The client is a 26-year-old female who was in a car accident 6 months ago that killed her mother, husband, and 2-year-old

She and her father were the only survivors of the crash. She is seeking care for depression.

Click to highlight the areas that the nurse should react to immediately.

The client has returned to work at an accounting firm and has started going to a grief support group. She states she is seeking care from a healthcare professional because her father is worried about her. The client states she only gets 2-3 hours of sleep due to nightmares about the crash.

She states that exercising right after work helps her get better sleep and to relax. She feels that she is "jumpy after the accident, especially when she is in the car. She also stated, " feel so sad that I can't seem to feel anything at all." In addition to her father, the client has a large family and friend support system. She denies alcohol or drug use.

she only gets 2-3 hours of sleep due to nightmares about the crash

She feels that she is "jumpy after the accident

especially when she is in the car

feel so sad that I can't seem to feel anything at all

Answer and Explanation

The Correct Answer is ["A","B","C","D"]

Insufficient sleep, particularly due to nightmares, can exacerbate depression and should be addressed promptly.

Feeling "jumpy" or experiencing heightened anxiety, especially in situations reminiscent of the trauma, indicates a possible post-traumatic stress disorder (PTSD symptom.

A profound sense of sadness and numbness can be indicative of severe depression, requiring immediate attention.

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Correct Answer is C

Explanation

A. Increasing the intake of dark green leafy vegetables while taking warfarin can affect INR levels due to their high vitamin K content, potentially increasing the risk of bleeding.
B. Eating two servings of raw dark green leafy vegetables daily and continuing for 30 days after warfarin therapy is completed is not recommended as it may affect INR levels.
C. Eating approximately the same amount of leafy green vegetables daily helps maintain consistent vitamin K intake, which is important for keeping INR levels stable while on warfarin therapy.
D. Avoiding all foods containing vitamin K is not necessary and may lead to nutritional
deficiencies; instead, it's important to consume a consistent amount of vitamin K-containing foods.

A. A 14-year-old client with anorexia nervosa who is refusing to eat the evening snack. B. An 18-year-old client with antisocial behavior who is being yelled at by other clients. C. A 17-year-old client diagnosed with bipolar disorder who is pacing around the lobby. D. A 16-year-old client diagnosed with major depression who refuses to participate in group

Correct Answer is B

Explanation

A. While the refusal to eat is concerning, it does not pose an immediate risk to the client's safety.
B. The situation involving the 18-year-old client could escalate quickly and poses an immediate risk to the client's and others' safety, requiring prompt intervention.
C. Pacing may indicate agitation or anxiety; however, it does not require immediate intervention unless it escalates.
D. Refusal to participate in group therapy is a concern for the client's treatment but does not pose an immediate risk to their safety.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is being discharged with a prescription for warfarin. Which instruction should the nurse provide this client regarding diet?

Correct Answer is C

Explanation

The psychiatric nurse is caring for clients on an adolescent unit. Which client requires the nurse's immediate attention?

Correct Answer is B

Explanation

A female client with fibromyalgia asks the nurse to arrange for hospice care to help her manage the severe, chronic pain. Which intervention should the nurse provide to address the client's problem?

When preparing to administer a prescribed medication to a homeless male at a community psychiatric clinic, the client tells the nurse that he usually takes a different dosage. Which action should the nurse take?

The nurse is providing lifestyle change education for a client to slow the progression of coronary artery disease. Which statements by the client should the nurse recognize as needing additional education? (Select at that apply)

A mother calls the nurse to report that at 0900 she administered an oral dose of digoxin to her 4-month-old infant, but at 0920 the baby vomited the medicine. Which instruction should the nurse provide to this mother?

The nurse is assessing a first day postpartum client. Which finding is most indicative of a postpartum infection?

The charge nurse is planning for the shift and has a registered nurse (RN) and a practical nurse (PN) on the team. Which client should the charge nurse assign to the RN?

Which laboratory results should the nurse closely monitor in a client who has end-stage renal disease (ESRD)?