A patient admitted for injuries sustained while intoxicated has been hospitalized for 48 hours. The patient is now shaky, irritable, anxious, and diaphoretic and reports nightmares. The pulse rate is 130 beats/minute. The patient shouts, "Bugs are crawling on my bed. I've got to get out of here." Select the most accurate assessment of this situation. The patient
is attempting to obtain attention by manipulating staff.
has symptoms of alcohol withdrawal delirium.
may have sustained a head injury before admission.
is having an acute psychosis.
The Correct Answer is B
A. The patient’s symptoms are physiological and neurological, not intentional behaviors for attention.
B. Alcohol withdrawal delirium (delirium tremens) typically occurs 48–72 hours after the last drink and includes tremors, agitation, anxiety, diaphoresis, tachycardia, hallucinations, and nightmares—all present in this patient.
C. Although head injury can cause confusion and agitation, the timing of symptoms following alcohol withdrawal aligns more closely with delirium tremens.
D. Acute psychosis can present with hallucinations, but in this case, the onset following alcohol cessation and accompanying autonomic hyperactivity point toward alcohol withdrawal delirium.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Key features include severe weight loss, distorted body image, restrictive eating, and preoccupation with food (e.g., cooking for others but eating very little). Wearing loose layers to hide weight is also typical.
B. This disorder involves recurrent episodes of eating large amounts of food, often rapidly, which is not described here.
C. This category is used when symptoms do not fully meet criteria for anorexia or bulimia; the patient’s presentation fits anorexia nervosa criteria.
D. Bulimia involves bingeing and compensatory behaviors like vomiting or laxative use; no binge episodes are described in this case.
Correct Answer is C
Explanation
A. Thyroid function tests are not routinely required for valproate therapy; this applies more to lithium therapy.
B. A pretreatment EEG is not necessary before starting valproate; it is used primarily for seizure evaluation.
C. Valproate can cause hepatotoxicity, so monitoring liver function tests (LFTs) before and during therapy is essential for safety.
D. High serum sodium levels are not related to valproate toxicity; this concern is associated with lithium therapy, not valproate.
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