A college student brings a dorm roommate to the campus clinic because the roommate has been talking to someone who is not present. The client tells the nurse that the voices are saying, "Kill, kill." Which question should the nurse ask the client next?
"When did these voices begin?"
"Do you believe the voices are real?"
"Are you planning to obey the voices?"
"Have you taken any hallucinogens?"
The Correct Answer is C
It is important to determine if the client has any plans or intentions to act upon the voices' instructions. This information helps gauge the level of risk and guides further interventions and safety measures.
While the other questions may also be important to ask during the assessment, determining if the client believes the voices are real and when the voices began can provide valuable information about the client's perception and the duration of the symptoms. Asking about the use of hallucinogens is relevant to identify potential substance-induced causes of the hallucinations. However, assessing the client's intent and potential for harm is the priority in this situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Incorrect - While a salad includes vegetables and fruits, it may not provide sufficient protein for wound healing.
B) Incorrect - Vegetable soup and crackers might not provide enough protein compared to other options.
C) Incorrect - While a peanut butter sandwich includes some protein, soda and cookies are not rich sources of protein.
D) Correct- A tuna fish sandwich is a good source of protein. Protein is essential for wound healing as it supports tissue repair and regeneration. The choice of a tuna fish sandwich along with chips and ice cream suggests a balanced meal with adequate protein content, which aligns with the teaching of a high protein diet to promote wound healing.
Correct Answer is ["40"]
Explanation
To determine the amount of mL the child should receive per day, we need to calculate the total daily dose of ampicillin based on the prescription.
The prescription is for 500 mg of ampicillin four times a day, so the total daily dose is: 500 mg × 4 times = 2000 mg/day
The concentration of the suspension is 250 mg/5 mL, which means that there are 250 mg of ampicillin in every 5 mL.
To find out how many mL the child should receive per day, we divide the total daily dose by the concentration:
2000 mg ÷ 250 mg/5 mL = 40 mL/day
Therefore, the child should receive 40 mL of the ampicillin suspension per day.
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