NR-326 Mental Health Nursing - Set 4 - Part 3

Correct Answer: It wears off sooner than most opioids

Naloxone has a short half life compared with most opioids, so a client can wake and then sink back into sedation and respiratory depression. Monitoring continues for hours, and repeat dosing may be needed. Option a is incorrect because reversing an overdose treats one dangerous hour, nothing more. The chronic brain disorder underneath remains untouched, and the client leaves at high risk unless follow up care is arranged. Option c is incorrect because blocking receptors for an hour does nothing to craving, which is driven by conditioned cues and reward pathway changes. Many clients feel intense craving immediately after being reversed. Option d is incorrect because the reverse is true, and that reversal is the whole danger. Believing the antagonist outlasts the opioid leads staff to discharge a client who then stops breathing at home.

Correct Answer: Alcoholic hallucinosis with an intact sensorium

Hallucinations that arrive twelve to twenty four hours out, with the client oriented and knowing they are not real, define alcoholic hallucinosis. The clear sensorium is exactly what separates it from delirium tremens. Option a is incorrect because delirium tremens brings a fluctuating clouded sensorium, disorientation and autonomic instability, and it rarely starts before the second day. This client knows where he is and his vital signs hold steady. Option b is incorrect because schizophrenia is not diagnosed during active withdrawal, when the substance itself explains the perceptual disturbance. A primary psychotic disorder also lacks this tight link to the hours since the last drink. Option d is incorrect because Wernicke encephalopathy shows confusion, eye movement abnormalities and an unsteady gait rather than isolated visual imagery. None of those neurologic findings appear in this assessment.

Correct Answer: Anorexia is ego syntonic and bulimia is ego dystonic

Restriction usually feels like an achievement and a source of control, so the client defends it and denies the danger. Binge and purge behavior feels alien and shameful, which brings clients to help sooner. Option b is incorrect because the client with the low weight typically values the behavior and resists giving it up. Treating both presentations as unwanted misses why one client refuses treatment outright. Option c is incorrect because self evaluation driven by shape and weight is a required feature of bulimia nervosa. The concern is present in both illnesses, which is why weight alone cannot separate them. Option d is incorrect because the emotional coloring runs the other way around. Pride and a sense of mastery attach to restriction, while secrecy, guilt and self disgust follow the binge and purge cycle.

Correct Answer: Bradycardia, hypothermia and fine downy hair

Starvation slows the body to conserve energy, producing a slow pulse, a low temperature and the soft downy lanugo that grows once insulating fat is gone. Dry skin and brittle nails accompany them. Option a is incorrect because heat and a racing pulse point toward infection or thyroid excess. The starved body runs cold and slow, and many of these clients cannot even mount a fever. Option b is incorrect because blood pressure falls rather than rises with the volume depletion of restriction. Skin turns dry and scaly while nails become thin and ridged, the opposite of this picture. Option c is incorrect because starvation shuts down reproductive hormones, so menstrual periods stop rather than become heavy. Peripheral circulation shuts down too, leaving hands and feet cold and dusky instead of warm.

Correct Answer: A resting heart rate in the forties

Medical instability decides the level of care, and a resting pulse this low means the heart is failing to sustain normal output. Such a client is refed with telemetry and close nursing observation. Option a is incorrect because preoccupation with shape is present in nearly every client carrying this diagnosis. A universal symptom cannot separate the client who needs a monitored bed from the one who does not. Option c is incorrect because reluctance to join group reflects ambivalence about treatment, which outpatient and day programs are built to address. Engagement problems change the therapy plan, not the medical setting. Option d is incorrect because guilt after eating is a painful but expected part of the illness that therapy addresses over time. Emotional distress alone never establishes the physiologic instability admission requires.

Correct Answer: Change talk comes from the client, not the nurse

The spirit of motivational interviewing is collaboration, evocation, and respect for autonomy. The nurse draws the client's own reasons for change into the open instead of supplying reasons the client will resist. Option a is incorrect because advice has a place, offered with permission and as one item on a menu of options. What the approach avoids is unsolicited lecturing that provokes a defensive answer. Option b is incorrect because most clients already know the risks perfectly well. Information alone rarely moves anyone; ambivalence, not ignorance, is the obstacle that motivational interviewing was designed to work with. Option d is incorrect because health teaching sits squarely inside nursing practice, and nurses discuss lifestyle every day. The reason for the approach is effectiveness, since telling people to quit simply does not work.

Correct Answer: Provide a quiet well lit room with reorientation

A quiet, well lit room with frequent reorientation and consistent staff lowers misperception and fear. Shadows in a darkened room feed hallucinations, and one to one observation protects lines better than restraint. Option b is incorrect because restraint escalates struggling, raises body temperature and increases the chance of muscle injury during an autonomic storm. Guidelines reserve it for a last resort after safer measures fail. Option c is incorrect because darkness multiplies the visual misperceptions this client already has, turning a coat on a chair into a threatening figure. Light is deliberately kept adequate through the night. Option d is incorrect because hallway traffic, noise and constant movement worsen agitation in a delirious client. Close observation can be achieved without flooding the client with stimulation that the confused brain cannot sort out.

Correct Answer: Eating regular meals and snacks on a set schedule

Structured regular eating removes the restriction that sets up the next binge, which is why it breaks a large share of these cycles. Self monitoring and work on shape beliefs follow. Option a is incorrect because hunger and fullness signals are unreliable early in recovery, so eating follows the plan instead. Waiting for appetite recreates the very gap that ends in loss of control. Option b is incorrect because banning particular foods widens the list of forbidden items and strengthens the rules driving the illness. Therapy works toward including them again rather than ruling them out. Option c is incorrect because frequent self weighing feeds the preoccupation with the number and often triggers the next episode. Weights belong with the clinician on an agreed schedule, not with the client at home.

Correct Answer: Write one care plan every shift will follow exactly

Two accurate but opposite pictures signal that the split has moved into the team. A single written plan giving every shift the same answer to the same request is the active ingredient in correcting it. Option a is incorrect because a single assigned nurse cannot cover every shift and becomes the idealized figure the client anchors onto. Rotation of assignments helps, but only once a shared plan is already in place. Option c is incorrect because splitting is an unconscious defense against unbearable ambivalence, not a scheme. Accusing her of scheming invites shame and defensiveness while leaving the inconsistent staff responses that fuel the problem untouched. Option d is incorrect because individual judgment is exactly what produced the disagreement. Different answers to identical requests teach the client that people are unreliable, and the argument in report will simply repeat tomorrow.

Correct Answer: Cluster C with dependent personality disorder

Handing over ordinary decisions, seeking constant reassurance and feeling helpless when alone define dependent personality disorder, which sits in cluster C where anxiety is managed through attachment to a caretaker. Option a is incorrect because histrionic clients pull attention toward themselves with theatrical emotion and flamboyant style. This client wants someone else in charge, which is submission rather than performance. Option b is incorrect because schizoid clients want no one near them and show no anxiety when left alone. Constant requests for company and reassurance are the reverse of the indifference that defines that diagnosis. Option d is incorrect because the avoidant client stays away from people out of fear of humiliation, not because she needs them to decide for her. Here contact is sought, not dodged.