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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Encouraging a client to live in the past is not a therapeutic goal. Reminiscence therapy is used to stimulate memories and conversations, not to have clients dwell in the past.
Choice B reason: Helping children identify old photographs may be a side benefit but is not the primary therapeutic reason for using photo albums in dementia care.
Choice C reason: Viewing photos as part of reminiscence therapy can help clients with dementia recall memories and engage with others, which can improve their mood and cognitive function.
Choice D reason: While sharing photos might encourage interaction, the primary benefit of viewing photos in dementia care is to provide comfort and stimulate memory for the client, not necessarily to foster interactions with others.
Correct Answer is D
Explanation
Choice A reason: Engaging in activities might be too demanding during a panic atack and could potentially exacerbate the client's anxiety.
Choice B reason: While medication may be part of the treatment plan, the immediate priority is to ensure the client's safety and comfort, which is best achieved by staying with them.
Choice C reason: Offering therapy in the midst of a panic atack is not practical; the immediate need is to help the client feel safe and manage their acute symptoms.
Choice D reason: Staying with the client to assess their needs is the most appropriate immediate intervention to ensure safety and provide reassurance during a panic atack.
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