass index (BMI)

answer

Skeletal muscle weakness

question

Which is an adverse effect of orlistat therapy? 1 Mania 2 Diarrhea 3 Fecal incontinence 4 Foul taste in the mouth

answer

Fecal incontinence - Orlistat is a drug used in the treatment of obesity. A common adverse effect of orlistat is gastrointestinal distress, which causes fecal incontinence and oily stools.

question

Which characteristic of amphetamines is the most likely reason that these drugs are abused? 1 They induce euphoria. 2 They increase energy. 3 They induce wakefulness. 4 They promote industriousness.

answer

They induce euphoria.

question

Which drug is most commonly used for the treatment of a spinal headache? 1 Caffeine 2 Modafinil 3 Sumatriptan 4 Atomoxetine

answer

Caffeine - Caffeine is a xanthine cerebral stimulant used to treat spinal headache. It acts by antagonizing the purine receptors.

question

The nurse is teaching a new nurse about medication administration for patients with attention deficit hyperactivity disorder (ADHD). Which statement by the new nurse indicates understanding of the teaching? 1 "I may dispense these medications to nursing staff if needed." 2 "I will give these drugs 30 to 45 minutes before meals to improve absorption." 3 "It is permissible to crush extended-release medications for patients who have difficulty swallowing pills." 4 "If I notice side effects of these medications, I should stop giving the drug immediately and notify the provider."

answer

"I will give these drugs 30 to 45 minutes before meals to improve absorption."

question

The nurse is assessing a patient who is obese. After reviewing the prescription the nurse instructs the patient to take the medication in the morning and avoid taking the medication before going to bed. Which drug is this patient taking? 1 Morphine 2 Diazepam 3 Phentermine 4 Phenobarbitone

answer

Phentermine

question

Which patients who have which conditions are contraindicated for anorexiant therapy? Select all that apply. 1 Patients who have glaucoma 2 Patients who have hypotension 3 Patients who have drug allergies 4 Patients who have hypothyroidism 5 Patients who have bulimia nervosa

answer

Patients who have glaucoma Patients who have drug allergies Patients who have bulimia nervosa

question

What is the dose regimen of methylphenidate (Ritalin) for a 6-year-old child with attention deficit hyperactivity disorder (ADHD)? 1 20 mg after lunch 2 120 mg at each meal 3 50 mg as a single dose 4 5 mg before breakfast and lunch

answer

5 mg before breakfast and lunch

question

Which is the primary action site for serotonin agonists? 1 Cerebral cortex 2 Medulla and brainstem 3 Cerebrovascular system 4 Hypothalamic and limbic regions

answer

Cerebrovascular system

question

The nurse explains to a patient using caffeine that which disease process/condition may be exacerbated by this drug? 1 Heart block 2 Constipation 3 Myelin degeneration 4 Cardiac dysrhythmias

answer

Cardiac dysrhythmias

question

Which drug should be used with caution with the herbal drug ginseng to prevent possible drug interactions? 1 Aspirin 2 Warfarin 3 Metformin 4 Disulfiram

answer

Metformin

question

Which class of drugs is prescribed for a patient who is obese to promote weight reduction? 1 Ergot alkaloids 2 Lipase inhibitors 3 Serotonin receptor agonists 4 Phosphodiesterase inhibitors

answer

Lipase inhibitors

question

The patient's serum phenytoin level is 31 mcg/mL. What is the appropriate nursing action? 1 Hold the medication. 2 Increase the medication dose. 3 Administer the medication intravenously. 4 Have the patient continue the current regimen.

answer

Hold the medication. - A therapeutic drug level for phenytoin is 10 to 20 mcg/mL. The nurse should hold the medication and then call the health care provider.

question

A patient receiving lamotrigine therapy has started using oral contraceptives. What is essential for the nurse to teach the patient? 1 "This combination may cause liver toxicity." 2 "With oral contraceptive use, you may need more lamotrigine." 3 "This medication may stop your oral contraceptive from working." 4 "This medication, together with oral contraceptives, may cause toxicity."

answer

"With oral contraceptive use, you may need more lamotrigine." - When given with oral contraceptives, lamotrigine [1] [2] may need an increased dose to be effective because the oral contraceptives also compete for the CYP450 enzyme pathway.

question

What is appropriate information for the nurse to give the patient who is taking an antiepileptic drug with a narrow therapeutic index? 1 Take the medication every other day. 2 Keep the medication with you at all times. 3 Make certain the drug is taken at the same time daily. 4 Crush the drug and put it in applesauce for better absorption.

answer

Make certain the drug is taken at the same time daily.

question

What is the appropriate way for the nurse to prepare a dosage of a suspension medication for a pediatric patient? 1 Pour it into a teaspoon 2 Draw it up in an oral syringe 3 Pour it into a medication cup 4 Pour the suspension without shaking

answer

Draw it up in an oral syringe

question

A patient is receiving carbamazepine to treat trigeminal neuralgia. What assessment indicates a therapeutic response to the medication? 1 The patient states no facial pain. 2 The patient states she is able to walk. 3 The patient has a reduction in foot pain. 4 The patient states they have no dizziness.

answer

The patient states no facial pain.

question

A nurse is caring for a patient who has been started on antiepileptic drug therapy for seizures. What information should be included in the teaching plan for the patient? 1 Alter drug therapy based on normal meal times. 2 If there are side effects of therapy, stop the drug. 3 Take the medication at the same time each day. 4 If this medication is not effective, another drug will be added.

answer

Take the medication at the same time each day.

question

Which intervention will best maintain therapeutic levels of an antiepileptic drug? 1 Give the medication every 8 hours. 2 Administer the medication intravenously. 3 Administer the medication only during the day. 4 Establish a drug regimen based on the half-life of the medication.

answer

Establish a drug regimen based on the half-life of the medication.

question

Which patient should the nurse assess first? 1 The patient taking valproic acid with an increased appetite. 2 The patient taking carbamazepine who has bruises on his arms. 3 The patient taking carbamazepine who is not oriented to place or time. 4 The patient taking valproic acid who has lost 2 pounds since starting therapy.

answer

The patient taking carbamazepine who is not oriented to place or time. - Any patient who is not oriented has a potential risk to his safety. The patient who is not oriented and taking carbamazepine could be experiencing adverse effects of therapy. This is the patient the nurse should assess first.

question

Which patient is most likely to have toxic effects of antiepileptic therapy? 1 The patient with a primidone level of 10 mcg/mL 2 The patient with a phenobarbital level of 8 mcg/mL 3 The patient with a valproic acid level of 50 mcg/mL 4 The patient with a carbamazepine level of 15 mcg/mL

answer

The patient with a carbamazepine level of 15 mcg/mL - The only value listed that is above therapeutic plasma levels is the carbamazepine, which has a therapeutic range of 4 to 12 mcg/mL; this patient is most likely to have toxic effects of therapy.

question

A patient is receiving phenobarbital. What information is essential to include in the discharge teaching plan? Select all that apply. 1 "This medication may cause confusion." 2 "Checkups with a cardiologist are essential." 3 "Respiratory assessments should be performed daily." 4 "Good dental care is essential while on this medication." 5 "Don't drive until you determine how the medication affects you."

answer

"This medication may cause confusion." "Good dental care is essential while on this medication." "Don't drive until you determine how the medication affects you." - The most common adverse effects are lethargy and cognitive changes as well as gingival hyperplasia. Confusion can be a result of this therapy. Good dental care is essential because the medication can cause gingival hyperplasia. The patient should evaluate how the drug affects him before driving.

question

The nurse is caring for a patient with a phenytoin level of 12 mcg/mL. What is the nurse's best action? 1 Continue to monitor the patient on this medication. 2 Assess liver function tests for clearance of the drug. 3 Call the health care provider for a decrease in the daily dose. 4 Call the health care provider for an increase in the daily dose.

answer

Continue to monitor the patient on this medication.

question

The nurse instructs a patient receiving phenytoin to visit the dentist regularly and perform frequent oral hygiene. What side effect will these interventions assist in preventing? 1 Oral candidiasis 2 Gingival hyperplasia 3 Increased risk of dental abscesses 4 Increased incidence of dental caries

answer

Gingival hyperplasia

question

What is the goal of antiepileptic therapy? 1 Reducing seizure occurrence to one per week. 2 Maximizing drug dosages to control seizure activity. 3 Maximally reducing seizure activity while minimizing side effects of medication therapy. 4 Eradicating all seizure activity and then weaning off medication once the patient is seizure-free for 3 months.

answer

Maximally reducing seizure activity while minimizing side effects of medication therapy.

question

The patient was started on an antiepileptic medication 6 weeks ago. The nurse notes that the patient's blood level of the medication is very low after 6 weeks of therapy. How will the nurse interpret this result? 1 The patient has received a toxic amount of the drug. 2 The patient should be placed on a different medication. 3 The patient may not be taking the medication as ordered. 4 The patient is experiencing an allergic reaction to the drug.

answer

The patient may not be taking the medication as ordered.

question

The nurse is teaching a patient about therapy for a newly diagnosed seizure disorder. What statement should the nurse include? 1 "You will only need to be on therapy for a few months." 2 "Your medication is chosen based on your type of seizure." 3 "You will be started on several drugs to control your seizures." 4 "Medication therapy is not essential to treat seizure disorders."

answer

"Your medication is chosen based on your type of seizure."

question

What is the reason for many potential drug interactions with antiepileptic drug therapy? 1 Altered urinary output 2 Altered electrolyte balances 3 Altered CYP450 enzyme metabolism 4 Alterations in blood urea nitrogen (BUN) and creatinine levels

answer

Altered CYP450 enzyme metabolism

question

What is important to teach the patient taking valproic acid for seizure management? 1 Do not take the medication with meals. 2 Take the medication every other day only. 3 Take the medication an hour before or after other medications. 4 Do not take the medication with milk or carbonated beverages.

answer

Do not take the medication with milk or carbonated beverages. - Oral forms of valproic acid are not to be given with milk, because this may cause the drug to dissolve early and irritate the mucosa. Carbonated beverages must also be avoided during the time of drug administration.

question

The health care provider has ordered once-daily phenytoin for an 8-year-old child who has a seizure disorder. The parents state the child cannot swallow pills. What intervention would the nurse recommend to the health care provider? 1 Suggest another medication be prescribed. 2 Suggest the phenytoin be administered intramuscularly. 3 Ask for a suspension form of the medication to be prescribed. 4 Ask for an intravenous form of the medication to be prescribed

answer

Ask for a suspension form of the medication to be prescribed.

question

The nurse is administering intravenous diazepam. When will the nurse expect the onset of action to occur? 1 Immediately 2 Within 1 hour 3 Within 5 minutes 4 Within 15 minutes

answer

Immediately

question

What intervention is appropriate to include in discharge teaching for a patient prescribed phenytoin therapy? 1 Perform good oral hygiene. 2 See a physical therapist for tremors. 3 Report headaches to your health care provider. 4 Report drowsiness to your health care provider.

answer

Perform good oral hygiene.

question

The nurse is assessing a patient who is receiving antiepileptic drug therapy with phenytoin. What assessment finding requires immediate action? 1 Nystagmus 2 Weight gain 3 Heart rate 60 beats/min 4 Blood pressure 130/80 mm Hg

answer

Nystagmus - The patient who has nystagmus may be presenting with adverse effects to phenytoin therapy and should be assessed for other signs of toxicity.

question

Which assessment is a priority for the patient starting on gabapentin therapy for a seizure disorder? 1 Cardiac assessment 2 Urologic assessment 3 Neurologic assessment 4 Respiratory assessment

answer

Neurologic assessment - Gabapentin requires a thorough neurologic assessment, including baseline energy levels, vision level, sensory and motor functioning, and any changes in speech.

question

The nurse is caring for a patient who has been taking phenytoin for the past week and has developed a rash. What is the first action the nurse should take? 1 Monitor the area. 2 Assess the patient. 3 Apply a topical steroid cream. 4 Notify the prescribing health care provider.

answer

Assess the patient.

question

A patient with a seizure disorder is taking oral phenytoin. He is nothing by mouth (NPO) for elective surgery. What is the appropriate nursing action? 1 Draw a serum phenytoin level after surgery. 2 Administer the medication immediately postoperatively. 3 Call the health care provider to clarify medication orders. 4 Administer the oral phenytoin before the patient goes to surgery.

answer

Call the health care provider to clarify medication orders.

question

What assessment indicates the patient is having a therapeutic response to valproic acid? 1 Nystagmus 2 Absence of seizures 3 Normal liver enzymes 4 Decrease in headaches

answer

Absence of seizures

question

A patient has been taking valproic acid and is being switched to another medication due to elevated liver function tests. What nursing action is appropriate? 1 Taper the valproic acid while starting the new medication. 2 Administer the new medication intravenously for fastest therapeutic action. 3 Stop the valproic acid and start the same dose of the new medication immediately. 4 Wait until the valproic acid is completely out of the patient's system before starting a new medication.

answer

Taper the valproic acid while starting the new medication.

question

A patient is admitted who has reportedly stopped taking her antiepileptic medication. What is the appropriate nursing action? 1 Assess for hypotension. 2 Assess for confusion and delirium. 3 Monitor for rebound seizure activity. 4 Monitor for acute withdrawal syndrome.

answer

Monitor for rebound seizure activity.

question

What intervention is essential before a patient starts therapy with lamotrigine? 1 Platelet count 2 Kidney function tests 3 Assessment of weight 4 Assessment of risk for Stevens-Johnson syndrome

answer

Assessment of risk for Stevens-Johnson syndrome

question

The nurse is administering intravenous phenytoin. When will the nurse expect the onset of the drug to occur? 1 Immediately 2 Within 5 minutes 3 Within 15 minutes 4 Within 1 to 2 hours

answer

Within 1 to 2 hours

question

What information should the nurse provide to a patient who will self-administer an antiepileptic agent for the first time at home? 1 "Do not take the medication if you have a fever." 2 "Lie in bed for at least an hour after taking your medication." 3 "Wait to see how you react to the medication before driving." 4 "Take the antiepileptic agent with milk or juice to prevent stomach upset."

answer

"Wait to see how you react to the medication before driving."

question

The nurse is administering morning medications. Which administration technique is in error? 1 The nurse administers intravenous phenytoin with a filter. 2 The nurse administers phenobarbital elixir with fruit juice. 3 The nurse administers carbamazepine with grapefruit juice. 4 The nurse administers gabapentin without checking when the patient ate.

answer

The nurse administers carbamazepine with grapefruit juice.

question

When administering phenytoin via intravenous (IV) push, which action will the nurse perform? 1 Monitor for hypertension. 2 Always use an infusion pump. 3 Administer through peripheral IV sites only. 4 Flush the line with normal saline before and after administration.

answer

Flush the line with normal saline before and after administration. - Phenytoin is very irritating to veins and incompatible with all fluids except normal saline.

question

A patient reports switching from brand-name antiepileptic drug therapy to generic drug products. What is an essential nursing intervention? 1 Call the insurance company. 2 Request a decrease in the patient's dose. 3 Request an increase in the patient's dose. 4 Monitor the patient's neurologic status closely.

answer

Monitor the patient's neurologic status closely. - Increased monitoring of the patient's neurologic status is necessary because there is concern that generic drugs may not be as effective as brand-name medications. When the patient switches preparations, the patient may have seizures if the blood level does not remain therapeutic.

question

The nurse is administering phenytoin intravenously. What interventions are essential? Select all that apply. 1 Administer using a filter. 2 Administer the medication through a large vein. 3 Administer the medication no faster than 50 mg/min. 4 Mix the medication in 5% dextrose with 0.9% saline. 5 Administer the medication through a 20-gauge or larger catheter.

