A nurse suspects the client is experiencing delirium. Which of the following assessment findings would support the nurse's suspicion?
A decreased level of consciousness with intermittent periods of hypervigilance.
A slow onset of confusion and agitation.
A decrease in the client's output and vital signs.
The symptoms have lasted longer than a month.
The Correct Answer is A
A. Delirium is characterized by a fluctuating level of consciousness, which can include periods of hypervigilance.
B. A slow onset of confusion and agitation is more characteristic of dementia rather than delirium.
C. A decrease in output and vital signs may indicate a different condition, but it is not specific to delirium.
D. Delirium is characterized by an acute onset and is typically short-lived, usually lasting days to weeks. Symptoms lasting longer than a month would suggest a different diagnosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Correct. These symptoms are indicative of opioid withdrawal. Opioid withdrawal symptoms include sweating (diaphoresis), goosebumps (piloerection), tremors, irritability, insomnia, and gastrointestinal symptoms like nausea and vomiting.
B) Incorrect. These symptoms are more indicative of withdrawal from substances like alcohol or benzodiazepines, rather than opioids.
C) Incorrect. These symptoms are not specific to opioid withdrawal and may be seen in various conditions.
D) Incorrect. This cluster of symptoms is not characteristic of opioid withdrawal.
Correct Answer is B
Explanation
A) Incorrect. While maintaining proper nutrition is important, this statement is not directly related to the use of risperidone.
B) Correct. Risperidone, an atypical antipsychotic, can be associated with metabolic side effects, including hypertension. Therefore, monitoring blood pressure is important.
C) Incorrect. While regular monitoring of blood parameters may be necessary for some medications, it is not a specific requirement for risperidone.
D) Incorrect. While weight changes can occur with risperidone, there is no specific indication to increase caloric intake in this context.
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