After being treated in the emergency department for an opioid overdose two weeks ago, a client arrives to an outpatient treatment clinic. During the admission interview with the nurse, the client denies having a problem with opioid addiction, but admits to gradually increasing the dosage. Which approach is best for the nurse to make?

Recommend substituting opioids with other pain medication.

Explore other coping stategies aside from using medications.

Provide a list of local Narcotics Anonymous meetings.

Explain that opioid abuse poses a great risk to life.

Answer and Explanation

The Correct Answer is B

A. Recommend substituting opioids with other pain medication: Simply switching to another pain medication without addressing underlying misuse behaviors may reinforce dependency. This overlooks the denial and psychological aspects of addiction.

B. Explore other coping strategies aside from using medications: This client-centered approach gently addresses the issue without direct confrontation. It encourages self-reflection, promotes healthy alternatives, and meets the client where they are in terms of readiness for change, which is essential in early recovery.

C. Provide a list of local Narcotics Anonymous meetings: Although this is useful, offering it during the first interaction with a client in denial may lead to resistance. Engagement and trust-building through conversation about alternatives are more effective initially.

D. Explain that opioid abuse poses a great risk to life: Providing factual information about risk can be helpful, but directly labeling it as abuse when the client is in denial may trigger defensiveness. It is more therapeutic to explore behaviors and build insight before confrontation.

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Correct Answer is C

Explanation

A. Suggest to the client that he take a walk: Allowing pacing might escalate the agitation or delusions, especially in a stimulating environment. This does not address the immediate need to reduce stimuli.

B. Use firmness and direct the client to sit for a while: Direct commands may increase the client's agitation or trigger a confrontation if the client feels threatened or challenged while delusional.

C. Move the client to a quiet place on the unit: Reducing environmental stimuli by relocating the client to a low-stimulation setting can help de-escalate the situation and prevent further loss of control.

D. Encourage the client to use the punching bag: Promoting physical aggression even if directed at an object may reinforce violent behavior and is inappropriate during acute delusional episodes.

A. Loperamide. B. Furosemide. C. Lactulose. D. Intravenous (IV) human albumin.

Correct Answer is C

Explanation

A. Loperamide: Although it treats diarrhea, loperamide would worsen ammonia buildup by reducing bowel transit time. It doesn’t address the underlying hepatic encephalopathy causing confusion in cirrhosis.

B. Furosemide: This loop diuretic is used to manage ascites or edema, not elevated ammonia. It doesn’t treat the neurological symptoms caused by hepatic encephalopathy or improve stool-based ammonia excretion.

C. Lactulose: Lactulose lowers serum ammonia by trapping it in the colon and promoting its excretion through diarrhea. It directly treats confusion related to hepatic encephalopathy, making it the most important intervention here.

D. Intravenous (IV) human albumin: Albumin helps restore oncotic pressure in cases of ascites or low serum protein but does not affect ammonia levels or mental status. It supports fluid balance, not toxin elimination.

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Naxlex Comprehensive Predictor Exams

The nurse notices that a male client is particularly delusional one afternoon. He begins to pace the floor and appears to be losing control of himself. Which intervention is best for the nurse to implement?

Correct Answer is C

Explanation

Correct Answer is C

Explanation

Exhibits The nurse reviews the prescriptions and plans initial steps for caring for the client. Click to indicate which interventions the nurse should perform to care for this client. Each row must have one response indicated.

An older adult client with a history of heart failure is admitted with influenza and requests assistance to sit up in bed to eat lunch. The nurse observes the unlicensed assistive personnel (UAP) wearing a gown and gloves to assist the client. Which action should the nurse take?

When performing suctioning for a client with a tracheostomy, which action should the nurse include?

The nurse assesses a client being treated for Herpes zoster (shingles). Which assessment(s) should the nurse include when evaluating the effectiveness of treatment? Select all that apply.

The nurse is setting up the equipment to assist with a sigmoidoscopy while the practical nurse (PN) positions the client in a flat prone position. Which action should the nurse implement?

The nurse is evaluating the effectiveness of the incentive spirometer implemented in the client's plan of care. Which outcome statement best describes the effectiveness of the incentive spirometer?