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.
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Correct Answer is C
Explanation
Choice A rationale:
While a client's unwillingness to accept treatment can be a challenge, it does not, in and of itself, meet the criteria for involuntary hospitalization beyond the initial 72-hour hold.
Forced treatment without a clear and imminent risk of harm can violate a patient's autonomy and rights.
It's crucial for healthcare professionals to balance a patient's right to self-determination with the need to protect individuals from harm.
Choice B rationale:
A client's plan to move out of state, even if it's considered a disruptive decision, does not constitute grounds for involuntary hospitalization.
Individuals have the right to freedom of movement and to make choices about their life, even if those choices are perceived as unwise or problematic.
Choice C rationale:
This is the correct answer because it aligns with the fundamental principle of involuntary hospitalization: to protect individuals who pose a serious risk of harm to themselves or others due to a mental health condition.
This rationale is rooted in the ethical and legal obligation to prevent harm and ensure public safety.
Choice D rationale:
A client's dislike of a neighbor is not a valid reason for involuntary hospitalization. Personal opinions or feelings, even if negative, do not automatically translate into a risk of harm that would justify involuntary confinement.
Correct Answer is D
Explanation
Rationale:
Choice A: While social isolation can be a risk factor for suicide, spending time with close friends can actually be protective. This statement alone does not suggest an increased risk.
Choice B: Religious involvement and participation in religious activities can be protective factors against suicide by providing support, meaning, and a sense of belonging. This statement does not indicate a specific risk.
Choice C: Consistent, healthy sleep patterns are generally associated with positive mental health and are not indicative of suicidal ideation. This statement does not raise concerns for suicide risk.
Choice D: Exposure to suicide, particularly within one's social circle or among individuals one admires, is a significant risk factor for suicide due to the phenomenon of "social contagion." The recent suicide of the adolescent's favorite actor increases his vulnerability and necessitates immediate assessment and intervention.
Social contagion refers to the tendency for suicidal behaviors to spread within a community or group, particularly among adolescents and young adults. Exposure to a suicide can trigger suicidal thoughts and feelings in vulnerable individuals, especially if they identify with the deceased or perceive the suicide as a viable coping mechanism.
The adolescent's age (15 years) is also a crucial factor. Adolescence is a period of heightened emotional vulnerability and increased risk for suicidal ideation and behavior due to various developmental and psychosocial challenges.
The father's concern suggests that the adolescent may be exhibiting other concerning behaviors or changes in mood or behavior. The nurse should gather more information and conduct a comprehensive suicide risk assessment to determine the level of risk and implement appropriate interventions.
Additional considerations:
The nurse should inquire about the nature of the adolescent's relationship with the deceased actor, his emotional state since the suicide, and any other potential stressors or vulnerabilities he may be facing.
The nurse should involve the parents in the assessment and intervention process, providing them with education and resources on suicide prevention and support.
If the assessment indicates a high risk of suicide, the nurse should immediately refer the adolescent to a mental health professional or emergency department for further evaluation and treatment.
Remember: Suicide is a serious public health issue, and early identification and intervention are crucial in preventing tragic outcomes. School nurses play a vital role in recognizing warning signs and providing timely support and resources to adolescents at risk.
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