answer

Administer using a filter. Administer the medication through a large vein. Administer the medication no faster than 50 mg/min. Administer the medication through a 20-gauge or larger catheter.

question

The patient asks the nurse why she is receiving a different drug than her usual phenytoin. The patient is NPO (nothing by mouth) and is receiving intravenous fosphenytoin. Which is the nurse's most accurate response? 1 "You cannot take phenytoin orally while you are NPO." 2 "You need to ask your health care provider this question." 3 "Your serum phenytoin levels were most likely not therapeutic." 4 "This is the same class of drug, but better tolerated intravenously."

answer

"This is the same class of drug, but better tolerated intravenously."

question

Which patient should receive her medication as ordered at 8 am? 1 The patient who is receiving phenobarbital and has a plasma level of 38 mcg/mL. 2 The patient who is scheduled to receive carbamazepine who was started on verapamil. 3 The patient who has been taking aspirin for a headache and is scheduled to receive valproic acid. 4 The patient who is scheduled to receive a barbiturate and was admitted after a night of drinking alcohol.

answer

The patient who is receiving phenobarbital and has a plasma level of 38 mcg/mL. - The patient who is scheduled to receive phenobarbital and has a plasma level of 38 mcg/mL is safe to receive the medication. The therapeutic range is 10 to 40 mcg/mL. Carbamazepine interacts with verapamil and can cause toxicity.

question

A patient receiving phenytoin complains of "blurred vision." What is the priority nursing action? 1 Monitor for seizure activity. 2 Assess the patient's pupils. 3 Hold the patient's medication. 4 Assess serum phenytoin levels.

answer

Assess serum phenytoin levels

question

What information should the nurse include in the care plan of a young woman who has been prescribed phenytoin? 1 "Take your blood pressure daily." 2 "Use birth control while on this medication." 3 "Do not take this medication with grapefruit juice." 4 "If your weight increases, call your health care provider."

answer

"Use birth control while on this medication." - The nurse should tell the young woman to use birth control while on the medication because an increased incidence of fetal defects occurred in those who took phenytoin while pregnant.

question

A patient receiving valproic acid should be monitored for which adverse effects? Select all that apply. 1 Dizziness 2 Pancreatitis 3 Weight gain 4 Hepatotoxicity 5 Hypoglycemia

answer

Dizziness Pancreatitis Weight gain Hepatotoxicity

question

The nurse is monitoring a patient with a phenytoin level of 8 mcg/mL. What is an appropriate nursing action? 1 Draw another drug level within the hour. 2 Hold the medication and call the health care provider. 3 Call the health care provider for an increase in dosage. 4 Document the value and continue to monitor the patient.

answer

Call the health care provider for an increase in dosage.

question

The parent of a child with a history of a seizure disorder calls into the clinic to report her child has a rash on his torso. What is the most appropriate assessment question for the nurse to ask? 1 "Has your child been outside today?" 2 "Does your child have seasonal allergies?" 3 "Has your child been around anyone who is ill?" 4 "Has your child started on any new medications lately?"

answer

"Has your child started on any new medications lately?"

question

A nurse is caring for a patient who has tonic-clonic seizures and is prescribed phenytoin therapy. What assessments should the nurse make to look for potential side effects? Select all that apply. 1 Eye exams for glaucoma 2 Changes in facial appearance 3 Assessment for increased body hair 4 Assessment for changes in the gums 5 Assessment for Stevens-Johnson syndrome

answer

Changes in facial appearance Assessment for increased body hair Assessment for changes in the gums

question

The nurse is assessing four patients who have seizures and are started on medication therapy. Which patient is receiving the correct assessment after starting medication therapy? 1 Patient starting barbiturate therapy being assessed for a rash. 2 Patient starting gabapentin therapy being assessed for anemia. 3 Patient starting iminostilbene therapy being assessed for neurologic symptoms. 4 Patient starting levetiracetam therapy being assessed for neuropsychiatric symptoms.

answer

Patient starting levetiracetam therapy being assessed for neuropsychiatric symptoms.

question

A patient was prescribed gabapentin for neuropathic pain. What information is essential to include in the patient's discharge teaching? 1 Take the medication before meals. 2 Do not drink alcohol while on this medication. 3 Take the medication with a full glass of water. 4 Stop the medication if you develop gastric upset.

answer

Do not drink alcohol while on this medication. - Gabapentin is effective as a single-drug therapy for new-onset epilepsy and is most commonly used for the treatment of neuropathic pain. It is essential to teach the patient that he should not drink alcohol while on the medication, as it contributes to neurologic depression and sleepiness.

question

A patient receiving phenytoin develops a measleslike rash. What is the appropriate nursing action? 1 Administer an antihistamine immediately. 2 Apply topical steroid cream for inflammation. 3 Instruct the patient to take oatmeal baths if it itches. 4 Stop the medication and notify the health care provider.

answer

Stop the medication and notify the health care provider. - The patient has a measleslike rash, which is an adverse effect of phenytoin. The nurse should stop administering the medication and notify the health care provider.

question

A patient is being seen at the clinic for follow-up regarding treatment for seizures. The nurse notes that the patient is diaphoretic and her hands are trembling. The patient is alert. What is the priority nursing action? 1 Document the finding and perform a neurologic assessment. 2 Question the patient regarding her state of mind during the visit. 3 Call for assistance from another health care professional in the clinic. 4 Stop the appointment and notify the health care provider of the findings.

answer

Document the finding and perform a neurologic assessment.

question

Which antiepileptic drug may cause gingival hyperplasia in patients? 1 Phenytoin 2 Gabapentin 3 Phenobarbital 4 Levetiracetam

answer

Phenytoin

question

Which action is the highest priority for a patient who is receiving antiepileptic drug therapy for the first time? 1 Weighing the patient weekly 2 Encouraging regular check-ups 3 Assessing for suicidal tendencies 4 Teaching the patient about potential side effects

answer

Assessing for suicidal tendencies

question

The patient taking carbamazepine should be instructed to avoid taking her dose with which beverage? 1 Grape juice 2 Apple juice 3 Orange juice 4 Grapefruit juice

answer

Grapefruit juice

question

A 25-year-old female patient is prescribed phenobarbital therapy for seizure control. What information is essential for the nurse to assess before discharge? 1 "Have you ever had headaches? 2 "What type of insurance do you have?" 3 "What form of birth control do you use?" 4 "How often have you been having seizures?"

answer

"What form of birth control do you use?"

question

A nurse is assessing a patient who has developed Stevens-Johnson syndrome as a result of medication therapy. What is the nurse's first intervention? 1 Hold all medications. 2 Assess for severity of rash. 3 Call the health care provider. 4 Increase the patient's fluid intake.

answer

Assess for severity of rash.

question

What is the most appropriate nursing action for a patient in status epilepticus? 1 Apply restraints. 2 Apply restraints, start and intravenous line and administer intravenous diazepam. 3 Start an intravenous line and administer intravenous diazepam. 4 Start an intravenous line and administer intravenous pain medications.

answer

Apply restraints, start and intravenous line and administer intravenous diazepam.

question

In administering barbiturate therapy for seizure disorders, what safety measures are essential for the nurse to perform? Select all that apply. 1 Assess the room for safety measures 2 A neurologic assessment before administration 3 Assess drug levels before each dose of medication 4 Assess vital signs before medication administration 5 Attach patient to electroencephalogram (EEG) monitoring before each dose of medication

answer

Assess the room for safety measures A neurologic assessment before administration Assess vital signs before medication administration

question

Which is the priority action when administering intravenous phenytoin therapy? 1 Monitor for side effects. 2 Monitor serum drug levels. 3 Flush the tubing after administration. 4 Administer by slow intravenous (IV) push.

answer

Administer by slow intravenous (IV) push. - The priority is to administer phenytoin slowly to prevent irritation to veins.

question

A patient is in status epilepticus. Which are essential nursing actions? Select all that apply. 1 Call a code. 2 Assess oxygenation. 3 Administer diazepam. 4 Sit the patient in high Fowler. 5 Turn the patient's head to the side.

answer

Assess oxygenation. Administer diazepam. Turn the patient's head to the side.

question

A patient who is postoperative neurosurgery is admitted to the intensive care unit and begins to have seizures. What is the nurse's priority action? 1 Reassure the patient. 2 Notify the family members. 3 Call the health care provider. 4 Assess for a patent intravenous line.

answer

Assess for a patent intravenous line.

question

Which phenomena does the nurse recognize as positive symptoms of schizophrenia? Select all that apply. 1 Catatonia 2 Delusions 3 Hallucinations 4 Poverty of speech 5 Social withdrawal 6 Conceptual disorganization

answer

Delusions Hallucinations Conceptual disorganization

question

Which activity should the patient be cautioned to avoid while taking a monoamine oxidase (MAO) inhibitor? 1 Eating aged cheese 2 Sunbathing at the pool 3 Participating in a bowling league 4 Smoking a low-nicotine cigarette

answer

Eating aged cheese - Eating foods high in tyramine, including aged cheese, can cause a hypertensive crisis in patients taking MAO inhibitors.

question

Which patient is a poor candidate for therapy with diazepam to treat generalized anxiety disorder? 1 One with a history of alcoholism 2 One with type 2 diabetes mellitus 3 One who had convulsions as a child 4 One who has had a myocardial infarction

answer

One with a history of alcoholism - A patient with a history of alcoholism is a poor candidate for therapy with diazepam because of the potential for substance abuse and the adverse effects of therapy.

question

The nurse notes lithium on a patient's drug history upon admission. Which condition would the nurse suspect that this patient has been diagnosed with? 1 Bipolar disorder 2 Absence seizures 3 Paranoid schizophrenia 4 Obsessive-compulsive disorder

answer

Bipolar disorder

question

Which theory states that depression and mania are caused by alterations in the concentration of dopamine and norepinephrine and serotonin and histamine in the brain? 1 Dopamine hypothesis 2 Permissive hypothesis 3 Dysregulation hypothesis 4 Biogenic amine hypothesis

answer

Biogenic amine hypothesis

question

Which medication increases the rate of urinary elimination of tricyclic antidepressants (TCAs) in the event of an overdose? 1 Diazepam 2 Antidysrhythmic 3 Activated charcoal 4 Sodium bicarbonate

answer

Sodium bicarbonate

question

The nurse is assessing a patient with depression who has been prescribed nortriptyline. Following the assessment, the nurse finds that the patient has constipation and urinary retention due to interaction between the prescribed medications. Which class of medication found in the patient's prescription is responsible for these effects? 1 Diuretics 2 Anxiolytics 3 Anticholinergics 4 Antihypertensives

answer

Anticholinergics

question

Which are common symptoms of serotonin syndrome? Select all that apply. 1 Delirium 2 Myoclonus 3 Drowsiness 4 Coarse tremors 5 Suicidal thoughts

answer

Delirium Myoclonus Coarse tremors

question

The nurse is assessing a patient who has been prescribed alprazolam to treat panic disorder. Which adverse effects does the nurse monitor for in the patient? Select all that apply. 1 Ataxia 2 Dizziness 3 Confusion 4 Blurred vision 5 Paradoxical anxiety

answer

Ataxia Dizziness Confusion

question

Which adverse effects result from antipsychotic drugs' action on alpha-adrenergic receptors? Select all that apply. 1 Weight gain 2 Lightheadedness 3 Reflex tachycardia 4 Tardive dyskinesia 5 Postural hypotension

answer

Lightheadedness Reflex tachycardia Postural hypotension

question

What is another approved and indicated use for bupropion, a second-generation antidepressant? 1 Smoking cessation 2 Orthostatic hypotension 3 Nocturnal enuresis in children 4 Anorexia in patients undergoing chemotherapy

answer

Smoking cessation

question

Which mood-stabilizing drugs are used to treat bipolar disorder? Select all that apply. 1 Bupropion 2 Imipramine 3 Isocarboxazid 4 Oxcarbazepine 5 Lithium carbonate

answer

Oxcarbazepine Lithium carbonate

question

Which anxiolytic drug promotes antagonistic activity at both the serotonin and dopamine receptors? 1 Buspirone 2 Alprazolam 3 Lorazepam 4 Amitriptyline

answer

Buspirone

question

Which instruction does a nurse provide to a patient who is taking a selective serotonin reuptake inhibitor (SSRI)? 1 "Change positions frequently." 2 "Avoid foods or beverages rich in tyramine." 3 "Avoid hot baths, saunas, and hot climates." 4 "Increase the intake of dietary fiber supplements."

answer

"Increase the intake of dietary fiber supplements."

question

A patient is detoxifying from alcohol abuse. Which type of medication is indicated to help the patient manage withdrawal symptoms? 1 Phenothiazine 2 Dibenzazepine 3 Benzisoxazole 4 Benzodiazepine

answer

Benzodiazepine

question

The nurse notes that the patient has an increased blood glucose level, increased blood pressure (BP), and abnormal cholesterol levels. What does the nurse infer from these observations? 1 The patient has mania. 2 The patient has dystonia. 3 The patient has dyskinesia. 4 The patient has metabolic syndrome.

answer

The patient has metabolic syndrome.

question

What are the current indications for tricyclic antidepressants (TCAs)? Select all that apply. 1 Seizures 2 Insomnia 3 Depression 4 Childhood enuresis 5 Neuropathic pain syndrome

answer

Insomnia Childhood enuresis Neuropathic pain syndrome

question

Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) both function by which mechanism? 1 Increasing the placebo effect 2 Increasing alertness levels in the brain 3 Blocking the reuptake of neurotransmitters at nerve endings 4 Decreasing levels of epinephrine and serotonin at nerve endings

answer

Blocking the reuptake of neurotransmitters at nerve endings

question

What atypical antipsychotic medication would the nurse anticipate a health care provider prescribing for treatment of refractory schizophrenia? 1 Trazodone 2 Phenelzine 3 Amoxapine 4 Risperidone

answer

Risperidone

question

A patient with bipolar disorder has involuntary wavelike movements of the legs. Which drug is responsible for this adverse effect in the patient? 1 Diazepam 2 Buspirone 3 Alprazolam 4 Lithium citrate

answer

Lithium citrate

question

The nurse is caring for a patient who is experiencing respiratory depression due to long-term use of diazepam in high doses. The patient has been prescribed flumazenil by the primary health care provider. What does the nurse monitor while caring for the patient? 1 Presence of seizures 2 Presence of impaired vision 3 Presence of increased pulse rate 4 Presence of reduced blood glucose

answer

Presence of seizures

question

A patient who has depression is prescribed duloxetine. Which tests will the nurse suggest to the provider before the therapy is started? 1 Renal function test 2 Liver function test 3 Complete blood count 4 Complete urine examination

answer

Liver function test

question

A patient diagnosed with depression is started on a tricyclic antidepressant (TCA) after failure to improve symptoms on a selective serotonin reuptake inhibitor. The nurse should include which teaching point when educating the patient about the new medication? 1 There are no contraindications to this medication. 2 The medication is safe; it has been used longer than many others. 3 There is a risk of toxicity when this medication is taken with alcohol. 4 This class of medications has no other use and is only for depression.

answer

There is a risk of toxicity when this medication is taken with alcohol.

question

What is the main receptor in the central nervous system (CNS) that is blocked by conventional antipsychotic drugs? 1 Serotonin 2 Dopamine 3 Acetylcholine 4 Norepinephrine

answer

Dopamine

question

The nurse is caring for a patient with acute mania who has been prescribed lithium carbonate. The blood tests of the patient indicate the serum lithium level to be 1.2 mEq/L. What does the nurse interpret from this result? 1 The patient will have persistent manic symptoms. 2 The patient may have cardiac dysrhythmia and tremors. 3 The patient may have impaired liver and renal functioning. 4 The patient should have effective relief from the manic symptoms.

