A male client with a long history of alcohol dependency arrives in the Emergency Department describing the feeling of bugs crawling on his body. His blood pressure is 170/102 mm Hg, pulse rate is 110 beats/minute, and blood alcohol level (BAL) is 0 mg/dL. Which prescription should the nurse administer?

Haloperidol.

Lorazepam.

Diphenyhydramine.

Thiamine.

Answer and Explanation

The Correct Answer is B

A) Haloperidol is an antipsychotic that may be used for agitation or hallucinations, but it is not the first-line treatment for alcohol withdrawal symptoms. Administering haloperidol without addressing withdrawal may not be effective and could lead to further complications.

B) Lorazepam is a benzodiazepine and is the preferred medication for managing alcohol withdrawal symptoms, including agitation, anxiety, and hallucinations. It helps reduce the risk of severe withdrawal symptoms and seizures while providing sedative effects. Given the client’s symptoms of feeling bugs crawling on his body, which may indicate tactile hallucinations due to withdrawal, lorazepam would be the most appropriate choice.

C) Diphenhydramine is an antihistamine that can be used for allergic reactions or as a sedative, but it is not effective for managing alcohol withdrawal symptoms.

D) Thiamine is important to prevent Wernicke's encephalopathy in clients with a history of alcohol dependency, especially if there are signs of confusion or neurological deficits. However, it does not address the immediate symptoms of withdrawal the client is experiencing.

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Correct Answer is B

Explanation

A) Advising the client to reschedule until committing to recovery may come across as dismissive and could discourage the client from making positive changes. It’s important to support any intention to improve rather than setting conditions that might lead to feelings of failure or frustration.

B) Supporting the client to list small behavioral changes needed is the best response. This approach empowers the client by encouraging them to take manageable steps toward their goals. Focusing on small changes can enhance the client's confidence and motivation, making the process of leading a healthier lifestyle more achievable.

C) Explaining the specific skills needed to prevent relapse is important, but it may be overwhelming for the client at this stage. The focus should be on fostering a sense of hope and readiness for change rather than diving immediately into complex relapse prevention strategies.

D) Providing teaching on the symptoms of substance use dependence might be relevant, but it may not directly support the client's desire for change. The client is expressing a wish to move forward, so it’s more beneficial to focus on positive actions rather than reiterating the challenges of dependence. Supporting behavioral change aligns better with the client’s expressed intentions.

A. Administer a PRN analgesic to the client. B. Further assess the client's pain and vital signs. C. Ask if the client to compare this pain to the pain in the past. D. Remind the client that the symptoms are psychological in cause.

Correct Answer is B

Explanation

A) Administering a PRN analgesic may provide temporary relief but does not address the need for a comprehensive assessment of the client's condition. It is essential to understand the nature and cause of the chest pain before treating it.

B) Further assessing the client's pain and vital signs is the most appropriate action. This allows the nurse to gather important clinical information that can help determine whether the chest pain is related to a medical condition or is part of the somatic symptom disorder. A thorough assessment is critical in ensuring the client's safety and addressing any potential underlying health issues.

C) Asking the client to compare this pain to past pain can provide context but is not a priority action. The immediate focus should be on assessing the current situation rather than reflecting on past experiences.

D) Reminding the client that the symptoms are psychological in cause can be invalidating and may hinder the therapeutic relationship. It is crucial to approach the client with empathy and understanding, rather than dismissing their experience.

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Naxlex Comprehensive Predictor Exams

A client with opioid dependence makes a statement to the nurse about desiring to lead a healthier lifestyle by making changes in the next 2 weeks. How should the nurse respond?

Correct Answer is B

Explanation

A client with somatic symptom disorder reports experiencing chest pain to the nurse. Which action should the nurse take?

Correct Answer is B

Explanation

The nurse is admitting a client who has not slept in three days to the inpatient care facility. The client has pressured speech and describes an increase in sexual promiscuity. Which problem should the nurse include in the client's plan of care?

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A client with bipolar disorder has not slept or eaten in four days. The client is pacing and becomes increasingly agitated and loud while the nurse talks to the client's spouse. Which intervention is best for the nurse to implement at this time?

The nurse is preparing a client for discharge who has been taking alprazolam long-term for generalized anxiety disorder (GAD). When evaluating the client's understanding of the discharge teaching, which statement made by the client shows awareness of the most important self-care goal?

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