Exhibits
Select from the options to complete the sentence.
After listening to the client's symptoms, the nurse realizes that she likely has
The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"D"}
After listening to the client's symptoms, the nurse realizes that she likely has acute stress disorder related to traumatic stress
Acute Stress Disorder: This diagnosis fits because the client is experiencing significant distress and anxiety related to the traumatic event (her house collapsing during a hurricane). Acute stress disorder is characterized by intrusive thoughts, nightmares, flashbacks, and avoidance behaviors following exposure to a traumatic event. The client's symptoms of persistent thoughts about the event, difficulty sleeping due to these thoughts, and feeling unable to return to her previous emotional state ("funk") are indicative of acute stress disorder.
Traumatic Stress: This describes the source of the client's symptoms. The collapse of her house during a hurricane is a traumatic event that has triggered her acute stress disorder symptoms. Traumatic stress refers to the psychological and emotional response to a deeply distressing or disturbing event.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","G","H"]
Explanation
A. Assessing temperature is important to monitor for any signs of infection or inflammation, which could exacerbate the asthma condition or indicate a concurrent illness.
B. Evaluating breath sounds helps determine the effectiveness of the albuterol treatment in relieving bronchospasm. Clearer breath sounds suggest improved air entry and reduced wheezing.
C. While CBC can provide valuable information, it is not typically immediately necessary after an albuterol treatment unless there are specific concerns about infection or other systemic issues.
D. Monitoring the heart rate is crucial as albuterol can cause tachycardia (elevated heart rate) as a side effect. It's important to ensure that the heart rate does not become excessively elevated, which may indicate a need to adjust treatment or monitor more closely.
E. Peak inspiratory flow is less commonly used in asthma management compared to peak expiratory flow. It's the maximum flow rate during inhalation and is not typically assessed routinely in the immediate post-treatment period.
F. Assessing serum sodium is not directly related to monitoring asthma exacerbation or response to bronchodilator therapy.
G. PEF measures the maximum speed at which a person can exhale air after a deep breath. It is a direct indicator of lung function and the severity of airway obstruction in asthma. Assessing PEF post-albuterol treatment helps gauge how well the airways have responded to the bronchodilator therapy.
H. Checking oxygen saturation ensures that the patient's oxygen levels have improved following the administration of albuterol. The goal is to maintain oxygen saturation above 94%, as per the treatment plan.
Correct Answer is B
Explanation
Rationale
A. Benzodiazepine antagonists, such as flumazenil, are used to reverse the effects of benzodiazepines in cases of overdose or excessive sedation. However, in the context of using temazepam for insomnia, this is not a standard approach.
B. Benzodiazepines like temazepam should not be stopped abruptly, especially if they have been taken regularly. Abrupt cessation can lead to withdrawal symptoms, including rebound insomnia, anxiety, agitation, and potentially seizures in severe cases.
C. This option addresses the symptom of feeling "hungover" or fatigued the next day after taking temazepam. It acknowledges that residual sedation or drowsiness can occur with temazepam use. The nurse can educate the client about the potential for these side effects and suggest allowing for adequate time for sleep to alleviate these symptoms.
D. Stopping temazepam abruptly is not recommended because it can lead to withdrawal symptoms and potentially worsen insomnia. This option does not address the need for tapering off the medication or managing the symptoms effectively.
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