answer

The patient should have effective relief from the manic symptoms. - There is a narrow therapeutic window between the therapeutic and toxic serum levels of lithium. A serum lithium level of 1 to 1.5 mEq/L is optimum for the treatment of acute mania. Therefore a serum lithium level of 1.2 mEq/L indicates that the patient will have effective relief from the manic symptoms. If the serum lithium level is less than 1 mEq/L, then the patient may have persistent manic symptoms. The adverse effects of lithium toxicity include cardiac dysrhythmia and tremors. If the lithium serum level is more than 1.5 mEq/L, then the patient may have lithium toxicity, which is characterized by impaired liver and renal functioning.

question

A female patient who takes lorazepam for anxiety tells the nurse that she plans to become pregnant. What is the best instruction for the nurse to give the patient? 1 Eat a well-balanced diet that includes milk. 2 Stop taking the drug and form another plan to manage anxiety. 3 Discuss tapering the drug with the health care provider before conception. 4 Visit an obstetrician to determine the correct dose of lorazepam during pregnancy.

answer

Discuss tapering the drug with the health care provider before conception.

question

Clozapine, an atypical antipsychotic medication, is prescribed for a patient with a schizophreniform disorder. Which information would be most important to include in the teaching plan for this patient? 1 The importance of promptly reporting flulike symptoms 2 Strategies to manage breast enlargement and nipple discharge 3 Contraceptive measures and expected changes in menstruation 4 The meaning of various components of a white blood cell count

answer

The importance of promptly reporting flulike symptoms

question

A patient asks the nurse how long it will take for escitalopram to be completely effective. Which time frame should the nurse include in patient teaching? 1 1 week 2 2 or 3 days 3 2 or 3 months 4 Several weeks

answer

Several weeks

question

A patient is admitted to the emergency department after an overdose of oxazepam. Which antagonist may be used to treat this patient? 1 Naloxone 2 Naltrexone 3 Nalmefene 4 Flumazenil

answer

Flumazenil

question

A patient diagnosed with an anxiety disorder has been using lorazepam but finds the side effect of drowsiness to be interfering with life. Which anxiolytic medications might be a better option for this patient? 1 Buspirone 2 Alprazolam 3 Chlordiazepoxide 4 Hydroxyzine hydrochloride salt

answer

Buspirone

question

The primary health care provider reviews the medical history of a patient who is receiving buspirone. The health care provider instructs the nurse to continuously monitor the patient's blood pressure to prevent hypertension due to a drug interaction. Which other medication is the patient taking? 1 Iron supplement 2 Oral contraceptives 3 Nonsteroidal antiinflammatory drugs 4 Monoamine oxidase inhibitor (MAOI)

answer

Monoamine oxidase inhibitor (MAOI)

question

A patient with psychosis is experiencing adverse effects of conventional antipsychotic pharmacotherapy, including dystonia, akathisia, and abnormal limb movements. The nurse collaborates with the psychiatrist to enact a change in therapy. Which medication is best suited to this patient? 1 Molindone 2 Haloperidol 3 Risperidone 4 Chlorpromazine

answer

Risperidone

question

The nurse is caring for a patient who has bipolar disorder who has been administered lithium citrate. The primary health care provider asks the nurse to constantly monitor the patient's blood sodium levels. What is the reason for giving such an instruction? 1 To ensure proper nourishment in the patient 2 To prevent renal toxicity caused by the drug 3 To maintain therapeutic concentration of lithium 4 To maintain normal cholesterol levels in the body

answer

To maintain therapeutic concentration of lithium

question

The nurse prepares a patient who is taking sertraline for discharge. Which instruction should the nurse include in patient education? 1 Report any increase in mania. 2 Expect to feel better in 4 to 6 days. 3 Take sertraline at the same time each day. 4 Avoid overheating and direct sun exposure.

answer

Take sertraline at the same time each day.

question

The nurse is assessing a patient with depression who has been prescribed isocarboxazid. The nurse advises the patient to use steam inhalation for a cold rather than taking cetirizine. What is the reason for giving such advice to the patient? 1 To prevent the increased risk of bleeding 2 To prevent the increased risk of infection 3 To prevent impaired cardiovascular function 4 To prevent central nervous system depression

answer

To prevent central nervous system depression

question

The nurse is caring for a patient diagnosed with depression who has been prescribed isocarboxazid. Due to a slight increase in blood pressure and agitation, the primary health care provider prescribed buspirone for the patient. What does the nurse do to prevent adverse effects in the patient? 1 Administer buspirone at night and isocarboxazid after lunch. 2 Administer buspirone intravenously and isocarboxazid orally. 3 Administer buspirone and isocarboxazid by dissolving in water. 4 Administer buspirone 14 days after discontinuing isocarboxazid.

answer

Administer buspirone 14 days after discontinuing isocarboxazid. - Buspirone is prescribed for the treatment of agitation. It should not be coadministered with monoamine oxidase inhibitors such as isocarboxazid because the drugs interact and increase blood pressure. In order to prevent such adverse effects, the drug must be administered after a sufficient washout period. Therefore the nurse should administer buspirone 14 days after discontinuing isocarboxazid. On the other hand, continuing the administration of isocarboxazid by changing the administration time, by changing the dosage forms, or by diluting the drugs in water may not be helpful in preventing adverse effects. Therefore in order to prevent the drug interaction, the nurse should not simply administer isocarboxazid after lunch, dissolve the drug in water, or give it orally.

question

A patient taking risperidone has a necrotic foot ulcer that started as a minor scratch. Which patient data should the nurse check to help prevent complications of the pharmacotherapy? 1 Leukocyte count 2 Liver function studies 3 Fasting blood glucose 4 Kidney function studies

answer

Fasting blood glucose

question

A male patient tells the nurse that he wants to stop taking citalopram because of the sexual side effects. Which instruction should the nurse provide while educating the patient to help relieve the patient's sexual dysfunction? Select all that apply. 1 Avoid alcoholic beverages. 2 Discontinue the medication. 3 Decrease the regular dosage. 4 Take infrequent "drug holidays." 5 Report complaints to the psychiatrist. 6 Maintain the current pharmacotherapy.

answer

Avoid alcoholic beverages. Take infrequent "drug holidays." Report complaints to the psychiatrist. Maintain the current pharmacotherapy.

question

A patient currently prescribed duloxetine comes to the health clinic complaining of restlessness, agitation, diaphoresis, and tremors. The nurse suspects serotonin syndrome and questions the patient regarding concurrent use of which substance? 1 Gingko 2 Ibuprofen 3 St. John's wort 4 Glucosamine chondroitin

answer

St. John's wort

question

Which laboratory test should be monitored frequently to assess for a potential life-threatening adverse reaction to clozapine? 1 Renal panel 2 Liver function tests 3 Complete blood count 4 Immunoglobulin levels

answer

Complete blood count

question

A patient with schizophrenia presents to a clinic with a poorly healing leg ulcer and hyperglycemia. Which atypical antipsychotic agent is the best medication for this patient? 1 Olanzapine 2 Quetiapine 3 Ziprasidone 4 Risperidone

answer

Ziprasidone

question

Which food can be included in the diet of a patient who is taking monoamine oxidase inhibitors? 1 Red wine 2 Fava beans 3 Corned beef 4 Cottage cheese

answer

Cottage cheese

question

The nurse obtains a medication history from a patient diagnosed with primary hypertension. The nurse recognizes that teaching is needed when the patient states that he takes which over-the-counter medication and/or supplement? 1 Garlic 2 Ginseng 3 Valerian root 4 St. John's wort

answer

Ginseng

question

The nurse is assessing a patient diagnosed with bipolar disorder who has been prescribed lithium carbonate. On reviewing the laboratory reports of the patient, the nurse suspects that the drug has a risk of causing cardiac dysrhythmia. What is the reason for reaching such a conclusion? 1 The sodium level of the patient was 142 mEq/L. 2 The sodium level of the patient was 160 mEq/L. 3 The sodium level of the patient was 140 mEq/L. 4 The sodium level of the patient was 138 mEq/L.

answer

The sodium level of the patient was 160 mEq/L.

question

Which statement made by a patient demonstrates a lack of understanding of patient teaching regarding phenothiazine drug therapy? 1 "I need to change positions slowly to prevent dizziness." 2 "I will need to wear sunscreen and protective clothing when outdoors." 3 "It is okay to take this drug with a small glass of wine to help me relax." 4 "I should call my doctor if I notice any uncontrollable movements of my tongue."

answer

"It is okay to take this drug with a small glass of wine to help me relax."

question

Which piece of objective data contraindicates the use of clozapine? 1 Allergy to phenothiazines 2 Self-destructive behavior 3 Failed antipsychotic therapy 4 Acute lymphocytic leukemia

answer

Acute lymphocytic leukemia

question

The nurse finds that a patient who has been prescribed tricyclic antidepressant (TCA) therapy consumes alcohol regularly. What intervention will the nurse expect to perform to promote drug safety? 1 Refer the patient for regular hemodialysis. 2 Perform urine acidification until the pH is 5. 3 Administer hypotensive drugs as prescribed. 4 Administer multiple doses of activated charcoal.

answer

Administer multiple doses of activated charcoal.

STUDY

Central Nervous System Depressants Nursing Three Times Per Day

Anxiety-NCLEX 3000 – Flashcards 68 terms

Owen Clarke

68 terms

Preview

Anxiety-NCLEX 3000 – Flashcards

question

A client who recently developed paralysis of the arms is diagnosed with conversion disorder after tests fail to uncover a physical cause for the paralysis. Which intervention should the nurse include in the plan of care?

answer

Exercising the client's arms regularly

question

(SELECT AL THAT APPLY) A 54-year-old client diagnosed with generalized anxiety disorder is admitted to the facility. Which therapeutic modalities are typically used to treat this disorder?

answer

1. Biofeedback 2. Buspirone 3. Relaxtion technique

question

During the client-teaching session, which instruction should the nurse give to a client receiving alprazolam (Xanax)?

answer

"Inform the physician if you become pregnant or intend to do so."

question

A client comes to the emergency department while experiencing a panic attack. The nurse should respond to a client having a panic attack by:

answer

staying with the client until the attack subsides

question

A client is admitted to the acute psychiatric care unit after 2 weeks of increasingly erratic behavior. The client has been sleeping poorly, has lost 8 lb (3.6 kg), is poorly groomed, exhibits hyperactivity, and loudly denies the need for hospitalization. Which nursing intervention takes priority for this client?

answer

Administering a sedative as prescribed

question

A client with obsessive-compulsive disorder tells the nurse that he must check the lock on his apartment door 25 times before leaving for an appointment. The nurse knows that this behavior represents the client's attempt to:

answer

reduce anxiety.

question

A 49-year-old painter who recently fractured his tibia worries about his finances because he can't work. To treat his anxiety, his physician prescribes buspirone (BuSpar), 5 mg by mouth three times per day. During buspirone therapy, the client should avoid which of the following drugs?

answer

Monoamine oxidase (MAO) inhibitors

question

A client is admitted to an inpatient psychiatric unit for treatment of obsessive-compulsive symptoms. Obsessive-compulsive disorder (OCD) is associated with:

answer

"repetitive thoughts and recurring, irresistible impulses.

question

While shopping at a mall, a woman experiences an episode of extreme terror accompanied by anxiety, tachycardia, trembling, and fear of going crazy. A friend drives her to the emergency department, where a physician rules out physiological causes and refers her to the psychiatric resident on call. To control the client's anxiety, the nurse caring for this client may expect the resident to prescribe:

answer

2. lorazepam (Ativan).

question

(SELECT ALL THAT APPLY) After receiving a referral from the occupational health nurse, a client comes to the mental health clinic with a suspected diagnosis of obsessive-compulsive disorder. The client explains that his compulsion to wash his hands is interfering with his job. Which interventions are appropriate when caring for a client with this disorder?

answer

2. Support the use of appropriate defense mechanisms. 4. Explore the patterns leading to the compulsive behavior. 6. Encourage activities, such as listening to music."

question

A client who has been diagnosed with a sexually transmitted disease (STD) asks that this information not be shared with her family members. Which of the following responses from the nurse would be appropriate?

answer

" ""Your health information is confidential, and I can't talk to anyone about it without your permission.""

question

Before eating a meal, a client with obsessive-compulsive disorder (OCD) must wash his hands for 18 minutes, comb his hair 444 strokes, and switch the bathroom light on and off 44 times. What is the most appropriate goal of care for this client?

answer

"Systematically decrease the number of repetitions of rituals and the amount of time spent performing them.

question

A client with a history of drug and alcohol abuse is concerned that the hospital will divulge her history to her employer without her knowledge. What response by the nurse would be appropriate?

answer

1. "Your personal health information can't be disclosed to your employer without your permission."

question

The nurse is caring for a Vietnam War veteran with a history of explosive anger, unemployment, and depression since being discharged from the service. The client reports feeling ashamed of being "weak" and of letting past experiences control thoughts and actions in the present. What is the nurse's best response?

answer

1. "Many people who have been in your situation experience similar emotions and behaviors."

question

Which nursing intervention would be most helpful for a client experiencing a panic attack?

answer

"3. Staying with the client and remaining calm, confident, and reassuring

question

A client is diagnosed with obsessive-compulsive disorder. Which intervention should the nurse include when assisting with development of the plan of care?

answer

2. Giving the client adequate time to perform rituals

question

While in the facility, a client with obsessive-compulsive disorder saves all used medicine cups and paper cups and arranges them in elaborate sculptures in the room. At home, the client saves mail and magazines and makes elaborate paper sculptures from them. Which outcome would indicate successful treatment for this client?

answer

1. The client throws away all disposable cups

question

A physician's order states to administer lorazepam (Ativan), 20 mg by mouth twice per day, to treat anxiety. How should the nurse proceed?

answer

2. Clarify the order with the prescribing physician because the amount prescribed exceeds the recommended dose.

question

A client is undergoing treatment for an anxiety disorder. Such a disorder is considered chronic and generalized when excessive anxiety and worry about two or more life circumstances exist for at least:

answer

3. 6 months

question

A client admitted to the psychiatric unit for treatment of repeated panic attacks comes to the nurses' station in obvious distress. After observing that the client is short of breath, dizzy, trembling, and nauseated, the nurse should first:

answer

"3. escort the client to a quiet area and suggest using a relaxation exercise that he's been taught.

question

(SELECT ALL THAT APPLY) A physician prescribes clomipramine (Anafranil) for a client diagnosed with obsessive-compulsive disorder (OCD). What instructions should the nurse include when teaching the client about this medication?

answer

"1. Avoid hazardous activities that require alertness or good coordination until adverse central nervous system (CNS) effects are known. 2. Avoid alcohol and other depressants. 3. Use saliva substitutes or sugarless candy or gum to relieve dry mouth. "

question

During alprazolam (Xanax) therapy, the nurse should be alert for which dose-related adverse reaction?

answer

1. Ataxia

question

A client with obsessive-compulsive disorder may use reaction formation as a defense mechanism to cope with anxiety and stress. What typically occurs in reaction formation?

answer

1. The client assumes an attitude that is the opposite of an impulse that the client harbors.

question

The nurse notices that a client with obsessive-compulsive disorder dresses and undresses numerous times each day. Which comment by the nurse would be therapeutic?

answer

1. I saw you change clothes several times today. That must be very tiring.

question

A client enters the crisis unit complaining of increased stress from her studies as a medical student. She states that she has been increasingly anxious for the past month. Her physician prescribes alprazolam (Xanax), 25 mg by mouth three times per day, along with professional counseling. Before administering alprazolam, the nurse reviews the client's medication history. Which drug can produce additive effects when given concomitantly with alprazolam?

