A nurse is caring for a client who was recently diagnosed with an opioid use disorder. They were a student in a local community college but were recently dismissed for failing their classes. Their previous diagnoses include anxiety. Crohn's disease, and chronic back pain due to a gymnastics injury in high school Which of the following should the nurse identify as potential underlying reasons why the client might have started using opioids?

To treat hallucinations and perform better at work

Because they witnessed their parents using drugs or alcohol to cope

To promote sleep and rest

To treat pain and ease anxiety

Answer and Explanation

The Correct Answer is D

A. Using opioids to treat hallucinations is not a common reason, as opioids are not typically prescribed for this purpose. Hallucinations might be indicative of another underlying mental health condition that needs assessment and appropriate treatment.

B. Witnessing parents using drugs or alcohol to cope is a risk factor for substance use disorders, but it does not directly explain the client's initiation of opioid use. There may be other contributing factors, such as pain or anxiety.

C. Using opioids to promote sleep and rest is a possibility, especially if the client has chronic pain or anxiety affecting their sleep. Opioids can have sedative effects, which might be appealing to individuals experiencing sleep difficulties. However, treating pain and anxiety is often a primary reason for opioid use in such cases.

D. To treat pain and ease anxiety.
Chronic back pain due to a gymnastics injury and anxiety are identified as pre-existing conditions. The client may have started using opioids to manage chronic pain and potentially as a way to cope with anxiety. Opioids are often prescribed for pain relief, and individuals may misuse them to self-medicate emotional distress.

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Correct Answer is A

Explanation

A. Set limits on the amount of time the client talks about delusions.Clients with paranoid delusions may fixate on them, increasing distress and reinforcing their beliefs. The nurse should allow the client to express feelings but set limits on discussions about delusions to help refocus on reality-based topics.

B. Schedule a variety of competitive stimulating group activities for the client.Competitive activities can increase stress and paranoia in a client with schizophrenia. Instead, the nurse should encourage structured, low-stimulation activities like drawing or walking.

C. Tell the client that the delusions are not real. Directly challenging the delusions can increase defensiveness and mistrust.

D. Avoid asking the client about triggers for the delusions. Identifying triggers can help prevent or manage delusional episodes. The nurse should gently explore what makes the client feel more paranoid or anxious to develop coping strategies.

A. Sodium level B. Blood pressure C. Respiratory rate D. Capillary refill E. Glucose level F. Phosphate level G. Magnesium level

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

Explanation

A. Sodium level: Correct. Sodium imbalances can have serious consequences, including neurological symptoms. Hyponatremia is a common electrolyte imbalance seen in anorexia nervosa.

B. Blood pressure: Correct. Abnormal blood pressure, especially low blood pressure, can indicate cardiovascular compromise, which is a concern in severe cases of anorexia nervosa.

C. Respiratory rate: Not selected. While monitoring respiratory rate is important, the client's pallor and capillary refill suggest potential issues with peripheral perfusion, making capillary refill more urgent.

D. Capillary refill: Correct. Prolonged capillary refill time is a measure of peripheral perfusion and may indicate poor tissue perfusion, requiring immediate attention.

E. Glucose level: Not selected. While monitoring glucose levels is important, hypoglycemia might not be an immediate concern in this scenario. The client's neurological symptoms may be more related to electrolyte imbalances.

F. Phosphate level: Not selected. Monitoring phosphate levels is important, but severe abnormalities may not require immediate follow-up unless other critical issues are addressed first.

G. Magnesium level: Not selected. Magnesium imbalances are significant but may not require immediate follow-up unless severe abnormalities are noted.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an acute care mental health facility is contributing to the plan of care for a client who is newly diagnosed with schizophrenia and is verbalizing paranoid delusions. Which of the following interventions should the nurse include in the plan?

Correct Answer is A

Explanation

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

Explanation

A nurse overhears a client who has schizophrenia talking to herself. The client keeps stating "The muxtranks are coming. The muntranks are coming. The nurse correctly recognizes the client's use of the word mazuka as an example of which of the following alterations in speech?

A nurse is caring for a client who has been brought to the emergency department and is experiencing acute fentanyl toxicity. The nurse should expect to observe which of the following adverse effects in this client?

A nurse is reinforcing teaching with a client who is scheduled to receive electroconvulsive therapy (ECT). Which of the following statements should the nurse include in the teaching?

A nurse is caring for a client who has schizophrenia. Exhibits Select the "3" findings that should indicate to the nurse the client is experiencing negative symptoms related to their schizophrenia.

As part of the plan of care for a client with borderline personality disorder, the nurse reviews the day's schedule with him each morning. While doing so, the client states. "Why don't you shut up already! I can read it myself, you know!" Which of the following is an appropriate nursing response?

A nurse is assisting in the development of a community education course about the physical complications related to substance use disorder. Which of the following complications should the nurse include in the discussion about heroin use?

A nurse is caring for a client who is threatening to commit suicide, which of the following questions should the nurse ask?

A nurse is talking with a client who has schizophrenia. Suddenly the client states, "I'm frightened. Do you hear that? The voices are telling me to do terrible things." Which of the following responses by the nurse is appropriate?