A nurse in a mental health facility is reinforcing teaching to a newly licensed nurse about how to perform an Abnormal Involuntary Movement Scale (AIMS) test on a client. The charge nurse should identify that the AIMS test is used for which of the following conditions?

Lithium toxicity

Alcohol withdrawal

Tardive dyskinesia

Opiate withdrawal

Answer and Explanation

The Correct Answer is C

A. Lithium toxicity. The AIMS test does not assess lithium toxicity. Lithium toxicity is monitored through serum lithium levels and clinical symptoms such as tremors, nausea, confusion, and ataxia. Severe toxicity can lead to seizures, coma, and organ failure, requiring immediate intervention.
B. Alcohol withdrawal. The AIMS test does not assess alcohol withdrawal. Withdrawal symptoms include tremors, hallucinations, seizures, and autonomic instability. The Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) is commonly used to assess symptom severity and guide treatment.
C. Tardive dyskinesia. The AIMS test is used to assess tardive dyskinesia, a movement disorder caused by long-term antipsychotic use. It evaluates involuntary movements of the face, tongue, and extremities, helping clinicians monitor progression and adjust medications to minimize symptoms.
D. Opiate withdrawal. The AIMS test does not assess opiate withdrawal. Symptoms include sweating, agitation, diarrhea, and muscle aches. The Clinical Opiate Withdrawal Scale (COWS) is typically used to assess withdrawal severity and guide opioid detoxification or replacement therapy.

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Correct Answer is A

Explanation

A. "Avoid looking at other clients on the unit." Distractions reduce the quality of communication and make the client feel undervalued. Focusing on the client demonstrates attentiveness and encourages open dialogue. Looking at others while a client speaks may suggest disinterest. Giving full attention strengthens therapeutic relationships and supports effective listening.
B. "Interrupt the client's statement to clarify thoughts or ideas." Interrupting can disrupt the client’s thoughts and make them feel unheard. Active listening requires patience, allowing the client to speak fully before responding. Clarifications should be made after they finish to ensure understanding. Frequent interruptions may hinder trust and open communication.
C. "Show emotion when a client is disclosing sensitive information." While empathy is important, excessive emotional reactions can shift focus away from the client. A calm and composed demeanor helps maintain a supportive environment. Overreacting may make the client feel uncomfortable or hesitant to share. Active listening involves offering validation without overwhelming emotional responses.
D. "Keep direct eye contact to a minimum." Eye contact conveys attentiveness and respect, helping to establish rapport. Avoiding eye contact may make the client feel ignored or dismissed. However, excessive staring can be intimidating, so a balanced approach is best. Appropriate eye contact fosters trust and enhances communication.

A. Suspiciousness of others B. Requiring frequent reassurance from others C. Inflated sense of self D. Lack of feelings of remorse

Correct Answer is A

Explanation

A. Suspiciousness of others: Paranoid personality disorder is characterized by pervasive distrust and suspicion of others, leading to difficulty forming relationships. Clients may misinterpret benign actions as malicious and hold long-standing grudges.
B. Requiring frequent reassurance from others: This is more characteristic of dependent personality disorder, where individuals struggle with self-confidence and rely on others for decision-making and emotional support.
C. Inflated sense of self: This is commonly seen in narcissistic personality disorder, where individuals display grandiosity, a need for admiration, and a lack of empathy for others.
D. Lack of feelings of remorse: This trait is associated with antisocial personality disorder, where individuals exhibit disregard for the rights of others, manipulative behavior, and a lack of guilt or remorse for their actions.

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A nurse in a mental health facility is reinforcing teaching to a newly licensed nurse about how to perform an Abnormal Involuntary Movement Scale (AIMS) test on a client. The charge nurse should identify that the AIMS test is used for which of the following conditions?

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Correct Answer is A

Explanation

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