answer

3. Diphenhydramine (Benadryl)

question

A client with borderline personality disorder tells the nurse, "You're the only nurse who really understands me. The others are mean." The client then asks the nurse for an extra dose of antianxiety medication because of increased anxiety. How should the nurse respond?

answer

2. ""I'll have to discuss your request with the team. Can we talk about how you're feeling right now?""

question

After seeking help at an outpatient mental health clinic, a client who was raped while walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months later, the client returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate for this client?

answer

1. Exploring the meaning of the traumatic event with the client

question

Victims of sexual assault can experience posttraumatic stress reactions after the attack. Which of the following statements best describes symptoms associated with posttraumatic stress disorder (PTSD)?

answer

4. Flashbacks, recurring dreams, and numbness

question

(SELECT ALL THAT APPLY) After being examined by the forensic nurse in the emergency department, a rape victim is prepared for discharge. Due to the nature of the attack, this client is at risk for posttraumatic stress disorder (PTSD). Which symptoms are associated with PTSD?

answer

" 1. Recurrent, intrusive recollections or nightmares 3. Sleep disturbances 6. Difficulty concentrating "

question

The physician orders a new medication for a client with generalized anxiety disorder. During medication teaching, which statement or question by the nurse would be most appropriate?

answer

"Do you have any concerns about taking the medication?"

question

The nurse refers a client with severe anxiety to a psychiatrist for medication evaluation. The physician is most likely to prescribe which psychotropic drug regimen for this client?

answer

1. Buspirone (BuSpar), 5 mg orally three times per day "

question

Which of the following drugs have been known to be effective in treating obsessive-compulsive disorder (OCD)?

answer

"3. Fluvoxamine (Luvox) and clomipramine (Anafranil)

question

A client is admitted to the psychiatric unit with a diagnosis of conversion disorder. Since witnessing the beating of his wife at gunpoint, he has been unable to move his arms, complaining that they are paralyzed. When planning the client's care, the nurse should focus on:

answer

1. helping the client identify and verbalize feelings about the incident.

question

A client in a psychiatric facility is prescribed escitalopram (Lexapro) for anxiety. She tells the nurse that she has been having "weird dreams" and feelings of wanting to "end it all." What action should the nurse take?

answer

2. Consult a pharmacist to see if these symptoms are adverse effects of the drug.

question

During a panic attack, a client hyperventilates, becomes unable to speak, and reports symptoms that mimic those of a heart attack. Which nursing intervention would be best?

answer

4. Accompany the client to his room; remain there and provide instructions in short, simple statements.

question

A client arrives on the psychiatric unit exhibiting extreme excitement, disorientation, incoherent speech, agitation, frantic and aimless physical activity, and grandiose delusion. Which nursing diagnosis takes highest priority for the client at this time?

answer

"3. Risk for injury

question

A client who lost her home and dog in an earthquake tells the admitting nurse at the community health center that she finds it harder and harder to "feel anything." She says she can't concentrate on the simplest tasks, fears losing control, and thinks about the earthquake incessantly. She becomes extremely anxious whenever the earthquake is mentioned and must leave the room if people talk about it. The nurse suspects that she has:

answer

"3. posttraumatic stress disorder (PTSD).

question

(SELECT ALL THAT APPLY) A registered nurse caring for a client with generalized anxiety disorder identifies a nursing diagnosis of Anxiety. The short-term goal identified is: The client will identify his physical, emotional, and behavioral responses to anxiety. Which nursing interventions will help the client achieve this goal?

answer

4. Observe the client for overt signs of anxiety. 5. Help the client connect anxiety with uncomfortable physical, emotional, or behavioral responses. 6. Introduce the client to new strategies for coping with anxiety, such as relaxation techniques and exercise.

question

A nurse observes a medical student walk into a client's room and begin questioning her about her current health status. The client appears reluctant to respond. How should the nurse intervene?

answer

3. Explain to the client that she has the right to refuse to answer questions asked by the medical student.

question

Initial interventions for the client with acute anxiety include:

answer

2. encouraging the client to verbalize feelings and concerns.

question

During a shift report, the nurse learns that she will be providing care for a client who's vulnerable to panic attacks. Treatment for panic attacks includes behavioral therapy, supportive psychotherapy, and medication such as

answer

2. antianxiety drugs.

question

A client with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobias include:

answer

2. severe anxiety and fear.

question

While administering medications to a group of clients admitted with anxiety, a nurse hears someone call for help. The nurse should respond by:

answer

"4. locking the medication cart and responding to the call for help.

question

While being escorted to an operating room, a client is extremely anxious and says, "I really don't know what they're going to do to me today. The physician said I have a lump in my breast and that's all I know." Which action is appropriate for the nurse to take?

answer

"4. Notify the physician upon arrival at the operating room.

question

The nurse is formulating a short-term goal for a client suffering from a severe obsessive-compulsive disorder (OCD). An appropriately stated short-term goal is that after 1 week, the client will:

answer

"2. participate in a daily exercise group.

question

The nurse is caring for a client experiencing an anxiety attack. Appropriate nursing interventions include:

answer

3. staying with the client and speaking in short sentences.

question

Lorazepam (Ativan) is often given along with a neuroleptic agent, such as haloperidol (Haldol). What is the purpose of administering the drugs together?

answer

1. To reduce anxiety and potentiate the sedative action of the neuroleptic

question

During the admission data collection, a client with a panic disorder begins to hyperventilate and says, "I'm going to die if I don't get out of here right now!" What is the nurse's best response?

answer

4. ""You're having a panic attack. I'll stay here with you

question

A client with a conversion disorder reports blindness, and ophthalmologic examinations reveal that no physiologic disorder is causing progressive vision loss. The most likely source of this client's reported blindness is:

answer

2. having been forced to watch a loved one's torture.

question

"After months of coaxing by her husband, a client comes to the mental health clinic. She reports that she suffers from an overwhelming fear of leaving her house. This overwhelming fear has caused the client to lose her job and is beginning to take a toll on her marriage. The physician diagnoses the client with agoraphobia. Which treatment options are effective in treating this disorder?

answer

2. Desensitization 3. Alprazolam (Xanax) therapy 4. Paroxetine (Paxil) therapy

question

The nurse is caring for a client with panic disorder who has difficulty sleeping. Which nursing intervention would best help the client achieve healthy long-term sleeping habits?

answer

"2. Encouraging the use of relaxation exercises

question

The nurse in a psychiatric inpatient unit is caring for a client with obsessive-compulsive disorder. As part of the client's treatment, the psychiatrist orders lorazepam (Ativan), 1 mg by mouth three times per day. During lorazepam therapy, the nurse should remind the client to:

answer

"1. avoid caffeine.

question

While driving home from work, a nurse realizes that she failed to communicate to the oncoming nurse that a client asked for more information about advance directives. Which action would be appropriate for the nurse to take?

answer

4. Phone the nurse caring for the client and inform her of the client's request.

question

A nurse notices that a client who came to the clinic for treatment of anxiety disorder has a strong body odor. What can the nurse do or say to help this client?

answer

"2. Ask the client basic hygiene questions to determine how frequently he bathes.

question

A client admitted to the unit is visibly anxious. When collecting data on the client, the nurse would expect to see which cardiovascular effect produced by the sympathetic nervous system?

answer

3. Increased heart rate

question

A client with obsessive-compulsive disorder and ritualistic behavior must brush the hair back from his forehead 15 times before carrying out any activity. The nurse notices that the client's hair is thinning and the skin on the forehead is irritated — possible effects of this ritual. When planning the client's care, the nurse should assign highest priority to:

answer

3. setting consistent limits on the ritualistic behavior if it harms the client or others.

question

Because antianxiety agents such as lorazepam (Ativan) can potentiate the effects of other drugs, the nurse should incorporate which instruction in her teaching plan?

answer

1. Avoid mixing antianxiety agents with alcohol or other central nervous system (CNS) depressants

question

A woman, age 18, is highly dependent on her parents and fears leaving home to go away to college. Shortly before the fall semester starts, she complains that her legs are paralyzed and is rushed to the emergency department. When physical examination rules out a physical cause for her paralysis, the physician admits her to the psychiatric unit where she is diagnosed with conversion disorder. The client asks the nurse, "Why has this happened to me?" What is the most appropriate response?

answer

3. "Your problem is real but there is no physical basis for it. We'll work on what is going on in your life to find out why it's happened."

question

The nurse is collecting data on a client suffering from stress and anxiety. A common physiological response to stress and anxiety is:

answer

2. diarrhea

question

A nurse on the psychiatric unit realizes that she typically fails to administer medications according to schedule. What's the best way for the nurse to improve her medication administration practice?

answer

"2. Evaluate her current practice and devise an improvement plan.

question

A client, age 40, is admitted for a surgical biopsy of a suspicious lump in her left breast. When the nurse comes to take her to surgery, she is tearfully finishing a letter to her two children. She tells the nurse, "I want to leave this for my children in case anything goes wrong today." Which response by the nurse would be most therapeutic?

answer

"In case anything goes wrong? What are your thoughts and feelings right now?"

question

The nurse discovers that a client with obsessive-compulsive disorder (OCD) is attempting to resist the compulsion. Based on this finding, the nurse should look for signs of:

answer

4. increased anxiety.

question

A client tells the nurse that she has an overwhelming fear of having a heart attack. This client is most likely suffering from which disorder?

answer

2. Panic disorder

question

A 59-year-old client is scheduled for cardiac catheterization the next morning. His physician prescribed secobarbital sodium (Seconal), 100 mg by mouth at bedtime, for sedation. Before administering the drug, the nurse should know that:

answer

"4. sedatives reduce excitement; hypnotics induce sleep.

question

The nurse notices that a client with obsessive-compulsive disorder washes his hands for long periods each day. How should the nurse respond to this compulsive behavior?

answer

"1. By designating times during which the client can focus on the behavior

question

A nurse has been providing care to the same group of clients for 4 consecutive days. On day 5, she sees that her assignment has changed, and she is concerned about the continuity of care for these clients. What should the nurse do?

answer

2. Voice her concerns about continuity of care with the charge nurse.

question

During a panic attack, a client runs to the nurse and reports breathing difficulty, chest pain, and palpitations. The client is pale with his mouth wide open and eyebrows raised. What should the nurse do first?

answer

1. Assist the client to breathe deeply into a paper bag

question

A client diagnosed as having panic disorder with agoraphobia is admitted to the inpatient psychiatric unit. Until her admission, she had been a virtual prisoner in her home for 5 weeks, afraid to go outside even to buy food. When planning care for this client, what is the nurse's overall goal?

answer

2. To help the client function effectively in her environment

STUDY

Central Nervous System Depressants Emergency Medical Technology Food Chemistry Hydrogen Sulfide Gas

KIN 125//Exam 3 – Flashcards 66 terms

Mya Day

66 terms

Preview

KIN 125//Exam 3 – Flashcards

question

Poisons may enter the body in 4 ways...

answer

Ingestion, Inhalation, Injection, Absorption

question

First Aid Care: Ingested Poisons

answer

Ask many questions when taking a history 1. Maintain the airway and monitor the victim's ABCD's 2. If poison was a corrosive (acid) or caustic (alkali): -Immediately give one or two 8-ounce glasses of cold water or milk to dilute the poison as instructed by Poison Control (cold absorbs heat better)‏ 3. Place the victim on his or her left side -Gravity will delay poison entering the small intestine, where most substances are absorbed into the bloodstream 4. Call Poison Control

question

Activated Charcoal

answer

-Odorless, tasteless powder or liquid -Used for Injested poisons -Absorbs poisons in stomach, preventing absorption by the body NEVER give if: - Victim is not fully conscious - Has swallowed acids or alkalies - Is unable to swallow Has taken Syrup of Ipecac

question

Pica

answer

The desire/action of eating inedible substances

question

First Aid Care: Inhaled Poisons

answer

1. Get the victim into fresh air as quickly as possible 2. Monitor the victim's ABCD's 3. If there are no contraindicating injuries and the victim is conscious, have the victim lie down with head elevated -Loosen all tight-fitting clothing, especially around neck and over the chest -If the victim is unresponsive, place the victim on his or her left side *CPR or Rescue Breathing as necessary *All victims of carbon monoxide poisoning must receive medical care

question

First Aid Care: Injected Poisons

answer

Activate EMS immediately, then: 1. Maintain the victim's airway 2. Be alert for vomiting -Keep sitting if possible to prevent vomit inhalation 3. In the case of an animal or insect bite or sting, protect yourself and the victim from repeated injection 4. Attempt to identify source and if possible send with victim to hospital 5. Assist with epi-pen, if applicable ANAPHYLACTIC SHOCK RISK

question

Urushiol

answer

The toxic element of poison ivy

question

First Aid Care: Absorbed

answer

1. Protecting your hands with gloves 2. Move victim from source of poison 3. Remove victim's contaminated clothing and jewelry 4. Brush any dry chemicals or solid poisons from the skin -Take extreme care not to scrape the skin 5. Irrigate the affected area with clean water for at least 20 minutes or until medical help arrives

question

First Aid Care: Absorbed (in contact with poisonous plant)

answer

1. If the victim has been in contact with a poisonous plant, clean the skin well with soap and water, and rinse well 2. To relieve the reaction from stinging nettle (Wash, rinse, apply cold wet compress) 3. If any reaction is severe, activate EMS or transport the victim to a medical facility

question

S/S of a Life Threatening Emergency

answer

1. Unconsciousness 2. Breathing difficulties 3. Fever 4. Abnormal or irregular pulse 5. Vomiting 6. Convulsions

question

Acute Intoxication

answer

- Drowsiness - Disordered speech and gait - Violence - May mimic insulin shock **Alchol is completely absorbed from stomach and intestine within 2 hours

question

4 General Stages of Alcohol Withdrawal Syndrome

answer

Stage 1: Occurs within about 8 hours of a cutback in alcohol (nausea, insomnia, sweating and tremors) Stage 2: Occurs within 8-72 hours Stage 3: Usually occurs within 48 hours, is characterized by major seizures Stage 4: Characterized by delirium tremens

question

Delirium Tremens

answer

Life threatening condition causing delirium that occurs within 5 days of an alcholic's last drink

question

General Guidelines for Managing a Drug/Alcohol Crisis

answer

1. Assure your own personal safety. 2. Provide a reality base. - Introduce yourself - Use victim's name, family/friends 3. Provide appropriate nonverbal support. 4. Encourage communication. 5. Foster confidence

question

Managing a Violent Drug/Alcohol Victim

answer

To prevent a victim from becoming violent, take these steps: 1. Do not invade the person's personal space (moving closer than 3 feet to the victim). Getting too close may seem threatening. 2. Use a calming voice and compassionate tone. 3. Do not place objects between the victim and the door or appear as if you are blocking his or her escape. 4. Move dangerous objects out of sight and reach of the victim.

question

If a victim is violent...

answer

1. Leave the scene and notify law enforcement authorities. 2. Do not attempt restraint unless you are trained and authorized to do so and you have sufficient people to do so effectively. 3. Leave the scene at any time weapons of any type are used or threatened.

question

What type of drug is heroin?

answer

Narcotic

question

Drugs of Concern

answer

- Hallucinogens: Changes moods, alters perception of space and time - Stimulant: Affects CNS, physical & mental activity - Depressants: Affects CNS, physical & mental - Club Drugs:

question

Care for Drug Misuse or Abuse

answer

- Recognize abnormalities in victim level of consciousness, breathing circulation skin color behavior -You do not need to know the specific substance to provide initial care -If overdose has occurred treat it as a form of poisoning

question

Without glucose, the body uses what as fuel What is insulin?

