The nurse continues caring for the client

Nurses' Notes

• Diagnosis: depression and post-traumatic stress disorder Diphenhydramine 12.5 mg PO every night at sleep (HS) • Buspirone hydrochloride 7.5 mg PO twice a day

During the conversation with the client, the nurse documents a statement by the client about wishing she had died in the crash.

Choose the most likely options for the information missing from the statement by selecting from the list of options provided.

The statement by the client represents and should be followed up with an

Answer and Explanation

The Correct Answer is ["suicidal ideation"," assessment of risk factors for suicide"]

In the context of mental health care, a statement by a client expressing a wish to have died in a traumatic event is indicative of suicidal ideation. This is a serious concern and warrants immediate and careful attention from the healthcare provider. The appropriate response involves conducting a thorough assessment of risk factors for suicide, which may include evaluating the client's mental health history, current stressors, support systems, and any previous suicide attempts or self-harm behavior. This assessment is crucial in determining the level of risk and the need for potential interventions, which may range from close monitoring to emergency psychiatric evaluation. It is essential for healthcare professionals to approach such situations with sensitivity, providing support and ensuring the safety of the client as a priority.

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Correct Answer is C

Explanation

A. Prochlorperazine is an antiemetic and antipsychotic medication used to treat nausea, vomiting, and psychotic disorders, but it is not indicated for the treatment of delirium tremens. B. Hydromorphone is an opioid analgesic and would not be appropriate for the treatment of delirium tremens.
C. Lorazepam is a benzodiazepine medication commonly used to manage alcohol withdrawal symptoms, including delirium tremens.
D. Chlorpromazine is an antipsychotic medication primarily used to treat psychotic disorders and would not be the first-line choice for managing delirium tremens.

A. A retired older male whose significant other has passed away. B. A nurse who works in a pediatric emergency department. C. An adolescent male whose parents recently divorced. D. A single working mother with three pre-school aged children.

Correct Answer is C

Explanation

A. While the loss of a significant other can be a risk factor for suicide, retired older males may have developed coping mechanisms over time that could mitigate the risk.
B. While working in a pediatric emergency department can be stressful, it does not necessarily indicate a higher risk for suicide compared to other factors such as personal life stressors or mental health issues.
C. Adolescents experiencing significant life changes such as parental divorce are at increased risk for suicide due to the emotional upheaval and lack of coping skills typical of this age group.

D. While being a single working mother with three preschool-aged children can be stressful, it does not inherently indicate a higher risk for suicide compared to other factors such as social support, coping mechanisms, and mental health status.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Which individual should the nurse consider at highest risk for suicide?

Correct Answer is C

Explanation

The nurse is using the CAGE questionnaire as a screening tool for a client who is seeking help because his wife said he had a drinking problem. Which information should the nurse explore in depth with the client based on this screening tool?

A young female client is admitted to the emergency room because she was raped that evening by her date. Which computer documentation should the nurse enter in the electronic medical record as the client's chief complaint?

The nurse documents that a client with schizophrenia is delusional. Which statement by the client confirms this assessment?

The nurse is caring for a client Exhibits In order to help the client disclose a situation that is upsetting to him, what therapeutic communication tools could the nurse use? Select all that apply.

The nurse has received a new prescription for the client to begin taking sertraline. Prior to administering the initial dose of sertraline, it is most important for the nurse to obtain which information?

The nurse wants to teach the client about the long-term phase symptoms of rape-trauma syndrome. What symptoms are consistent with long-term rape trauma? Select all that apply.

A client who is an alcoholic receives a prescription for disulfiram 500 mg by mouth (PO) daily. Which instruction should the nurse provide to this client?