Title PRE-INTENSIVE - NP5 - SC ✅

33. Which of the following is a possible side effect which you will discuss with the patient? * A. Hemorrhage within the brain B. Encephalitis C. Robot-like body stiffness D. Confusion, disorientation, and short term memory loss 34. Informed consent is necessary for the treatment for involuntary clients. If this cannot be obtained, permission may be taken from the: A. Social worker B. Doctor C. Next of kin or guardian D. Chief nurse 35. After ECT, What should the nurse do before giving the client food, fluid, or medication? A. Assess the gag reflex B. Assess the sensorium C. Ask for the passage of flatus D. Check O2 saturation with a pulse oximeter Situation:Mrs. Janna Mendoza, 52 years old, teacher, is affected with myasthenia gravis. 36. Looking at Mrs. Mendoza, your assessment would include the following except: * A. Nystagmus B. Difficulty of hearing C. Weakness of levator palpebrae D. Weakness of the ocular muscle 37. In an effort to combat complications which might occur, relatives should be taught: * A. Checking cardiac rate B. Taking blood pressure reading C. Technique of oxygen inhalation D. Administration of oxygen inhalation 38. The drug of choice for her condition is: * A. Prostigmine B. Morphine C. Codeine D. Prednisone 39. As her nurse, you have to be cautious about administration of medication, if she is undermedicated this can cause: A. Emotional crisis B. Cholinergic crisis C. Menopausal crisis D. Myasthenic crisis 40. If you are not extra careful and by chance you give overmedication, this would lead to: * A. Emotional crisis B. Cholinergic crisis C. Menopausal crisis D. Biological treatment for mental disorders Situation: Teri, 25 years of age, unmarried, believes that the toilet for female patients is contaminated with AIDS virus and refuses to use it unless she flushes it three times and wipes the seat same number of times with antiseptic solution. 41. The fear of using “contaminated toilet seat” can be attributed to Teri’s inability to: * A. Adjust to a strange environment B. Express her anxiety C. Develop the sense of trust in other persons D. Control unacceptable impulses or feelings 42. Assessment data upon admission helps the nurse identify which appropriate nursing diagnosis? A. Ineffective denial B. Impaired adjustment C. Ineffective individual coping D. Impaired social interaction 43. An effective nursing intervention to help Teri is: * A. Convincing her to use the toilet after the nurse has used it first B. Explaining to her that AIDS cannot be transmitted through the toilet seat C. Allowing her to flush and clean the toilet seat until she can manage her anxiety D. Explaining to her how AIDS is transmitted 44. The goal of treatment for Teri must be directed towards helping her to: * A. Walk freely about her past experience B. Develop trusting relationship with others C. Gain insight that her behavior is due to feeling of anxiety D. Accept the environment unconditionally 45. Psychotherapy, which is prescribed for Teri, is described as: A. Establishing an environment adapted to an individual patient needs B. Sustained interaction between the therapist and client to help her develop more functional behavior C. Using dramatic techniques to portray interpersonal conflicts D. Biological treatment for mental disorders Situation: Tom, a 38-year old married man, an industrial engineer, was admitted with the diagnosis of paranoid disorder. He has become suspicious and mistrustful two months before admission. Upon admission, he kept saying: “My wife has been planning to kill me.” 46. A paranoid individual who cannot accept the guilt demonstrates which of the following defense mechanisms? A. Denial B. Projection C. Rationalization D. Displacement 47. One morning, Tom was seen tilting his head as if he was listening to someone. An appropriate nursing intervention would be: A. Tell him to socialize with other patients to divert his attention B. Involve him in group activities C. Address him by his name to ask if he is hearing voices again D. Request for an order of antipsychotic medicine 48. He says “These voices are telling me that my wife is going to kill me.” A therapeutic response by the nurse is: A. “I do not hear the voices you say you hear.” B. “Are you really sure you heard those voices?” C. “I don’t think you heard those voices.” D. “Whose voices are those?” 49. The nurse confirms that Tom is manifesting auditory hallucination. The appropriate nursing diagnosis is: A. Sensory perceptual alteration B. Self-esteem disturbance C. Ineffective individual coping D. Impaired verbal communication 50. What is the most appropriate nursing intervention for a client with suspicious behavior? A. Talk to the client constantly to reinforce reality B. Involve him in competitive activities C. Use non-judgmental and consistent approach D. Project cheerfulness in interacting with the patient 51.Which of these questions should a nurse ask a patient who is suspected of having acromegaly? A. “Do you urinate often?” B. “Are you buying larger size shoes?” C. “Is your mouth frequently dry?” D. “Have you had increase hair loss?” 52.Which of the following assessment findings, if identified in a patient who has a short-leg east, would require immediate follow-up by a nurse? A. Bounding pedal pulses B. Rapid capillary refill C. Nail beds blanch with pressure D. Tingling of the toes 53. A nurse is assessing a patient with a fractured femur. The development of a fat embolus in this patient would be indicated by A. calf tenderness B. shortness of breath C. abdominal distention D. urinary retention 54. Which of the following nursing diagnoses would be most appropriate for a patient who has a diagnosis of deep venous thrombosis in the leg? A. Impaired gas exchange B. 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