answer

Glucose does not get delivered to cells and they resort to fats and proteins as fuel Insulin- a hormone that takes sugar from blood stream to the cells

question

Type 1 Diabetes

answer

-"Juvenile-onset" Begins during childhood -Victim has little or no ability to produce insulin -Require daily insulin injections

question

Type 2 Diabetes

answer

-"Adult-onset diabetes," -Victim produces insulin but either not enough insulin or the cells do not respond to it

question

Gestational diabetes

answer

-Develops during pregnancy and occurs when hormone in placenta causes body to resist action of insulin -Usually not permanent, ends when baby born -Usually treated with diet, occasionally meds -Babies tend to be very large

question

For diabetics, when in doubt...

answer

give sugar

question

Hyperglycemia/Hypoglycemia

answer

Hyper- not enough of insulin and too much sugar (Happens gradually) Hypo- too much insulin and not enough sugar in the blood (Instant onset)

question

Without glucose, the body uses what as fuel

answer

resorts to fat and proteins as fuel

question

Upper right abdominal quadrant

answer

Right Upper Quadrant: Liver, Right kidney, colon, pancreas, gallbladder

question

First Aid Care: Abdominal Injuries

answer

1. Secure and maintain the airway; be alert for vomiting and possible aspiration 2. Position the victim as comfortably as possible, and take steps to prevent shock -If no S/S of shock are present they may prefer the fetal position. 3. Comfort and reassure the victim 4. Never give anything by mouth. Never give the victim medications of any kind, and do not let the victim take medications on his or her own 5. Record signs and symptoms, including the victim's description of the condition, and continue to monitor until emergency help arrives

question

Gastroenteritis

answer

Inflammation of the stomach and intestines

question

Kidney Stones

answer

A sharp, cramping pain in the back and side area of the kidney or in the lower abdomen.

question

Peptic Ulcers

answer

Deep ulcer in the stomach or duodenum

question

Labor

answer

The process that begins with the first uterine contraction and ends with delivery of the baby and placenta 3 stages: Dilation, delivery of baby delivery of the placenta, recovery

question

Stage 1: Dilation

answer

From the first contraction until the cervix is completely dilated longest stage!

question

Stage 2: Delivery of the baby

answer

Head becomes visible (crowning) The emergence of the baby's head at the vaginal opening

question

Stage 3: Delivery of the Placenta

answer

Occurs within 30 minutes after birth Placenta separates from uterine wall and exits through vagina

question

Stage 4: Recovery

answer

Recovery and stabilization of the mother Lasts approx 1 hour uterus contracts to control bleeding monitor vital signs

question

Care of a Newborn

answer

1. Immediately dry the infant, paying particular attention to the head, which has a large surface area. 2. Repeat suctioning with the bulb syringe, making sure the infant's nostrils and mouth are clear. 3. Assess the infant, evaluating the infant's color, pulse, grimace. 4. Stimulate the newborn if it is not breathing or the heart rate is less than 100 per minute.

question

Breech Birth

answer

1. When the buttocks or lower extremities are the first to present 2. Support the baby 3. If the baby has not delivered w/in 10 min place one hand in the vagina and form a V with your fingers around the babies nose 4. Get to the hospital -keep the mother in a gravity dependent position

question

Meconium

answer

Feces of a newborn -Indicates that the baby had a bowel movement in the uterus before delivery

question

What happens when the amniotic sac ruptures?

answer

Amniotic sac- A plastic-like sac of fluid in which the baby floats... time to push!

question

General Assessment procedure for a child

answer

Special Assessment Techniques -Difficult to pin point pain -Lack of body awareness -Lack of vocabulary to describe pain Does the child look sick? Is the child in shock? Is the child in extreme pain? How is the child breathing? Take vital signs- child: radial

question

Croup and Epiglottitis

answer

Croup- upper airway viral infection Epiglottitis- bacterial infection

question

5 ways the body loses heat

answer

1. radiation 2. convection 3. conduction 4. evaporation 5. respiration

question

Heat cramps

answer

Lest severe: Muscle spasm caused by electrolyte imbalance - usualy from excessive sweating - low calcium levels - too much water and not enough electrolytes - can be caused by supplementes or medications

question

First aid care: Heat cramps

answer

-Remove victim from hot environment immediately, rest in a cool place -Administer sips of salt water -Half a glass every 15 minutes -Dilute 1 tsp salt or 1 bouillon cube in 1 qt of water -Apply moist towels to victim's forehead and over cramping muscles -To relieve pain, try gently stretching the involved muscles -Ice resultant soreness afterward

question

Heat Exhaustion vs. Heat stroke

answer

Heat exhaustion- Caused by excessive loss of water and salt through sweating -Profuse Sweating -Pale, cool, ashen skin -weak, rapid pulse Heatstroke- most dangerous, body's temp regulation system shuts down -Body temperature of 105°or more -Hot, red skin -Initially rapid, strong pulse

question

Heatstroke (what needs to happen?)

answer

- remove from source of heat to cool the victim until mental status returns to normal

question

Heatstroke treatment

answer

1. Establish an airway 2. Remove victim from source of heat when possible 3. Remove as much of victim's clothing as possible, down to his or her underwear 4. Elevate victim's head and shoulders slightly 5. Use a combination of methods to cool the victim until mental status returns to normal 6. Never give the victim stimulants or hot drinks

question

first aid care: general hypothermia

answer

1. Check victim's vital signs -Measure for 1 full minute, vital signs are slowed in hypothermia -If there is no pulse, open airway and begin CPR -AED - deliver only one shock If no correction in rhythm, continue CPR, do not deliver additional shocks -Handle victim very gently -Don't let victim walk around or move much on own -Keep victim in a supine position -Prevent shock and increase blood flow to the brain.

question

Frostbite

answer

Damage to tissues resulting from prolonged exposure to extreme cold - ice crystals form between cells of skin

question

First aid care frostbite

answer

-Immediately remove victim from cold environment -Keep tissue frozen until you can initiate care -Never thaw tissue if there is any chance of it refreezing -Protect injured tissue from friction or pressure -Never poke or squeeze the tissue -Remove constricting clothing or jewelry that is not sticking to the skin -Thaw frostbitten tissue in water 100-110°F- Do not allow extremity to touch sides or bottom of container -Keep re-warming until skin color no longer improves -This may take as long as 40 minutes -Once skin is thawed, any solution that comes in contact with it must be sterile -Cover thawed parts with loose, dry, sterile dressings and elevate extremities -Place sterile gauze between fingers and toes to reduce the risk of increased injury -Monitor vital signs and keep the victim warm until EMS arrives -Do not let victim walk if feet are involved -Do not let the victim smoke

question

Severity of a snakebite

answer

-Location of bite - size of victim - weight of victim - whether disease causing organisms are in the venom - general health/physical activity right after

question

First aid care: snakebite

answer

never - cut the skin, use a tourniquet, apply ice Do the following: - clean with soap/water, cover with dressing, seek medical advice

question

Insect bites/stings: medical help is needed if..

answer

itching last longer than 2 days - signs of infection develop - signs of an allergic reaction develop - the insect is poisonous

question

Brown recluse spider bite symptoms

answer

A brown poisonous spider identified by a violin-shaped mark on its back Bites do not heal and require surgical grafting Serious medical condition Hone

question

what bee can only sting once?

answer

honeybees can only sting once, as they lose their stinger

question

Scorpion stings

answer

rarely fatal - severe paint, nausea, difficulty breathing/swallowing, irregular heart beat call 911, clean wound, apply ice

question

Removing a tick/care for a tick bite

answer

1. Using fine-tipped tweezers, grasp the tick as close as possible to the point where it is attached to the skin 2. Pull slowly, firmly, and steadily until the tick is dislodged 3. Wash the bite area thoroughly with soap and water and apply an antiseptic or antibiotic ointment to the area 4. Apply a cold pack or use Calamine lotion to relieve any pain and swelling 5. Encourage the victim to report the tick bite to a doctor

question

Siezures vs Epilepsy

answer

Seizures: Involuntary Sudden change in sensation, behavior, muscle activity, or level of consciousness Caused by irritation or over activity of brain cells Epilepsy:Chronic brain disorder characterized by recurrent seizures not caused by acute problems, with or without loss of consciousness

question

Types of Seizures

answer

Simple partial (Jacksonian) seizure- -Simple, partial seizure characterized by jerking in the fingers and toes Jerking may spread to involve the entire arm or leg, or even the entire body -Victim stays awake and aware Complex partial (psychomotor) seizure -Starts with a blank stare, then progresses into chewing and random activity -Victim seems dazed Myoclonic seizure -Sudden, brief, massive muscle jerks that involve part or all of the body Atonic seizure -"Drop attack," a seizure in which the legs of a child suddenly and temporarily collapse Absence (petit mal) seizure Characterized by a blank stare that lasts only a few seconds Most common in children Absence seizures do not involve convulsions

question

Generalized Tonic Clonic Seizures

answer

Grand Mal

question

First Aid care seizures

answer

1. Do not move the victim unless he or she is near a dangerous object that cannot be moved. Otherwise, move objects away from the victim. Place padding under the victim's head to prevent injury. 2. Maintain an open airway. 3. Stay calm; if the victim is responsive, reassure him or her; reassure others who are with the victim. 4. Stay with the victim until the seizure has passed; if you need to get help, send someone else. 5. Never try to force anything between the victim's teeth, and never give the victim anything by mouth. 6. Remove or loosen any tight clothing, especially around the neck; remove eyeglasses. 7. Turn the victim on his or her left side with the face pointed downward so secretions and vomitus can drain quickly out of the mouth and so the tongue will not fall back and block the airway. 8. If the victim stops breathing, open the airway, remove anything that might impair breathing, and provide artificial ventilation. 9. Do not try to restrain the victim unless he or she is in danger from objects that cannot be moved. 10. Cover the victim with a blanket to preserve warmth. 11. Keep the victim from becoming a spectacle; ask bystanders to leave. 12. Following the seizure, reassure and reorient the victim; speak slowly and calmly in a normal tone of voice. Allow the victim to rest; help the victim be as comfortable as possible. ***IF SEIZURE LASTS +5 MINUTES CALL EMS***

question

Central Vertigo

answer

Central Vertigo -Least common -Mimics transient ischemic attach or stroke -Victims do NOT experience nausea, vomiting, hearing loss or a whirling sensation Signs and Symptoms -Dysfunction of the eye muscles -Unequal pupil size -Facial droop

question

Labyrinthine Vertigo

answer

most common

question

Preventing Syncope

answer

If the victim has not yet fainted, prevent him or her from falling by having the victim sit down with head between the knees or have the victim lie on the floor with legs elevated 8 to 12 inches.

question

Seizure during pregnancy is indicative of

answer

Endocrine changes during pregnancy or menstruation

STUDY

Central Nervous System Depressants Driving Under The Influence Inflammation Of The Stomach Nursing

substance abuse disorders – Flashcards 60 terms

Pedro Huang

60 terms

Preview

substance abuse disorders – Flashcards

question

Which individual would have the lowest potential for alcohol dependency?

answer

A 20-year-old Asian woman.

question

The nurse is working with a 45-year-old client who has abused alcohol since age 20. Related to this client's stage of psychosocial development, what developmental data would the nurse expect to assess?

answer

The client may have trouble establishing intimate relationships.

question

Using the principles of biological theory, what contributing factor puts a client at risk for alcoholism?

answer

The client is a child of an alcoholic parent

question

Using the principles of social learing theory, what contributing factor puts a client at risk for alcoholism?.

answer

2. The client was raised in a home where substance use was the norm. 3. The client is from a family that culturally accepts the use of substances. 4. The client experiences pleasure when a substance is used and subsequently driven to repeat the use.

question

Which nursing statement focuses on the personality factors that are implicated in the predisposition to the abuse of substances?

answer

"A tendency toward addictive behaviors increases as low self-esteem, passivity, and an inability to relax or defer gratification increase."

question

. From a biochemical perspective, what factor is implicated in the predisposition to the abuse of substances?

answer

Animal tests show that injections of the morphine-like substance that is produced by alcohol results in addicted test animals.

question

. A client diagnosed with substance dependence states to the nurse, "My wife causes me to abuse methamphetamines. She uses and expects me to." This client is using which defense mechanism?

answer

Projection.

question

A client admitted for chest pain related to cocaine abuse states, "This is nothing but a little indigestion. What is all the fuss about?" This client is using which defense mechanism?

answer

Denial.

question

A client who has recently relapsed from alcohol abstinence is seen in the out-patient mental health clinic. The client states, "I don't know what all the fuss is about. Can't I have a few drinks now and then?" Which nursing diagnosis applies to this client?

answer

Ineffective denial.

question

Which assessment data should the nurse gather when confirming a diagnosis of substance dependence?

answer

A need for markedly increased amounts of the substance to achieve desired effect

question

While performing an intake interview, the nurse learns that the client drinks to avoid early morning "shakes." The nurse recognizes this behavior as characteristic of which assessment?

answer

Substance dependence.

question

The emergency medical service brings an intoxicated client to the emergency department, after the client has been hit by a car while walking on the side of the road. The client states, "How did I get here? Who brought me to the hospital?" Which is the client most likely experiencing?

answer

A blackout

question

What situation places an individual at highest risk for mood and behavioral changes related to alcohol consumption?

answer

A 180-lb college student drinking four beers in a 1-hour period

question

Which of the following are parts of the CAGE questionnaire screening tool? Select all that apply.

answer

1. Have you ever felt you should cut down on your drinking? 2. Have people annoyed you by criticizing your drinking? 3. Have you ever felt guilty about your drinking? 4. Have you ever had a drink in the morning to steady your nerves?

question

A client with a long history of alcoholism recently has been diagnosed with WernickeKorsakoff syndrome. Which symptom should the nurse expect to assess?

answer

Loss of short-term and long-term memory and the use of confabulation

question

A client with a long history of alcohol abuse is seen in the emergency department. The client complains of extreme muscle pain, swelling and weakness of extremities, and reddish-tinged urine. What lab value related to this client's symptoms would the nurse expect to assess?

answer

An elevated creatine phosphokinase

question

A client on an in-patient psychiatric unit is overheard stating, "I blew some snow yesterday while I was out on a pass with my family." What would the nurse expect to assess as a positive finding in this client's urine drug screen?

answer

Cocaine.

question

The following clients are waiting to be seen in the emergency department. Which client should the nurse assess first?

answer

A cocaine abuser with chest pain.

question

A client diagnosed with alcohol dependency states that his wife complains about his alcoholism, but continues to stock his bar with large quantities of bourbon. The nurse suspects codependency. Which characteristic would the nurse expect the wife to exhibit that would be indicative of this problem?

answer

The wife is a "people pleaser" and would do almost anything to gain approval.

question

Which of the following are effective ways to identify a substance-impaired nurse? Select all that apply

answer

1. The nurse may frequently administer medications to other nurses' clients. 2. High absenteeism if the substance source is outside of work area. 3. Denial of substance abuse problems. 4. A high incidence of incorrect narcotic counts. 5. Poor concentration and difficulty in meeting deadlines.

question

What percentage of a single dose of alcohol is absorbed immediately into the bloodstream from which organ of the body?

answer

1. 20% is absorbed through the stomach wall

question

Which statement is true regarding how the body processes alcohol?

answer

Rapidity of absorption is influenced by various factors, such as a full stomach.

question

Which behavior reflects the prealcoholic phase of drinking progression?

answer

Alcohol is used to relieve the stress of life situations, leading to the development of tolerance

question

The nurse is caring for a client on an in-patient substance abuse unit. Because of the client's alcohol abuse, the client has lost family, job, and driver's license. What phase of drinking pattern progression is this client experiencing?

answer

Crucial phase.

