Safety is the nursing priority for a client who is at risk for alcohol withdrawal. A care plan for the client who is in withdrawal must include which nursing interventions?

Seizure precautions and vital signs.

Observation for symptoms, vital signs, seizure and fall precautions, medications as ordered.

Suicide precautions because suicide atempts are frequent during withdrawal.

Vital signs and medications as prescribed.

Answer and Explanation

The Correct Answer is B

Choice A reason: Seizure precautions and monitoring vital signs are important but not comprehensive enough for a complete care plan.
Choice B reason: This is the correct choice. It encompasses a broad range of interventions that are critical for a client undergoing alcohol withdrawal, including monitoring for various symptoms, ensuring safety, and administering medications.
Choice C reason: While suicide precautions are important, they are not the only intervention needed for a client in alcohol withdrawal.
Choice D reason: Monitoring vital signs and administering medications are important but do not cover all necessary precautions such as seizure and fall precautions.

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Correct Answer is D

Explanation

Choice A reason: Implementing relaxation techniques is a helpful goal, but it does not directly address the compulsive behavior which is the focus of response prevention therapy.

Choice B reason: Understanding the benefits of deep breathing is beneficial, but it is not the primary goal of response prevention therapy.

Choice C reason: Confronting the trigger is part of the process, but the ultimate goal is to reduce anxiety associated with delaying or preventing the ritual.

Choice D reason: This is the correct choice. The primary goal of response prevention therapy is to reduce the anxiety associated with OCD rituals, making this the most appropriate goal.

A. The client has multiple motor tics and several vocal tics. B. The client becomes overly atached to those around the client. C. The client spends time alone and shows litle interest in making friends. D. The client has an irresistible urge to pull out the client's own hair.

Correct Answer is C

Explanation

Choice A reason: Multiple motor and vocal tics are more characteristic of Tourete syndrome, not autism spectrum disorder.

Choice B reason: Overly atached behavior is not typically associated with autism spectrum disorder; individuals with ASD often have difficulty with social atachments.

Choice C reason: This is correct. Individuals with autism spectrum disorder often prefer solitary activities and may show limited interest in social interactions.

Choice D reason: An irresistible urge to pull out one's hair is indicative of trichotillomania, not autism spectrum disorder.

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Safety is the nursing priority for a client who is at risk for alcohol withdrawal. A care plan for the client who is in withdrawal must include which nursing interventions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which goal is appropriate for the client being treated for obsessive-compulsive disorder with response prevention therapy?

Correct Answer is D

Explanation

A 6-year-old client who has been diagnosed with autism spectrum disorder would be expected to display which behavior?

Correct Answer is C

Explanation

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