Exhibits

A nurse is assessing a client who has schizophrenia. Which of the following findings should the nurse report to the provider? (Click on the “Exhibit” button for additional information about the client. There are three tabs that contain separate categories of data.)

Hallucinations

Temperature

Weight gain

Blood pressure

Answer and Explanation

The Correct Answer is B

Choice A Reason: Hallucinations are a common symptom of schizophrenia and may not require immediate reporting to a provider unless they represent a change from the patient’s baseline or are causing distress.
Choice B Reason: The client’s temperature of 39.4° C (103° F) is significantly higher than the normal body temperature range of 36.5° C to 37.5° C (97.7° F to 99.5° F). This indicates a fever, which could suggest an infection or another acute health issue that requires immediate attention.
Choice C Reason: While weight gain is a concern for patients with schizophrenia, especially due to the potential side effects of medications like olanzapine, it is not typically an acute issue requiring immediate reporting unless it is rapid and significant, which could indicate other health problems.
Choice D Reason: The client’s blood pressure reading of 128/82 mm Hg falls within the normal range for adults, which is less than 120/80 mm Hg for normal blood pressure. Therefore, it does not need to be reported urgently.

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

Explanation

Choice A Reason: Vital signs are a critical indicator of a patient’s health status. Normal ranges for vital signs in a resting adult include a body temperature of 97.8°F to 99.1°F (36.5°C to 37.3°C), blood pressure between 90/60 mmHg and 120/80 mmHg, a pulse rate of 60 to 100 beats per minute, and a respiratory rate of 12 to 18 breaths per minute. The client’s vital signs have stabilized from the initial erratic readings to within normal ranges by hospital day 5, indicating a positive response to the treatment plan.
Choice B Reason: Movement through the stages of grief is essential for emotional recovery, especially in the context of alcohol use disorder where the grief may have triggered the relapse. The stages of grief include denial, anger, bargaining, depression, and acceptance. Progress in these stages can be a sign of emotional healing and a successful coping mechanism in the recovery process.
Choice D Reason: Participation in group therapy is a key component of substance use disorder treatment. It provides social support, reduces isolation, and helps develop effective communication and interpersonal skills3. Active participation in group therapy sessions indicates the client’s engagement with the treatment process and their commitment to recovery.
Choice E Reason: Appetite changes are common during recovery from alcohol use disorder. Initially, there may be a loss of appetite due to the effects of alcohol on the gastrointestinal system and overall health. However, as recovery progresses, appetite usually returns, and the individual may even overeat5. An improvement in appetite suggests that the client’s physical health is improving and that they are regaining a normal relationship with food.

Choice C Reason: Cognition refers to the mental processes involved in gaining knowledge and comprehension, including thinking, knowing, remembering, judging, and problem-solving. These are higher-level functions of the brain and encompass language, imagination, perception, and planning. A person’s cognitive ability can be affected by alcohol use disorder, as alcohol can impair cognitive functions and damage brain structures. However, recovery from alcohol abuse can lead to improvements in cognitive functions. Research indicates that most noticeable improvement in cognitive function begins after one year of abstinence from alcohol. Therefore, if the client shows signs of improved cognition, such as better memory, clearer thinking, or improved problem-solving, it would indicate progress in their recovery.
Choice F Reason: The client’s resolve to limit alcohol consumption is a significant indicator of their commitment to long-term recovery. Setting limits on alcohol intake is a crucial step in the process of recovery and can help prevent relapse. For men, moderate drinking is defined as up to two drinks per day and for women, up to one drink per day3. If the client expresses a desire to limit their alcohol consumption to within these guidelines, or better yet, abstains from alcohol completely, it would demonstrate a positive change in behavior and mindset towards their health and recovery.

A. "You should administer the medication immediately before bedtime." B. "The provider will gradually decrease the dose as the disease improves." C. "This medication stops the progression of early Alzheimer's disease." D. "Your partner is at a decreased risk for falls while taking donepezil."

Correct Answer is A

Explanation

Choice A reason: Donepezil is often administered before bedtime to reduce the risk of nausea, which is a common side effect. Taking it at bedtime can also coincide with the body's natural rest period, potentially minimizing the impact of any side effects.

Choice B reason: Alzheimer's disease is a progressive condition, and currently, there is no cure. The provider will not decrease the dose as the disease improves because the disease typically worsens over time. Medication management may change, but it is based on symptom control, not improvement of the disease.

Choice C reason: Donepezil does not stop the progression of Alzheimer's disease. It can help manage symptoms and improve quality of life, but it does not cure or halt the disease's progression.

Choice D reason: Donepezil does not decrease the risk of falls. In fact, some of its side effects, such as dizziness, may increase the risk of falls. It is important for caregivers to monitor their partners for such side effects and take precautions to prevent falls.

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Exhibits A nurse is assessing a client who has schizophrenia. Which of the following findings should the nurse report to the provider? (Click on the “Exhibit” button for additional information about the client. There are three tabs that contain separate categories of data.)

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the day 5 vital signs. Exhibits A nurse is evaluating the client’s response to treatment. Select the 4 findings that indicate the client is progressing with their plan of care.

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

Explanation

A nurse is providing teaching to the partner of a client who has Alzheimer's disease and a new prescription for donepezil. Which of the following pieces of information should the nurse include?

Correct Answer is A

Explanation

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Exhibits

A nurse is assessing a client who has schizophrenia. Which of the following findings should the nurse report to the provider? (Click on the “Exhibit” button for additional information about the client. There are three tabs that contain separate categories of data.)