question

. A nursing student is reviewing a client's chart. It is noted that the client is exhibiting signs of a drinking pattern in the early alcoholic phase. Which behavior would the student expect to note?

answer

Amnesia that occurs during or immediately after a period of drinking

question

A client brought to the emergency department is observed to be sweating, has dilated pupils, and complains of muscle aches and abdominal cramping. A toxicology screen is ordered. The nurse would suspect these symptoms are indicative of withdrawal from which substance?

answer

Heroin.

question

Three days after surgery to correct a perforated bowel, a client begins to display signs and symptoms of tremors, increased blood pressure, and diaphoresis. What should the nurse suspect?

answer

Withdrawal from alcohol or other central nervous system depressants.

question

A newly admitted client with a long history of alcoholism complains of burning and tingling sensations of the feet. The nurse would recognize these symptoms as indicative of which condition?

answer

Peripheral neuropathy.

question

A client with a long history of alcoholism presents in the emergency department with a sudden onset of muscle pain, swelling, and weakness, and reddish-tinged urine. What lab value would the nurse evaluate as evidence of this client's disorder?

answer

Increase in CPK

question

A client has been diagnosed with Wernicke-Korsakoff syndrome. Which is an example of this client's use of confabulation?

answer

The client clearly discussed a field trip, when in reality no field trip occurred

question

A client with a long history of alcohol dependence comes to the emergency department with shortness of breath and an enlarged abdomen. Which complication of alcoholism is this client experiencing, and what is the probable cause?

answer

Ascites resulting from cirrhosis of the liver

question

. A client with a long history of alcohol dependence comes to the emergency department with frank hemoptysis. Which life-threatening complication of alcoholism is this client experiencing, and what is the probable cause?

answer

Hemorrhage of esophageal varices resulting from portal hypertension

question

A client with a history of alcoholism is seen in the emergency department 2 days after a binge of excessive alcohol consumption. The nurse suspects pancreatitis. Which symptoms would support the nurse's suspicion?

answer

Constant, severe epigastric pain; nausea and vomiting; and abdominal distention.

question

What substance stimulates the central nervous system?

answer

"Crack."

question

The nurse is educating a client about how to avoid sources of stimulation. What produces the least significant stimulation to the central nervous system?

answer

Tequila shooter.

question

All states had to conform to the __________ g/dL blood level standard of legal intoxication by 2004 or risk loss of federal highway funding.

answer

0.08

question

A client is admitted to the emergency department and is tested for blood alcohol level (BAL). The client has a BAL of 0.10 g/dL. What is an accurate assessment of this lab value?

answer

The client is assessed as legally intoxicated.

question

Which is the priority diagnosis for a client experiencing alcohol withdrawal?

answer

Risk for injury.

question

A client with a long history of alcoholism has been recently diagnosed with alcoholic cardiomyopathy. Which nursing diagnosis would take priority?

answer

Altered perfusion R / T effects of alcoholism AEB decreased oxygen saturations

question

Which is the priority diagnosis for a client experiencing cocaine withdrawal?

answer

Powerlessness.

question

. Which is the priority nursing diagnosis for a client experiencing cocaine intoxication?

answer

Risk for altered cardiac perfusion

question

Which is the priority diagnosis for a client experiencing alcohol intoxication?

answer

Risk for aspiration.

question

Which is true about the outcomes of nursing interventions for clients experiencing chemical dependence?

answer

Outcomes should be tailored to the individual's immediate needs and abilities

question

A client who is exhibiting signs and symptoms of alcohol withdrawal is admitted to the substance abuse unit for detox. One of the nursing diagnoses for this client is ineffective health maintenance. Which is a long-term outcome for this diagnosis?

answer

The client's medical tests will show a reduced incidence of medical complications related to substance abuse within 6 months

question

When the nurse is planning relapse prevention strategies for clients diagnosed with substance dependence, which should be the initial nursing approach?

answer

Keep the interventions simple

question

Family members bring a client to the emergency department after a serious motor vehicle accident caused by the client driving under the influence of cocaine. The client states, "This is my first time using crack." Which nursing intervention would the nurse implement next?

answer

Validate this information with family members

question

Which nursing intervention is appropriate for a client who has a nursing diagnosis of risk for injury R / T alcohol withdrawal?

answer

Provide the client with a quiet room free from environmental stimuli

question

Ineffective denial is the nursing diagnosis that is appropriate at this time for a client who has relapsed into alcoholism. What is the priority nursing intervention to address this problem?

answer

Help the client analyze the effects of substance abuse on life situations

question

A client is admitted for benzodiazepine dependence detox. This is the client's fourth detox, and the client's third detox was considered complicated. What would determine the nurse's priority intervention at this time?

answer

The nurse should monitor the client closely and initiate seizure precautions because the client will be at high risk for seizures.

question

Which intervention takes priority when dealing with a client experiencing WernickeKorsakoff syndrome?

answer

Monitor parenteral vitamin B1.

question

A client diagnosed with alcoholism is admitted to a substance abuse unit complaining of decreased exercise tolerance, lower extremity edema, arrhythmias, and dyspnea. Which nursing intervention would be appropriate for this client?

answer

Administering digoxin (Lanoxin) and furosemide (Lasix).

question

A client on the substance abuse unit states, "I used to be able to get a 'buzz on' with a few beers. Now it takes a six pack." How should the nurse, in the role of teacher, address this remark?

answer

. By explaining the effects of tolerance and telling the client that this is a sign of alcohol dependence

question

The nurse has given a client information on alcoholism recovery. Which client statement indicates that learning has occurred?

answer

"I realize that recovery is a lifelong process that comes about in steps."

question

Which of the following are reasons for the success of 12-step programs such as Alcoholics Anonymous (AA)? Select all that apply

answer

1. 12-step programs break down denial in an atmosphere of support. 2. 12-step programs give clients feelings of belonging to a community

question

What classification of drugs shares similar features with alcohol overdose and alcohol withdrawal?

answer

Anxiolytics.

question

A client with a long history of alcohol abuse is showing signs of cognitive deficits. What drug would the nurse recognize as appropriate in assisting with this client's alcohol recovery?

answer

Naltrexone (ReVia).

question

A client with a long history of heroin abuse is showing signs of cognitive deficits. What drug would the nurse recognize as appropriate in assisting with this client's recovery?

answer

Buprenorphine/naloxone (Suboxone)

question

A client receives lorazepam (Ativan) because of a high Clinical Institute Withdrawal Assessment (CIWA) score. What is the rationale for this pharmacologic intervention?

answer

Lorazepam (Ativan) is substitution therapy to decrease the intensity of withdrawal symptoms

question

The nurse is planning a teaching session for a client who has recently been prescribed disulfiram (Antabuse) as deterrent therapy for alcoholism. What statement indicates that the client has accurate knowledge of this subject matter?

answer

"I'll have to stop using my alcohol-based aftershave while I am taking the Antabuse."

question

A fasting blood glucose level value is to a sliding scale insulin dosage as a Clinical Institute Withdrawal Assessment (CIWA) score is to:

answer

A lorazepam (Ativan) dosage

STUDY

Central Nervous System Depressants Drug Delivery System

ATI- pain management – Flashcards 35 terms

Mary Moore

35 terms

Preview

ATI- pain management – Flashcards

question

acute pain (uh-kewt pane)

answer

transient discomfort or physical distress signaling actual or potential tissue damage and characterized by an identifiable cause, a short duration, resolution with healing, and few long-term emotional consequences

question

addiction (uh-dik-shun)

answer

referring to drug addiction: a dependence phenomenon characterized by impaired control over drug use, compulsive use, continued use despite harm, and craving

question

adjuvant analgesia (aj-joo-vent an-uhl-jee-zee-uh)

answer

a drug primarily used to treat something other than pain but also enhances pain relief

question

alternatives therapies (all-tur-nuh-tiv ther-uh-peez)

answer

treatment approaches, used to replace conventional medical treatments, which are not currently considered part of conventional Western medicine

question

analgesia (an-uhl-jee-zee-uh)

answer

absence of sensitivity to pain

question

analgesic (an-uhl-jee-zik)

answer

substance used as a pain reliever; a drug that acts to reduce pain, including over-the-counter drugs such as aspirin as well as those available by prescription only

question

analgesic ceiling (an-uhl-jee-zik seel-ing)

answer

the dose of a particular drug beyond which additional amounts of the same drug do not increase the analgesic effect

question

breakthrough pain

answer

a flaring of moderate to severe pain despite therapeutic doses of analgesics

question

chronic pain

answer

a feeling of physical distress or discomfort that persists over a long period of time and does not always have an identifiable cause

question

complimentary therapies

answer

treatment approaches used to complement conventional medical treatments

question

dermatome (dur-muh-tome)

answer

area of skin supplied with afferent nerve fibers from a single posterior spinal root

question

efficacy (ef-ik-uh-see)

answer

the ability of a drug to achieve its desired effect

question

epidural anesthesia (ep-ih-dur-il an-es-thee-juh)

answer

medication injected via a catheter into the space between the dura mater and the lining of the spinal canal to create a regional nerve block; also called spinal anesthesia

question

nociceptor

answer

a peripheral sensory receptor for pain, stimulated by various types of tissue injury

question

narcotic

answer

an outdated umbrella term that has been used to refer to opioids, controlled substances, illicit drugs, central nervous system depressants, strong analgesics, and drugs capable of causing physical dependence; opioid is the preferred term for the family of potent pharmacologic analgesics commonly referred to as narcotics

question

neuropathic pain

answer

a type of pain usually felt as burning or tingling and resulting from direct stimulation of nerve tissue of the peripheral or central nervous system

question

non-steroidal anti-inflammatory drug (NSAID)

answer

any of a group of drugs that reduce pain, fever, and swelling (inflammation), including aspirin

question

opioid

answer

one of a group of analgesics that act on higher centers of the brain and spinal cord to modify perceptions of moderate to severe pain

question

pain scale

answer

assessment tool used to rate the severity of pain

question

pain treshold

answer

the point at which a person feels pain

question

pain tolerance

answer

the level of pain a person is willing to endure

question

paresthesia (par-ess-thee-zhuh)

answer

an abnormal burning, prickling, tingling, or numbing sensation or hypersensitivity most often felt in the extremities and typically associated with neuropathic pain

question

patient- controlled analgesia

answer

a drug delivery system that uses a computerized pump with a button the patient can press to deliver a dose of an analgesic through an intravenous catheter

question

physical dependence

answer

an adaptive state characterized by a drug class-specific withdrawal syndrome induced with abrupt cessation, rapid dose reduction, or administration of an antagonist

question

placebo

answer

a pharmacologically inert substance, such as a sugar pill or an injection of sterile water, given with the implication of effective treatment

question

progressive muscle relaxation

answer

a systematic, stepwise approach to releasing tension in major muscle groups

question

somatic pain

answer

generally well-localized pain that results from activation of peripheral pain receptors without injury to the peripheral nerve or central nervous system, such as musculoskeletal pain

question

spinal anesthesia (also called epidural anesthesia)

answer

medication injected via a catheter into the space between the dura mater and the lining of the spinal canal to create a regional nerve block; also called epidural anesthesia

question

titration

answer

the process of gradually adjusting the dose of a medication until the desired effect is achieved

question

tolerance

answer

an adaptive state characterized by a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response

question

transmission

answer

spreading of the pain "message" across the various nerve fibers linking the pain impulse to the brain

question

visceral pain

answer

pain that results from activating the pain receptors of organs in the thoracic, pelvic, or abdominal cavities and is felt as a generalized aching or cramping sensation sometimes referred to the surface of the body

question

visual analog scale

answer

a pain rating scale using a straight line; the left end of the line represents no pain, the right end represents the worst pain, and patients mark the place on the line that best represents the severity of their pain

question

WONG-BAKER FACES SCALE

answer

a pain assessment tool that asks patients (often children) to select one of several faces indicating expressions that convey a range from no pain through the worst pain

question

World Health Organization (WHO)

answer

the specialized agency of the United Nations that deals with health on an international level, functioning as a directing and coordinating authority on international health, and has developed a three-step pain "ladder" for cancer pain relief

STUDY

AP Environmental Science Central Nervous System Depressants Criminal Law Forensic Science Photography Spectroscopy

CSI chapter 7 and 8 164 terms

Patsy Brent

164 terms

Preview

CSI chapter 7 and 8

question

What is trace evidence?

answer

a generic term for small, often microscopic material. it is physical evidence of contact, and can become a significant part of an investigation.

question

this chapters discusses ways trace evidence is____

answer

collected, preserved, identified, and used

question

What is the Locard Exchange principle?

answer

a concept of transfer,when a person comes into contact with another person/environment, there are some small changes that take place. something is added or taken away. \"certain small and seemingly insignificant changes occur\"

question

what is the importance of transferred trace evidence?

answer

it links suspects to victims or locations

question

Who is the bad guy?

answer

suspect, perpetrator,

question

who is the good guy?

answer

victim

question

sources of trace evidence means

answer

places/hosts of where trace evidence can be found/is on.

question

types of source of trace evidence

answer

trace evidence can be found: on clothes (fibers/hairs on clothes), footwear, on the body, tools, weapons

question

how can trace evidence stick to clothes?

answer

static electricity or become caught in the fabric

question

things to know about clothes as a source of trace evidence:

answer

-collect clothes from the suspect and victim asap (bc evidence/fibers can be dislodged) -make the suspect undress on clean wrapping paper, so the paper will catch any trace evidence that might fall from the clothing -collect clothing, tag the clothing, marked and packaged in paper bags (NEVER PLASTIC BC THAT MAKES MOLD/MILDEW) -dont shake the clothes in the bag because it could dislodge the evidence -if the clothes are wet/bloodstained,they should first be allowed to air dry before packaging -keep suspects clothing away from any sources of trace evidence

question

clothes should be packaged in ___bags

answer

PAPER

question

If known samples from the scene have been collected as exemplars, they should never be packaged with the suspects clothing.

answer

because if he says he wasn't at the seen, then none of the samples should be found on his clothing right?

question

sentence that makes things clear

answer

officers at the scene collected samples of roofing, tar, wood, and plaster to be used as exemplars for any trace evidence that might be found on the suspect.

question

known samples=

answer

exemplars

question

what happens once the clothes have been put in a PAPER bag?

answer

submitted to the crime laboratory for careful examination

question

what if there is a hair/small fiber that could be dislodged on the shirt?

answer

carefuly packaged it in a test tube, pill box, paper fold, post-it note, or other appropriate container. Naturally, the location of this evidence should be noted and the items appropriately marked for identification.

question

how to solve improper evidence handling by emergency medical personnel when they are acting to save someone's life/an emergency?

answer

have police agencies attempt to educate them. crime laboratory personell should be advised to paramedics cut off pieces of clothing, etc.

question

how to collect clothes from deceased victims

answer

before the victim is undressed, the body should be carefully examined for trace evidence by the investigator. An alternate light source can be used in locating trace evidence. The clothing should be carefully removed and placed onto wrapping paper.-if wet from blood, let the clothes air-dry before placing into paper bags

question

Next type source for trace evidence: footwear

answer

shoes have dust, soil, debris, vegetation, or bloodstains on them -useful in shoe impression evidence comparison

question

how should shoes be packaged?

answer

INDIVIDUALLY PACKAGED TO AVOID CROSS CONTAMINATION

question

what happens if there is soil stuck to the shoe?

answer

particular care must be taken when packaging footwear evidence containing clumps of dried soil. make sure the soil does not become dislodged on its transmission to the laboratory

question

Next type source for trace evidence: evidence from the body

answer

Injuries-show signs of struggle -microscopic particles of gunshot residue are often present on the hands of a shooter -hair found on the victims body in rape cases -bloodstains on a victim or suspects body during an assault/murder -CLOSE examination of head, ears, fingernails scraping, and hands may yeild trace evidence so be on the lookout

question

other objects for sources of trace evidnece

answer

tools and weapons, and other objects

question

how to package tools?

