A client presents to the Emergency Department (ED) after ingesting phencyclidine (PCP). Characteristic behaviors of an individual who has ingested PCP include:

Sedated, heightened senses, withdrawn.

Heightened sensory perceptions, nystagmus, hypotension.

Grandiose delusions, hypotension, quiet.

Violence, psychomotor agitation, hypertension.

Answer and Explanation

The Correct Answer is D

Choice A Reason:

Sedated, heightened senses, withdrawn. This statement is incorrect. While PCP can cause a range of sensory and psychological effects, sedation and withdrawal are not typical primary symptoms. PCP is more likely to cause agitation and aggressive behavior rather than sedation.

Choice B Reason:

Heightened sensory perceptions, nystagmus, hypotension. This statement is partially correct. PCP can cause heightened sensory perceptions and nystagmus (rapid, involuntary eye movements), but hypotension is not a common symptom. Instead, PCP often leads to hypertension (high blood pressure) due to its stimulant effects.

Choice C Reason:

Grandiose delusions, hypotension, quiet. This statement is incorrect. While PCP can cause grandiose delusions, it is more likely to result in agitation and aggressive behavior rather than a quiet demeanor. Hypotension is also not a typical symptom of PCP intoxication.

Choice D Reason:

Violence, psychomotor agitation, hypertension. This statement is correct. PCP intoxication is commonly associated with violent behavior, psychomotor agitation, and hypertension. These symptoms are due to the drug’s stimulant and dissociative effects, which can lead to severe agitation and aggressive behavior.

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Correct Answer is A

Explanation

Choice A Reason:

When a client with a personality disorder engages in self-destructive behavior, it is crucial for the staff to observe this behavior closely to ensure the safety of both the client and others around them. Self-destructive behaviors can include actions such as self-harm, substance abuse, or reckless activities that pose a significant risk to the individual’s well-being. By monitoring these behaviors, staff can intervene promptly to prevent harm and provide necessary support. Ensuring safety is a fundamental aspect of care in mental health settings, as it helps to stabilize the client and create a secure environment for their treatment and recover.

Choice B Reason:

Indulging the client’s wishes is not a recommended approach when dealing with self-destructive behavior. While it is important to understand and validate the client’s feelings, indulging their wishes can reinforce negative behaviors and hinder their progress towards healthier coping mechanisms. Instead, staff should focus on providing appropriate interventions and support that address the underlying issues contributing to the self-destructive behavior. This approach helps the client develop more constructive ways of meeting their needs and managing their emotions.

Choice C Reason:

While self-destructive behavior may provide a temporary outlet for feelings of anger and frustration, it is not a healthy or sustainable way to cope with these emotions. Encouraging or allowing such behavior can lead to further harm and exacerbate the client’s mental health issues. Staff should work with the client to identify and implement healthier coping strategies that effectively address their emotional needs without causing harm. This can include therapeutic interventions, counseling, and skills training to help the client manage their anger and frustration in more constructive ways.

Choice D Reason:

Assuming responsibility for the client’s behavior is not an effective way to reduce their anger and anxiety. In fact, it can create a dependency on staff and prevent the client from developing their own coping skills and sense of autonomy. It is important for staff to support the client in taking responsibility for their actions and learning how to manage their emotions independently. This empowerment is a key component of the therapeutic process and contributes to the client’s long-term recovery and well-being.

Correct Answer is ["5"]

Explanation

Step 1: Determine the concentration of Heparin in units per mL. 25,000 units ÷ 250 mL = 100 units per mL Result: 100

Step 2: Determine the rate in mL per hour needed to deliver 500 units per hour. 500 units ÷ 100 units per mL = 5 mL per hour Result: 5 mL per hour

The nurse should set the infusion pump to deliver at a rate of 5 mL per hour.

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A client presents to the Emergency Department (ED) after ingesting phencyclidine (PCP). Characteristic behaviors of an individual who has ingested PCP include:

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Naxlex Comprehensive Predictor Exams

When a client with a personality disorder uses self-destructive behavior as a way of getting needs met, the staff observe the behavior closely because:

Correct Answer is A

Explanation

A client is to receive a continuous Heparin infusion at s00 units per hour. Pharmacy supplies Heparin in a concentration of 25,000 units per 250mL of NSS. Calculate the rate at which the nurse should set the infusion pump.

Correct Answer is ["5"]

Explanation

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