A mental health nurse is planning care for a client who has a new prescription for clonazepam. For which of the following adverse effects should the nurse plan to monitor?
Manifestations of seizure activity.
Decreased urine output.
Inability to recall events.
Increase in white blood cell count.
The Correct Answer is C
Choice A rationale:
Manifestations of seizure activity are not a common adverse effect of clonazepam. In fact, clonazepam is often used to treat seizures. It is a benzodiazepine that works by decreasing abnormal electrical activity in the brain.
While it is possible for clonazepam to worsen seizures in some individuals, this is not a typical response. Therefore, it is not the most important adverse effect for the nurse to monitor.
Choice B rationale:
Decreased urine output is not a known adverse effect of clonazepam.
Some medications can affect kidney function and urine output, but clonazepam is not one of them. Therefore, it is not necessary for the nurse to monitor urine output in a client taking clonazepam. Choice C rationale:
Inability to recall events, also known as amnesia, is a common adverse effect of clonazepam.
Clonazepam can impair short-term memory, making it difficult for people to remember things that happened recently.
This can be a significant problem for clients who need to be able to recall important information, such as instructions from their healthcare providers.
Therefore, it is important for the nurse to monitor clients taking clonazepam for signs of amnesia.
Choice D rationale:
An increase in white blood cell count is not a known adverse effect of clonazepam. In fact, clonazepam can sometimes cause a decrease in white blood cell count.
However, this is a rare side effect and is not typically something that the nurse would need to monitor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale: A 13-year-old girl worrying about a pimple on her face is a common concern at this age. Adolescence is a time of significant physical changes, including the onset of acne. While this can cause distress and affect self-esteem, it is not as immediate a concern as some of the other options.
Choice B rationale: Menarche, or the onset of menstruation, typically occurs around the age of 12-14, but it can vary widely. Some girls may start their periods as early as 9 or as late as 16. This girl’s concern about not having started her period yet, while valid, is not unusual or immediately concerning given her age.
Choice C rationale: Feeling like one’s parents are treating them like a baby is a common sentiment among adolescents who are striving for more independence. It’s a normal part of the developmental process and, while it can cause conflict and frustration, it is not an immediate concern.
Choice D rationale: This statement indicates that the girl is feeling socially isolated, which can be a sign of social problems or mental health issues such as depression or anxiety. Social relationships and a sense of belonging are crucial for mental health, particularly during adolescence. This should be the nurse’s priority to address.
Please note that these rationales are based on general knowledge and understanding of adolescent development and mental health. For a more accurate and detailed explanation, it would be best to consult with a healthcare professional or refer to trusted health resources.
Correct Answer is D
Explanation
Choice A: Limit the amount of time available to interact with others
While the client's behavior may indirectly limit their interactions with others by occupying their time, this is not the primary function of their actions. The core motivation lies in reducing anxiety, not social avoidance.
Choice B: Manipulate and control others' behaviors
Although the client's cleaning may influence others to tidy up, this is not a deliberate attempt to control their behavior. The primary drive stems from the client's internal need for order and cleanliness, not a desire to dictate the actions of others.
Choice C: Focus attention on meaningful tasks
While the act of cleaning can be productive and contribute to a pleasant environment, it's not the primary function or intention behind the client's behavior. Their actions are primarily driven by the need to quell anxiety, not necessarily to accomplish meaningful tasks.
Choice D: Decrease anxiety to a tolerable level
This is the most accurate rationale for the client's behavior. Individuals with OCD engage in compulsions, like excessive cleaning, to alleviate the intense anxiety associated with their intrusive thoughts and obsessions. In this case, the act of picking up after others provides the client with a sense of order and control, thereby reducing their anxiety to a manageable level.
Elaboration:
Obsessive-compulsive disorder (OCD) is a mental health condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). Individuals with OCD experience significant anxiety due to their obsessions and feel compelled to engage in compulsions to manage that anxiety.
In the scenario presented, the client's constant cleaning behavior likely stems from an obsession with order and cleanliness. This obsession triggers anxiety when the environment is perceived as messy or disorderly. The act of picking up after others serves as a compulsion, a ritualistic behavior performed to reduce the anxiety caused by the obsession. By restoring order and cleanliness, the client temporarily alleviates their anxiety and achieves a sense of control over their environment.
It's important to recognize that the client's cleaning behavior, while seemingly productive, is primarily driven by their internal need to manage anxiety, not by a genuine desire to help others or maintain a tidy environment. This understanding is crucial for the nurse to effectively support the client and guide them towards healthier coping mechanisms for managing their OCD symptoms.
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