answer

but in cardboard box and secure it with zip ties. If the tool/instrument has parts that could fall off-they should be removed and placed in appropriately labled containers.

question

Larger items can also be sources of trace evidence

answer

such as a car, search the car for trace evidence on the scene (if the lab doesnt have a car lot to bring to car to investigate)

question

microscopic evidence can be seen

answer

with high and low power light microscopes, scanning electron microscopes, various types of spectrigraphic tools-its not hard, it is common place to find trace evidnece! :) -it isn't a problem

question

A far greater problem than the SIZE is the QUANTITY of the material brought into the lab

answer

...

question

Collection and preservation of trace evidence

answer

there are legal and scientific aspects to collecting and preserving trace materials

question

what are some of the legal issues regarding trace evidence?

answer

chain of custody, search warrant, court orders are needed-investigators should contact the district attorney for guidance

question

commonly asked question: is it better to remove an item of trace material from a larger item or leave it alone?

answer

the answer is: it depends. If a hair, fiber, lose paint chip, or other very small easily lost item of evidence can reasonably be expected to become dislodged or lost from the item of origin, the smaller item should be removed. If the investigator thinks it will not be lost, then it should not be removed.IT IS PREFERABLE TO SEND THE TRACE EVIDENCE ATTACHED WITHOUT BEING REMOVED.

question

what is something is too large to transport/send to the lab?

answer

trace material should be carefully removed, packaged, and sent to the lab for examination

question

when possible

answer

send photographs of from where the trace evidence was taken from.

question

small items of evidence should always be ____ packaged

answer

double

question

what to mark on the containers?

answer

mark these things on BOTH of the containers: person doing the packaging, date/time, case number, brief description of the item

question

the known exemplars should never be packed with the

answer

questioned samples

question

examples of trace evidence:

answer

building materials, asbestos, safe insulation, paint, rust, metals, textiles/fibers, buttons, cordage and rope, cigarette/tobacco, matches, burned paper, ash, soil, chips and wood splinters, sawdust, wood meal, particles of finely powdered wood, plant material, glass, broken panes of glass, objects left at a crime scene (paper, articles of clothing, product markings), foodstuffs, hair, feathers, electrical wires, broken tools, tape, headlamps,

question

first example of trace evidence: building materials

answer

materials such as stucco, cement, brick, mortar, plaster, sheetrock, plasterboard, window glass, wood and paint constitute evidence generally considered as building materials.

question

where is building material trace evidence most likely to be found?

answer

on the clothes of burglars (in their cuffs, pockets, shoes), or the tools used to break into the location

question

additional building material as trace evidence info:

answer

-examine the point of entry, and take exemplars from it -If tool marks are present, samples of building material should NOT be taken from the area of the tool mark, but rather adjacent to the mark. don't cut through the tool mark -collect known specimens from each area of damage/ break in (bc the composition of the building may vary from spot to spot) -package each item of evidence separatly -TOOLS may be useful sources of building material trace evidence-chips of paint, bm, glass, may stick to them (if found on a tool, don't dislodge the evidence, send it into the lab attached to the tool) -search the interior of a suspects truck for building materials (vacuum sweepings), on shirts

question

building material evidence can only demonstrate_____ and cannot be shown to be unique to a specific source. It is valuable as_____ (this is true for most all trace evidence)

answer

class characteristics, circumstantial evidence

question

How can building material be identified?

answer

by physical, chemical, and microscopic means

question

Next type of trace evidence: Asbestos

answer

used to insulate older homes, can be identified microscopically

question

Next type of trace evidence: Safe insulation

answer

suspects clothes, shoes, and tools may yeild safe insulation

question

how can safe insulation be identiffied?

answer

microscopically and chemically

question

Next type of trace evidence: paint

answer

can show if paint came from a specific location if peices are large enough and can be fitted like a jigsaw puzzle back together with it's orginal place of location. (but most often only class characterisitcs can be demonstrated). easier to tell if came from once source if there are many layers of paint

question

how is paint identified?

answer

by physical and chemical properties

question

physical properities of paint

answer

color, layering, weathering, texture

question

chemical properties of paint

answer

solubility and composition

question

in cases where there was forced entry:

answer

take paint samples as close to the area of damage as possible to lessen the possibility that a further away spot had paint composed differently. BUT DONT COLLECT NEAR THE PRY AREA/TOOL MARK LEAVE THAT ALONE dont take a sample from here

question

In a hit and run investigation involving two vehicles, how many paint samples should be collected?

answer

four paint samples, separately packaged. collect a sample from sample A the point of impact that contains a paint transfer from vehicle b. Also collect a standard paint sample that shows no damage but is adjacent to the damaged area. do this with vehicle b as well

question

how to get a paint sample

answer

tap the side of the vehicle with a pocketknife and let it fall onto a pieve of paper. DO NOT PACKAGE A PAINT SAMPLE IN AN ENVELOPE OR PLASTIC BAG. package in folded paper or a small box with a good seal. Include the substrate

question

Rust

answer

rust may sometimes be confused with bloods stains but can be differentiated by a chemical test

question

Metals

answer

can be identified chemically or spectrographically. Metal filings (from doorknobs) can be found on teeth wrenches used in burgarly cases.

question

textiles and fibers

answer

torn fabric used to gag victims, left clothing at crime location, a portion of fabric may be physically fitted into another piece of fabric (individual characterists-came from one source location) as well as class characteristics. physical, chemical, and microscopic properties-thread count, dye, color, direction of yarn twist, etc. fiber evidence can be transfered from blankets, etc.

question

trace evidence that can have individual characteristics

answer

anything that can be jigsaw fitted into something else. Paint, textiles (clothing pieces/fabric BUT NOT FIBERS)

question

If textile evidence is found at the crime scene it should be:

answer

its location should be noted. Indicated on a crime scene diagram, and photographed. As with other trace evidence, it is preferable not to remove the textile from the object to which it is attached.

question

five types of textile fibers can be encountered as evidence:

answer

animal fibers (wool), vegetable fibers (cotton/hemp), synthetic fibers (polyester, nylon rayon), mineral fibers (glass wool), and blends of synthetic and nature fibers (such as cotton and polyester)

question

you should leave fibers intact to original object, but if not possible (fall off easily) you can

answer

remove by using forceps, cellophane tape, or vacuum sweeping. Of these three the tape method is probably the best (bc it only collects surface material, whereas a vacuum sweeping collects huge amounts and forceps may not capture the trace evidence). Fiber evidence can never come from one unique source (bc garments today are mass produced).

question

buttons

answer

can usually only be used as trace evidence if thread/piece of clothing was attached to the button.

question

cordage and rope

answer

If they were used to tie up a victim, don't untie the knots ( leave them alone). Cut the rope in another spot and tie it back together with string. The knots could provide to be useful evidence! In strangulation cases, skin cells may be attached

question

cigs and tobacco

answer

identify a brand from a butt (info about what brand a suspect uses could be useful).types of ashes left (smokes pipes?)-shows suspect habits.fingerprints may be found on cigs using the ninhydrin process. dna from the saliva left on the butt. cig box-determine location of sale from numbers on the box.

question

matches

answer

find the book of matches on the suspect. Paper/cardboard matches are most common. saliva found at the end of the match-dna could be on it.

question

burned paper

answer

if found in a metal file box, leave it there and send to lab. otherwise, put paper in rigid cardboard boxes. slide a flat peice of cardboard under charred paper to lift it up.- hand carry boxes to lab bc of their fragile nature. If a paper is burning at the scene-DO NOT PUT OUT THE FIRE. do not separate layers of paper, just turn it all into the lab

question

how to read burned documents?

answer

chemical treatement, photography, and examination under ultraviolet and infared light can make the writing legible.

question

how can ash be identified?

answer

microscopically, chemically, or by means of spectroscopy. the source of the ash may be difficult to determine.

question

what is the common type of ash in arson cases?

answer

residue of burned highway flares.

question

what does the ash contain a significant level of?

answer

strontium (responsible for the bright red color of the flare)

question

soil as trace evidence

answer

can be found on shoes, underside of a vehicle-impression evidence on soil-can tie a suspect/car to a place.

question

what is soil

answer

a mixture of decaying and weathered rock and decomposed organic material known as humus. minerals are in it such as quartz, feldspar, and mica, as well as decomposed leaves, pine needles, pollen grains, and other plant fragments. THUS IT IS EASY TO DIFFERENTIATE SOILS FROM VARIOUS LOCATIONS BY MICROSCOPIC EXAMINATION

question

how should soil be collected?

answer

it should be collected in various regions at the specific location in question, and several feet away from it, and at other locations (such as the subjects home or work) for elimination purposes.

question

Where should you place soil specimens?

answer

known samples can be placed in individual small glass jars, such as clean baby food jars. METAL CONTAINERS SHOULD BE AVOIDED.

question

how much of the soil should be taken?

answer

two or three tablespoons of TOPSOIL (DO NOT dig deeper than an inch bc the subsoil may have a different composition)

question

Wood

answer

can take the shape of many forms: sawdust, splinters, chips, large pieces used as assault weapons, etc. wood can have tool marks on it

question

Wood trace evidence is ___ valuable

answer

most....it is possible to identify, compare and match sources of wood evidence.

question

what are the two types of wood?

answer

hard woods and soft woods. It is possible to determine the type of wood and type of tree from pieces the size of sawdust particles (WHOA)

question

how is the examination of wood done?

answer

microscopically.

question

the ____rings of a tree are very characteristic

answer

annual

question

read the section on wood-it is confusing

answer

...

question

plant material

answer

wood, leaves, seeds, bark, twigs, and pollen-attached to clothing, found in a vehicle, etc. fragments of plant material are hard to identify, so botanists from a museum are likely to be sought out for help.

question

What type of plant material is useful to know if a suspect was in an area with flowered plants?

answer

pollen....vacuum sweeps of a suspects clothes may yeild microscopic pollen grains.

question

GLASS ASS ASS ASSS ASSSS

answer

broken glass may yield information about the direction and speed of a projectile, and, in the case of multiple projectiles, the sequence of events (this is importante!!)

question

Broken panes of glass

answer

was it broken from the outside of inside/struck by a bullet or a rock?....how to find out:

question

What can determine from which direction the force came from that caused the glass to break?

answer

rib markings

question

what are the two types of glass fractures?

answer

radial and concentric

question

how to determine the direction of force?

answer

by examining the rib markings along the edges of radical and concentric fractures

question

when examining rib marks of radial fractures

answer

look at the right angles..the side without the right angles is the side that the force was applied opposite side-concentric is the other way around

question

how to send glass to a lab?

answer

the pieces should be individual wrapped in paper.the wrapped evidence may be placed together in a box for easier transportation.

question

high velocity bullets leave:

answer

an almost circular hole in a pane of glass without noticable cracking or with cricks merely starting

question

lower velocity bullets leave:

answer

an almost regular polygon with radial cracks running outward.

question

a shot at very close range:

answer

more or less completely shatters the glass from the pressure of the muzzle gases-in such cases it is impossible to obtain a clear idea of the appearance of the shot hole. evidence of a shooting at close range-gun shot residue on the glass. sometimes you can metal around the ridges of glass that it when through (spectrographically).

question

difference between rock and bullet holes:

answer

the crater-like expansion of a hole caused by a small stone may not show the same uniform fracture in the glass as a bullet hole would. holes caused by small stones do not show the same geometric regularity in the radial and concentric cracks in the glass around the hole as that is shown by a bullet hold. Large stone can shatter a piece of glass if thrown at close range-thus you should search for the projectile that did the damage

question

order of cracks? If multiple

answer

radical cracks produced by the first incident stop by themselves or run to the edges of the glass.the cracks on the subsequent incident stop when they meet the cracks already present from the earlier fracture

question

cracked or burst panes of glass

answer

...

question

glass cracked by heat shows

answer

characteristic long wavy fractures. pieces fall out in the same direction as the source of heat.

question

objects left at the crime scene

answer

paper, such as newspaper, wrapping paper, can be left behind-handwriting, latent fingerprints can be found. torn or cut peices, can find matching peices in the suspects home.stains may be used to show connection to another site

question

articles of clothing

answer

clothing left at a scene can show the nationality of the wearer, and the size, laundry marks. Initials could be found inside the clothes. if dried blood is found on clothing, you can look for DNA.

question

what is foodstuffs? cosmetics?

answer

foodstuffs in the form of stains or debris can be used to determine the type of work the suspect does. if starch is found in the vacuum sweep, the suspect could have been baking.

question

Hair as trace evidence

answer

hair should use 2 things:microscopic hair evaluation should be couples wth DNA testing. mitochondrial DNA testing if the shaft is present, nuclear DNA testing if there is a root)

question

what can hair tell us?

answer

species, location, growth place on the body, hair treatment, hair disease, if hair fell out naturally or pulled

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how to search for hair?

answer

flashlight and a pair of twezers.

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how many hair should be collected from the head to use an exemplars?

answer

question

Chapter 8: Blood, Forensic biology, and DNA

answer

...

question

what can deoxyribonucleic acid (DNA do)?

answer

determine the identity of unknown human remains, tie a suspect or victim to a crime scene, establish paternity, and identity the unknown prepertrator to a cold case.

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safty procautions

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people working with wet or dried blood should use PPE personal protective equitment such as tyvek suits, lab coats, gloves, masks, and goggles/face shields. ppl should get hepitis vacinations. blood could have HIV, etc. so it is dangerous.

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_____ should be worn when working with any biological products (blood, saliva, semen)

answer

surgical gloves

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______ gloves should be used when scraping an item for DNA evidence with a razor blade.

answer

cut resistant

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how to dispose of biological evidence?

answer

use commerical disposal companies that specialize in biohazardous material waste.

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____is a big concern when handling biological evidence

answer

contamination. try to eliminate dna transfer. collected items of evidence should be packaged separatly. KNOWN AND QUESTIONED SAMPLES SHOULD NEVER BE PACKAGED TOGETHER.

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What should tools be wiped down with to avoid cross contamination??

answer

10% bleach, followed by 70% ethanol.

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any individual in a crime scene should submit their dna in case their was contamination/transfer (used as elimination samples)--They will NOT be uploaded to CODIS

answer

...

question

what is the name of the national DNA database?

answer

CODIS COmbined DNA Indexing System

question

Blood pattern analysis-what ccan it do?

answer

the shape, grouping, and distribution of bloodstains can assist the investigator in reconstructing what took place at the crime scene. Determines the movement and direction of the person, the sequences of events, the area of origin, the number of impacts during an incident, and the object used to create the pattern.

question

what are the three basic classifications of bloodstains?

answer

passive, spatter, and altered

question

what are the two types of bloodstains?

answer

impact spatter (blood that travels through the air from an impact mechanism), and transfer stains (stains resulting from contact with a bloody surface)

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a pointed of tail end of a bloodstain indicates direction of travel.

answer

...

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equation for the angle of impact

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=arc sin(width of ellipse)/(length of ellipse)

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who is the BPA?

answer

The Scientific Working Group on Bloodstain Pattern Analysis

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Presumptive tests for blood aka catalyic tests

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may be used to search for small amounts of blood, or note that its blood if they think it might be something else. They are chemical tests and can be used to see if a suspect cleaned up the crime scene.

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HOWEVER

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Presumptive tests are NOT confirmatory tests for blood.

