A nurse in a mental health clinic is assessing a client who was brought in by her adult daughter. The daughter states that her mother has not been able to leave her home for weeks because she is afraid to be outdoors alone. Which of the following phobias should the nurse anticipate planning care for managing?

Acrophobia

Xenophobia

Agoraphobia

Mysophobia

Answer and Explanation

The Correct Answer is C

Choice A reason: Acrophobia is the fear of heights, which is not indicated by the client's fear of being outdoors alone.

Choice B reason: Xenophobia is the fear of strangers or foreigners, which does not align with the client's described fear.

Choice C reason: Agoraphobia is the fear of open spaces or being in crowded, public places like markets. It also includes the fear of leaving a safe place, such as home, which aligns with the client's symptoms.

Choice D reason: Mysophobia is the fear of germs, which is not related to the fear of being outdoors alone.

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Correct Answer is B

Explanation

Choice A reason: Gastric lavage is typically not the first-line treatment for lithium toxicity due to the risk of aspiration and potential complications. It is usually reserved for cases where the ingestion was recent and massive.

Choice B reason: When a client presents with an extremely elevated lithium level, it is crucial to hold further doses to prevent exacerbation of toxicity. The nurse should monitor for early signs of toxicity, which include gastrointestinal symptoms like nausea, vomiting, diarrhea, and neurological symptoms such as tremors, confusion, and ataxia. The normal therapeutic range for lithium is 0.6 to 1.2 mmol/L, and levels above 1.5 mmol/L are considered toxic.

Choice C reason: While it is important to review the medication record, the immediate concern with an extremely elevated lithium level is addressing the toxicity. Checking the medication record can be part of the assessment process but is not the priority action.

Choice D reason: Administering the morning dose of lithium could worsen the client's condition by increasing the lithium level further, which is already extremely elevated. This could lead to severe toxicity or even fatal consequences.

A. The explosive episode does not provide a feeling of relief in the client. B. The spouse states that the client is mild-mannered and kind unless this occurs. C. After having an explosive anger episode, the client was embarrassed and apologetic. D. The client punched a hole in the wall and broke furniture during an episode. E. The spouse states that the anger arises from something that is not even a big issue.

Correct Answer is ["B","D","E"]

Explanation

Choice A reason: Not feeling relief after an explosive episode can indicate that the behavior is not a controlled release of tension, which is characteristic of intermittent explosive disorder.

Choice B reason: Being mild-mannered and kind does not necessarily indicate intermittent explosive disorder; this behavior could be part of a normal range of personality traits.

Choice C reason: Feeling embarrassed and apologetic after an episode is common in intermittent explosive disorder, as individuals often regret their actions.

Choice D reason: Physical aggression, such as punching walls and breaking furniture, is a key indicator of intermittent explosive disorder.

Choice E reason: Anger that is disproportionate to the situation, especially over minor issues, is a hallmark of intermittent explosive disorder.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has an extremely elevated lithium level. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A client and their spouse come to talk with the nurse about their suspicion that the client may have intermittent explosive disorder after researching it on the internet. Which behaviors reported by the spouse indicate that the client may be experiencing this disorder? (Select all that apply.)

Correct Answer is ["B","D","E"]

Explanation

The nurse is educating a client with alcoholism who has been in rehabilitation for two weeks to prepare for discharge. Which statement made by the client indicates that education was effective and the client is best prepared for discharge?

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