A nurse is collecting data from a client who reports feeling stress. Which of the following should the nurse identify as an external stressor?

Recurring urinary tract infections

A recent move to a new city

Lack of nutritional knowledge

Report of feeling depressed

Answer and Explanation

The Correct Answer is B

A.   Incorrect. Recurring urinary tract infections are related to health and hygiene and are not typically considered external stressors.
B.   Correct. A recent move to a new city is an external stressor because it is an environmental change that can lead to feelings of stress and adjustment.
C.   Incorrect. Lack of nutritional knowledge is an internal stressor related to the client's knowledge and awareness, not an external factor.
D.   Incorrect. Feeling depressed is an internal emotional state and is not an external stressor.

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Correct Answer is C

Explanation

A. Insert an oral airway into the client's mouth.Inserting anything into the client’s mouth during a seizure is contraindicated due to the risk of oral injury, aspiration, or causing airway obstruction.

B. Lower the side rails of the bed when the seizure begins.Lowering the side rails is inappropriate and increases the risk of the client falling out of bed and sustaining an injury. Instead, the nurse should ensure padded side rails are in place or protect the client by cushioning their head and limbs if side rails are not padded.

C. Measure the duration of the seizure.It is critical to measure the duration of a seizure to provide accurate information to the healthcare team. The duration helps determine the severity of the seizure and the need for medical interventions, such as administering medications to stop prolonged seizures (status epilepticus).

D. Restrain the client's arms and legs to prevent injury.Restraint during a seizure is inappropriate and can cause musculoskeletal injuries. The nurse should allow the seizure to run its course while ensuring the client’s safety.

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"C"}

Explanation

The client likely suffered from intoxication as evidenced by hypokinesia.

Intoxication from substances such as opioids can lead to a range of symptoms including sedation and altered mental status. In this case, the presence of a needle in the antecubital space and the administration of naloxone suggest opioid use.

Hypokinesia, characterized by reduced movement, aligns with the symptoms observed in opioid intoxication, such as decreased responsiveness and drowsiness. The historical pattern of sedation, miosis (constricted pupils), and mood alteration further supports the diagnosis of intoxication as the underlying condition.

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A nurse is collecting data from a client who reports feeling stress. Which of the following should the nurse identify as an external stressor?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client in bed and begins experiencing a tonic-clonic seizure. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is assisting with the care of a client. Exhibits The client likely suffered from dropdown as evidenced by dropdown

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"C"}

Explanation

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