A nurse is reviewing the medical record of a client.
The client is an 18-year-old admitted to an inpatient psychiatric unit after passing out at home. The client reports using laxatives and "making myself throw up after eating" for about 6 months.
After reviewing the client's medical record and new diagnostic results, the nurse determines the client is at risk for further health issues.
The client is at risk for developing which of the following?

Hypomagnesemia

Renal failure

Heart failure

Hyperthyroidism.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

The client’s reported behavior of using laxatives and inducing vomiting after eating can lead to a condition known as hypomagnesemia. Hypomagnesemia is a condition characterized by low levels of magnesium in the blood. This condition can be caused by poor intake, excessive loss, or movement of magnesium from the blood into less accessible locations. The use of laxatives can lead to excessive loss of magnesium through increased bowel movements. Similarly, self-induced vomiting can also result in a loss of magnesium. Therefore, the client’s behavior puts them at risk for developing hypomagnesemia.

Choice B rationale:

Renal failure, also known as kidney failure, occurs when the kidneys lose their ability to filter waste products from the blood. While the use of laxatives and self-induced vomiting can lead to dehydration, which can strain the kidneys, these behaviors are not directly associated with renal failure. Therefore, while it’s possible for the client to develop kidney problems, it’s less likely compared to hypomagnesemia.

Choice C rationale:

Heart failure occurs when the heart muscle doesn’t pump blood as well as it should. This condition can cause symptoms like shortness of breath, swelling, fatigue, and other symptoms. While severe electrolyte imbalances, such as those that might result from the use of laxatives and self-induced vomiting, can affect heart function, they would typically result in arrhythmias (irregular heartbeats) rather than heart failure. Therefore, it’s less likely for the client to develop heart failure based on the behaviors described.

Choice D rationale:

Hyperthyroidism is a condition where the thyroid gland produces and releases too much thyroid hormone. This condition can cause symptoms like rapid heartbeat, weight loss, and anxiety. The client’s behaviors of using laxatives and inducing vomiting after eating do not directly influence the production of thyroid hormones. Therefore, it’s less likely for the client to develop hyperthyroidism based on the behaviors described.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

Choice A rationale:

While a client's unwillingness to accept treatment can be a challenge, it does not, in and of itself, meet the criteria for involuntary hospitalization beyond the initial 72-hour hold.

Forced treatment without a clear and imminent risk of harm can violate a patient's autonomy and rights.

It's crucial for healthcare professionals to balance a patient's right to self-determination with the need to protect individuals from harm.

Choice B rationale:

A client's plan to move out of state, even if it's considered a disruptive decision, does not constitute grounds for involuntary hospitalization.

Individuals have the right to freedom of movement and to make choices about their life, even if those choices are perceived as unwise or problematic.

Choice C rationale:

This is the correct answer because it aligns with the fundamental principle of involuntary hospitalization: to protect individuals who pose a serious risk of harm to themselves or others due to a mental health condition.

This rationale is rooted in the ethical and legal obligation to prevent harm and ensure public safety.

Choice D rationale:

A client's dislike of a neighbor is not a valid reason for involuntary hospitalization. Personal opinions or feelings, even if negative, do not automatically translate into a risk of harm that would justify involuntary confinement.

A. "St. John's wort can be used to treat severe depression." B. "St. John's wort can lower prostate-specific antigen levels." C. "St. John's wort increases estrogen levels in the body." D. "St. John's wort can reduce the effectiveness of oral contraceptives.".

Correct Answer is D

Explanation

The correct answer is choice d. “St. John’s wort can reduce the effectiveness of oral contraceptives.”

Choice A rationale:

St. John’s wort is commonly used to treat mild to moderate depression. It has been shown to be effective in alleviating symptoms of depression, likely due to its impact on neurotransmitters like serotonin.

Choice B rationale:

There is no evidence to suggest that St. John’s wort can lower prostate-specific antigen (PSA) levels. PSA levels are typically monitored for prostate health, and St. John’s wort does not have an impact on these levels.

Choice C rationale:

St. John’s wort does not increase estrogen levels in the body. It primarily affects neurotransmitters and has no known effect on hormone levels.

Choice D rationale:

St. John’s wort can indeed reduce the effectiveness of oral contraceptives. It induces certain liver enzymes that can increase the metabolism of contraceptive hormones, thereby reducing their effectiveness and increasing the risk of unintended pregnancy.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a psychiatric unit is admitting a client who attacked a neighbor.The nurse should know that the client can be kept in the hospital after the 72-hour hold is over for which of the following conditions?

Correct Answer is C

Explanation

A nurse is teaching a group of clients about St. John's wort. Which of the following pieces of information should the nurse include in the teaching?

Correct Answer is D

Explanation

A nurse in a mental health unit is admitting a female client who has anorexia nervosa. The admission vital signs are as follows: Heart rate 52/min, Respiratory rate 26/min, Blood pressure 84/50 mm Hg, Temperature 36.1C(97F). The nurse should first address the client's:

A mental health nurse is caring for a client who has schizophrenia and generalized anxiety disorder (GAD). The client has a prescription for lorazepam 2 mg PO every 6 hr PRN anxiety.For which of the following client statements should the nurse consider administering lorazepam?

A nurse is preparing to administer amantadine 150 mg PO every 12 hr. The available medication is amantadine 50 mg/5 mL syrup. How many mL should the nurse administer per dose?

A nurse is making a home visit for a 16-year-old adolescent who attempted suicide. Which of the following behaviors should alert the nurse that the adolescent still has suicidal intent?

A nurse is caring for a client who requires a crisis intervention for acute anxiety. Which of the following actions should be the nurse's highest priority?

A nurse is preparing to administer diphenhydramine 50 mg PO every 6 hr to a client who has acute dystonia. The available medication is diphenhydramine 25 mg tablets. How many tablets should the nurse administer per dose?

A nurse on an acute mental health unit is caring for a group of clients. For which of the following clients is seclusion contraindicated?

A client who has coronary artery disease tells the nurse he is afraid of dying from a heart attack. Which of the following responses should the nurse make?