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 D

Explanation

A. "You may experience muscle cramping from the induced seizure." While muscle stiffness is possible, the term "muscle cramping" might not accurately describe the postictal state after ECT.

B. "The most common adverse effects of ECT are related to anesthesia." While anesthesia is used during ECT, the most common adverse effects are related to the ECT procedure itself, such as confusion, memory loss, and headache.

C. "You should expect to have ECT once per week for 6 weeks." The frequency and duration of ECT treatments vary based on the individual's response and treatment plan. This statement provides a specific schedule that may not apply to all patients.

D. "You might feel a bit confused and disoriented when you first wake up." This statement accurately reflects a common and expected postictal effect of ECT. Patients undergoing ECT commonly experience confusion and disorientation upon awakening. This is a temporary and expected side effect of the treatment. It's important for the patient to be aware of this possibility as part of the informed consent process.

A. Set limits on the amount of time the client talks about delusions, B. Schedule a variety of competitive stimulating group activities for the client C. Tell the client that the delusions are not real D. Avoid asking the client about triggers for the delusions

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.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

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

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?

A nurse is caring for a client who reports a state of increasing anxiety and the inability to sleep and concentrate. Which of the following is an appropriate response by the nurse?

A nurse is caring for a client who witnessed her brother's homicide and has posttraumatic stress disorder (PTSD). Which of the following findings should the nurse expect?

A nurse is caring for a client who has paranoid schizophrenia and a new prescription for risperidone. The client asks the nurse what the s is supposed to do. Which of the following responses should the nurse make?

A nurse is caring for a client who has obsessive compulsive disorder (OCD) and is constantly picking up after others and cleaning in the day room. The nurse should recognize the client's actions as which of the following?

A nurse is collecting data from a newly-admitted client who has bipolar disorder and is displaying manic behavior. Which of the following findings should the nurse expect? (Select all that apply.)

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 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?