The nurse continues to assist in the care of the client.
2030: Medication Administration Record.
Day 5, 0700: Ziprasidone 20 mg IM left deltoid muscle. Paliperidone 6 mg PO.
Nurses' Notes.
2015: 2030: Client appears disheveled with matted hair and stained clothing. Attempting to get out of handcuffs. The client states, "I have to. get out of here. I hear the helicopters. They are coming to get me!” Client able to state name, but not date. They believe they are in. a laboratory, run by the doctors who have been prescribing their medications.
When asked about their medical history, they reply, "My name is Jamie, and you are the devil.”
2145: Reviewed police report: Client found attempting to break through a window at the clinic downtown. When approached,. client yelled and tried to hit the officer with the stick they were using. "Get away, I have to get the notes, they are trying to. poison me.” Client appears to be responding to internal stimuli but is less outwardly agitated.
Changed into hospital scrubs with encouragement.
Handcuffs removed by police and 1:1 sitter at. The nurse is collecting data from the client 5 days after admission.
For each finding, click to specify whether the finding indicates the client's condition has improved or declined.
Response to other clients
Sleep patterns
Hygiene patterns
Interaction with the nurse
The Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"A,B"},"D":{"answers":"A,B"}}
Here are some possible answers: Response to other clients: This finding could indicate that the client’s condition has improved if they are more cooperative and respectful of others, or that it has declined if they are more hostile and paranoid of others. Sleep patterns: This finding could indicate that the client’s condition has improved if they are sleeping more regularly and peacefully, or that it has declined if they are sleeping less or having nightmares.
Hygiene patterns: This finding could indicate that the client’s condition has improved if they are taking care of their personal hygiene and appearance, or that it has declined if they are neglecting or refusing to do so. Interaction with the nurse: This finding could indicate that the client’s condition has improved if they are more trusting and communicative with the nurse, or that it has declined if they are more suspicious and withdrawn from the nurse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Grapes are a choking hazard for toddlers due to their small size and round shape. Young children can easily choke on grapes if they are not cut into smaller pieces or grapes are not adequately supervised during consumption. Educating parents and caregivers about cutting grapes into smaller, more manageable pieces is crucial to prevent choking incidents.
Choice B rationale:
Oranges (choice B) are generally not considered a high choking hazard for toddlers. However, parents and caregivers should still exercise caution and cut oranges into small, manageable pieces to reduce the risk of choking.
Choice C rationale:
Potatoes (choice C) can be a choking hazard for toddlers if not prepared and served appropriately. It is essential to cut potatoes into small, soft pieces and ensure that toddlers are supervised during mealtime to prevent choking incidents.
Choice D rationale:
Corn (choice D) can also pose a choking hazard for toddlers, especially if served on the cob. To minimize the risk, parents and caregivers should cut corn into small, bite-sized pieces or remove it from the cob before serving to young children.
Correct Answer is D
Explanation
Choice A rationale:
Children who have erythema infectiosum (fifth disease) require short-term antibiotic therapy. Erythema infectiosum, also known as fifth disease, is caused by a virus and does not require antibiotic therapy. It is a self-limiting illness that does not respond to antibiotics.
Choice B rationale:
Administration of childhood immunizations will prevent exanthem subitum (roseola infantum) Exanthem subitum, or roseola infantum, is typically a viral illness and is not prevented by childhood immunizations. It is caused by human herpesvirus 6 (HHV-6) and human herpesvirus 7 (HHV-7)
Choice C rationale:
Restrict fluids for children who have pertussis. Restricting fluids for children with pertussis is not recommended. Pertussis, also known as whooping cough, can cause severe coughing spells, and it is important to ensure that affected children stay well-hydrated. Restricting fluids can lead to dehydration, which can worsen the condition.
Choice D rationale:
Isolate children who have varicella until the vesicles have formed crusts. Isolation of children with varicella (chickenpox) until the vesicles have formed crusts is a standard infection control measure. Varicella is highly contagious, and isolating affected individuals helps prevent the spread of the virus to others. Once the vesicles have crusted over, the risk of transmission is significantly reduced.
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