A nurse is performing an admission assessment for a client who is receiving treatment following a situational crisis. Which of the following assessments by the nurse is the highest priority?

Determining if the client has psychotic thinking

Asking the client to identify the cause of the crisis

Identifying the client's coping skills

identifying the client's support systems

Answer and Explanation

The Correct Answer is A

The highest priority assessment in this situation is to determine if the client has psychotic thinking. Psychotic thinking can indicate a severe mental health condition that requires immediate attention and intervention. If the client is experiencing psychotic symptoms, they might be at risk of harming themselves or others. Identifying and addressing psychotic thinking is crucial to ensure the safety and well-being of the client and those around them.

B. Asking the client to identify the cause of the crisis.

While understanding the cause of the crisis is important for providing appropriate care, it is not the highest priority. Psychotic thinking or risk of harm takes precedence over understanding the cause.

C. Identifying the client's coping skills.

Coping skills are important for managing the crisis and promoting the client's well-being, but assessing for psychotic thinking and immediate safety concerns comes before evaluating coping skills.

D. Identifying the client's support systems.

Support systems are valuable for the client's overall recovery, but they are not as time-sensitive as assessing for psychotic thinking or imminent safety risks. Identifying support systems can come after addressing the immediate concerns.

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Correct Answer is ["2"]

Explanation

The nurse should administer 2 tablets of olanzapine 10 mg orally-disintegrating tablets per dose.

Here's the calculation:

20 mg (desired dose) ÷ 10 mg (strength of each tablet) = 2 tablets

So, the nurse should administer 2 tablets of olanzapine 10 mg orally-disintegrating tablets per dose.

A. Low self-esteem B. Irritability C. Chronic pain D. Insomnia E. Euphoria

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

Explanation

A. Low self-esteem is a risk factor for depression because negative self-perception and feelings of worthlessness can contribute to the development of depressive symptoms.

B. Irritability is associated with depression, especially in adolescents. It can manifest as a mood symptom and is often seen alongside other depressive features.

C. Chronic pain can be both a symptom and a risk factor for depression. Persistent pain can lead to changes in mood, behavior, and physical function, contributing to the development of depressive symptoms.

D. Insomnia, or difficulty sleeping, is a common symptom of depression and can also be a risk factor. Sleep disturbances are often seen in individuals with depression, and they can contribute to the severity of the condition.

E. Euphoria is not a risk factor for depression. In fact, it is more commonly associated with conditions like bipolar disorder, where individuals experience periods of elevated mood (mania or hypomania) alternating with periods of depression.

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A nurse is performing an admission assessment for a client who is receiving treatment following a situational crisis. Which of the following assessments by the nurse is the highest priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer olanzapine 20 mg PO daily. Available is olanzapine 10 mg orally disintegrating tablets. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["2"]

Explanation

A nurse is caring for an adolescent who is experiencing indications of depression. Which of the following findings are risk factors of depression? (Select all that apply.)

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

Explanation

A nurse is making a home visit to a client who has Alzheimer's disease and the client's partner. Which of the following observations indicates to the nurse that the partner is experiencing caregiver role strain?

A nurse is preparing to administer clozapine 300 mg PO daily to a client who has schizophrenia. The amount available is clozapine 200 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.l

A nurse is caring for a client who has been diagnosed with obsessive compulsive disorder (OCD) and is constantly picking up after others in the day room. The nurse should recognize that the client uses this behavior to do which of the following?

A nurse who works in a psychiatric unit is caring for a client who has bipolar disorder. The client comes to the nurse's station at 0300 demanding that the nurse call the provider immediately. Which of the following responses by the nurse is appropriate?

A nurse in a psychiatric unit is caring for several clients. Which of the following clients should the nurse recommend for group therapy?

A nurse is teaching a client who has a new prescription for chlorpromazine. Which of the following client statements indicates an understanding of the teaching?

A nurse observes that a client who has depression is sitting alone in the room crying. As the nurse approaches, the client states, "I'm feeling really down and don't want to talk to anyone right now." Which of the following responses should the nurse make?