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names of the presumptive tests

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leucomalachite green, phenolphtalein, orthotolidine, tetramethylbenzidine, luminol

question

Presumptive tests are ____ tests that depend on the properties of ______

answer

color spot....hemoglobin (the oxygen carrying material found in blood). a positive result can result from human or animal blood, as well as some plant material so be careful

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which two PTs are the most specific?

answer

phenolphthalein and leucomalachite green

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which two PTs are the most sensitive?

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orthotolidine and tetramethylbenzidine

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generally, the _____aka Kastle Mayer test is a good overall choice

answer

phenolphthalein

question

how is phenolphthalein conducted?

answer

on filter paper or on cotton-tipped swabs. PERFOMRING THE TEST DIRECTLY ON EVIDENCE SHOULD BE AVOIDED. then kastle mayer reagent is added, then a drop of 3% hydrogen peroxide....color will change from clear to pink if hemoglobin is present

question

____can be purchased at a drug store and was used to test for blood in urine

answer

Hemastix

question

what is the luminol test good for?

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very useful for searching for large areas of blood, specifically blood that has been cleaned up.

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what are the drawbacks to the luminol test?

answer

room must be completely dark bc blood reacts with luminol by giving off light, a process called chemiluminescence. The reagent is sprayed with an aerpsol sprayer. the glow given off is faint. The test works best on older stains.-bleach can cause a false positive.

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what is a better test than luminol and why?

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bluestar forensic latent bloodstain reagent-is nontoxic, total darkness is not required, has stronger luminescnce, longer lasting reactions, and higher sensitivity.

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Postive presumtive test plus DNA test are both needed to indicate the presence of human blood. OR

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The Hexagon OBTI test allows the investigator to confirm the presence of human blood.

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What color is a dry but relatively fresh bloodstain?

answer

reddish brown color and glossy. in a very thing layer the color may be grayish green. the gloss slowly dissapears.

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color change on blood is ____ on metal surfaces and ____ on textiles

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quicker, slower

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how to search for stains

answer

use lights, colored lights, red, green, white or infared lights.

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how to record blood stains

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describe their form, size, color, position, direction of splash--

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the best way to preserve the appearance of bloodstains if through____

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photography-overall, medium, and close up range shots (close up range should provide a scale)-also a sketch-(a drop of blood located 25 inches from the floor and 16 in east of the doorway om the north kitchen wall indicating a downward direction.

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collection and preservation of bloodstains

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air dryed sample in a paper bag at room temperature. it does degrade over time in certain environmental conditions.

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_____the specimans down slows down deteriroation

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drying.....DO NNOT place in air tight containers, or damp environments

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why is it important to save evidence for awhile?

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some defendants need to use it in court and the evidence must be preserved. or else the case could be thrown out.

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how to collect wet blood?

answer

place a cottown swaab into the still liquid pool of blood. or filter paper or cotton gauze. sterlyl cotton tip applicators...let air dry, then place in a coin enveleop

question

most blood found at crime scenes is ____

answer

dry.can collect with a cotton ball with distilled water on it. let it dry, place in an envelope, mark it

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for very small stains, it is best to ____the blood on one area of the swab rather than spread it around the entire surface of the swab

answer

concentrate.

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Bloodstained objects

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it is best to bring the entire blood stained object to the lab. If the blood apepars lose and flaky, then it should be collected and sent to the lab. packaged air dryed blood stained objects loosely in paper bags.

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semen stained objects

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sexual assault cases.

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how to identify semen stains?

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an alternate light source can be used due to semens flourescent properties under certain wavelengths of light. once a stain is located, a presumptive test is done to determine if the stain is indeed semen.

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what are the presumptive tests for semen?

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looking for acid phosphate (AP)-color spot test that changes from clear to reddish-purple. after the PT another test must be done-either look microscopically for sqimming spirm, or detect Prostate specific antigen (PSA) or p30.

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Forensic DNA typing

answer

...

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how to collect DNA

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buccal swipes are taken (inside of a cheek)-an excellent alternative to collecting blood samples.

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DNA typing is based on our_____

answer

genetic makeup

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differences has a root in

answer

genetics, mid 19th century, gregor Mendel

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DNA is the biochemical key to differentiating uniqueness amoung individuals.

answer

twisted ladder, double helix, the steps within the ladder consist of four chemical subunites or bases

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what are the names of the bases

answer

guanine (G) Adenine (A) Thymine (T) and Cytosine (C)

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the bases always pair in this way

answer

AT, CG

question

DNA is folded into microscopic bundles called

answer

chromosomes

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chromosomes exist in the celll

answer

nuclei

question

____ blood cells contain DNA

answer

white

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what has DNA?

answer

blood, semen, bone marrow, tissues, hair roots, dandruff, saliva, tooth pulp

question

How to examine DNA?

answer

using a Polymerse chain reaction procedure (PCR) or is known as STR analysis

question

PCR is

answer

a technology that copies short segments of DNA millions of times in a process that resembles the way in which DNA naturally duplicates itself in the body. It is a powerful method bc it can applied to any body sample no matter how small.

question

how PCR works

answer

extracts DNA from the cells, separates the DNA double helix into two strands by HEATING the sample. A PCR mixutre is then added. has DNA primers (Short segments to indicate the target segment of DNA to be copied), DNA polymerse (an enzyme), and the four nucleotide bases ACTG.

question

what type of instrument is a PCR performed in??

answer

thermocycler, repeated for 28 cycles.

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after DNA is separated, then it goes through a process called

answer

capillary electrophoresis.---eventually data is converted to electronic data into an exlectropherogram

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high sensitivity DNA testing/touch DNA

answer

used to detect and recover small amounts of DNA--increased cycle number for PCR and interpretation methods. example items to be used:car swabs, handles of weapons, keys, pens, air bags.

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mitochondrial DNA

answer

mitochondira are found in the cytoplasm of most cells.they are the engery for the cell.

question

how does mtDNA differ from DNA

answer

-mtDNA is much smaller molecule (circular shaped) -it is only inherited maternally -is present within a cell in multiple copies bc there are many mito in the cell

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Central Nervous System Depressants Nursing-LPN Psychology Theories And Techniques Of Counseling Zoology

Addiction Counseling Study Guide/ NAADAC 69 terms

Kevin Stewart

69 terms

Preview

Addiction Counseling Study Guide/ NAADAC

question

Principles of the Behavioral Modification theory

answer

There are three principles, Causes, Maintenance and change of behavior. Classical conditioning, Operant conditioning, Modeling is the most effective.

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Principle of CT/RT. Control Theory/ Reality Therapy

answer

is based on the principle that four elements guide human functions: Doing, Thinking, Feeling, and Physiology. People choose negative reactions to events, Is responsible for one's own life. Cant change how the body feels or functions but can control how he reacts and thinks.

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Principles of person centered therapy.

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Centered around the idea that it is the patient's responsibility to find ways to deal with reality. Three principles/ Positive regard, Empathy, Congruence, demonstrate being real and genuine.

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Principles of Freudian or Psychonalytical

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Human being are influenced by powerful inner and unconscious drives. id, ego, superego. People go through 5 stages of life. oral, anal, phallic, latency, and genital.

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How substance abuse and domestic violence programs may be in conflict.

answer

Terms such as denial, codependency, and powerlessness are seen as stigmatizing and self defeating in helping people who are in violence abuse situations.

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Rational Emotive Behavioral Theory.

answer

It is not the actual event that disturbs a person but how he sees the event. Negative life events, negative beliefs, and negative consequences. ABC model.

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Deductive reasoning

answer

The ability to solve problems by working from a given situation to a conclusion.

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Inductive reasoning

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The ability to solve problems by working from a specific experience to a conclusion.

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Adolescent egocentrism

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Self -centeredness based on the concern about what others think

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Identity formation

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Process that a person goes through in becoming a distinctive individual.

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Identity achievement

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Occurs when a person sets a goal based on his values.

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Pharmacotherapies in treatment of substance abuse

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Means using prescription drugs along with some form of therapy to treat substance abuse. Benzodiazepines and anti-seizure medicines are aids for this, and methadone for treatment of heroin.

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Family Systems and addiction counseling

answer

When a person uses drugs the whole family is affected.

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Solution focused therapy

answer

Focused on things that work rather than the problem. The successes of a patient should be dealt with rather than his disabilities or deficits.

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Gestalt Therapy

answer

Based on the idea that people must accept responsibility for what happens to them and find their own way in life. Help the patient be what he wants to be rather than try to be something that he is not.

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Adlerian Individual Therapy

answer

Believed that social urges were what influenced people. Based on people are always striving to do better. Therapist try to see the world from the viewpoint of the patient.

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id, ego, and Super Ego

answer

The unconscious drives, The internalized outside world and, Takes the forces of conflict results in creating a defense mechanisms such as denial.

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Characteristics of physical, mental and personality, Social development of young adulthood and late adulthood

answer

Physical health issues, Mental health issues, personality and social disorders.

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Motivational Enhancement Therapy - (MET)

answer

It is Motivational Psychology. Belief that the patient has the capability as well as the responsibility to change. 5 Stages of change.

question

pharmacotherapies is based on.

answer

Prescription drugs can be used to detox, stabilize and maintain people with substance abuse addictions.

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Behavior Modification Theory

answer

The idea that all behavior is learned, and what is learned can be unlearned.

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Classical conditioning

answer

Substituting a stimulus which brings about the same result

question

Operant Conditioning

answer

Increase or decrease of certain behaviors through the use of reinforcement. Negative reinforcement can decrease a behavior.

question

NAADAC regarding the addiction of alcohol to the National Drug Control Strategy

answer

Alcohol is a drug even though it is legal. Alcoholisim is the primary chronic disease among many groups of U.S. Citizens.

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Difference between medical malpractice and negligence.

answer

a patient filing a law suit for compensation, and a breach of duty.

question

Safety Sensitive

answer

refers to an employee's job description.

question

Reasonable cause

answer

is conducted when a supervisor suspects that an employee is engaging in alcohol or drug misuse.

question

DOT Drug testing policy

answer

Marijuana, cocaine, opiates, narcotics, amphetamines, PCP and Alcohol are required to be apart of a drug screen.

question

Professional issues and Self Referral Process

answer

When a professional is using substances, use the process to get help for their behavior.

question

NAADAC Peer assistance committee

answer

Help other professional that have relapsed or are using illicit drugs or are impaired and cannot perform their counseling duties.

question

Professional Ethical decision making

answer

Is it based off of what I believe, or professional codes of conduct? Which principle of ethical conduct is involved. Is the conflict based on intellect, emotion, or needs?

question

Client Relationship Principle of Ethical standards

answer

Make sure the client has access to effective treatment, and that the integrity of the treatment relationship is safeguarded. Do not use the Client/Counselor relationship for personal gain or sexual behavior etc.

question

Competence principle of ethical standards

answer

The counselor need to continue their education so that they can provide the very best professional competency. Counselor should be able to treat several types of disorders.

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Non-Discrimination, responsibility, Competence, legal and moral standards for alcohol and drug abuse counselors

answer

Not to discriminate against clients or members of the profession because of race, religion, age, gender, disability, ancestry, sexual orientation, or economic condition. Protect the rights of the client.

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Transportation services provided by DOT.

answer

Known as SAP services SAP is to provide a drug free work place. Professional services for substance abuse is set up by DOT.

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Ethical principles of interpersonal relationships, remuneration, and societal obligations.

answer

Members should be treated with courtesy, respect, fairness and good faith. Never counsel someone who already has a counselor. Co-operation with other professionals ethics committees is require unless confidentiality will be broken.

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Publication Credit -Ethical Principles

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Give every one credit who contributes to published material

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Client walfare-Ethical Principles

answer

Inform all client of the code of ethics, professional loyalties, and responsibilities

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Confidentiality -Ethical Principles

answer

Keep client confidentiality the first obligation.

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Client Relationship-Ethical Principles

answer

Must be safe guarded so that the moral soundness of the counseling relationship is preserved.

question

HIV infection and AIDs for chemically dependent individuals

answer

Many people have fear of HIV and AIDS: Therefore counselors must learn ways to deal with this fear.

question

Laws and regulations regarding reports and record keeping

answer

Accurate reports and record keeping is the responsibility of counselors. Federal, State and licensing require that appropriate records are kept by healthcare professionals

question

Quality Assurance (Q.A.)

answer

A means of evaluating the quality of treatment services by a facility. A written plan and documentation that problems are addressed after they are identified.

question

Referral, consultation and client welfare

answer

Knowing the responsibility of counseling as well as client, Competence, legal and moral standards, client welfare, confidentiality, consult with other professionals.

question

Federal Controlled Substance Act

answer

Record keeping for Programs. Documentation monitoring, All mandatory information on forms, Dosage. Maintain records for two years and kept confidential.

question

Alcohol health disorders

answer

Gastrointestinal disorder, Cardiovascular disorder,Skin disorder, Neurologic and psychiatric disorders

question

Confidentiality laws and regulations

answer

Signed Consent forms must be completed before any information can be shared.

question

Confidentiality exceptions by Law.

answer

imminent harm or danger, Legal attorney consultations.

question

Drug testing

answer

Is a means of getting help for someone and not a form of punishment.

question

Chemicals found in PSYCHOTROPIC DRUGS, ANTIDEPRESSANTS

answer

Dibenzoxazepine, Selective Serotonin, Prozac, Zoloft, Luvox, Selective Norepinephine, Effexor, Tetracyclic and Trazodone.

question

Psychotropic,Mood Stabilizer and Antipsychotic family

answer

Chlorpromazine, Triflupromazine Resperidone, resperadol, Clozapine,

question

Narcotics

answer

Opiates, codine, oxycodone, morphine, perocet, percodan, vicodin,

question

Benzodiazepine depressants

answer

Xanax, Clonazepam, Diazepam, Short term effects include anti-anxiety and sedative effects.

question

Barbiturate Depressant -taken oral, Intravenous, or smoke.

answer

Phentobarbital, short term effects are induced sleep, relax muscles,and calm anxiety. Long term, vomiting, constipation, high blood pressure, insomnia, confusion.

question

Naltrexone

answer

An opiate blocker, has been found to be effective in treatment of heroin addicts.

question

Withdrawal from Stimulants

answer

depression, increased appetite, irritability, weakness and energy loss. Increased need for sleep and loss of concertration

question

Pharmacotherapies available for alcohol use disorder are

answer

Disuliram and Naltrexone. Also groups for coping skills, relapse prevention, and the use of other support groups.

question

Central Nervous System Depressants

answer

Alcohol, Barbiturates, Benzodiazepines, Klonopin,

question

Cross Dependence

answer

Similar drugs substituting for each other within the body and preventing withdrawal or two drugs preserving the state of physical dependence.

question

Major class of psychoactive chemicals

answer

CNS Depressants,CNS Stimulants, Narcotics, Hallucinogens, Cannabis, Solvents/Inhalants,Steroids, Psychotropics.

question

Central Nervous System is made up of three parts.

answer

Brain & Spinal Cord, pheripheral nervous system, and The Autonomic nervous system.

question

Dependent delusional system is a way a person protects the inner person from the realization of his dependency on drugs.

answer

Memory and recall are one part, Denial is the second part of the system.

question

Stages of withdrawals from CNS depressants

answer

The Shakes, Hallucinations, Seizures, Delirium Tremens [DT]

question

Controlled substance

answer

Any drug that has an abuse liability and is placed on restricted use by the DEA.

question

Poly-chemical abuse

answer

When more than one psychoactive chemical is used at a time.

question

Anabolic-Androgenic Steroids

answer

Are drugs related to male hormones.

question

Methamphetamines

answer

Are chemically made stimulants/ Speed, Chalk , Ice, crystal, glass.

question

Inhalants

answer

Vapors that are inhaled in order to produce mind altering effects.

question

Cannabis long term effects

answer

Lung damage just as cigarettes, slow mental process

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