NSG 3450 Exam 3 -with 100% verified solutions 2024-2025, Exams of Nursing

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NSG 3450 Exam 3 -with 100%

verified solutions 2024-

When considering an eating ds, what is a physical criterion for hospital admission? a. a daytime HR of <50bpm b. an oral temp of 100F or more c. 90% of ideal body weight d. systolic BP >130mmHg - ANSWER A When considering the need for monitoring, which intervention should the nurse implement for a pt w/ anorexia? Select all that apply: a. provide scheduled portion-contolled meals and snacks b. congratulate pt's for weight gain and behavior that promote weight gain c. limit time spent in bathroom during periods when not under direct supervision d. promote exercise as a method to increase appetite e. observe pt during and after meals/snacks to ensure that adequate intake is achieved and maintained - ANSWER A, C, E

Which intervention will promote independence in a pt being treated for bulimia nervosa? a. have the pt monitor daily caloric intake and intake and output of fluids b. encourage the pt to use behavior modification techniques to promote weight gain behaviors c. ask the pt to use a daily log to record feelings and circumstances r/t urges to purge d. allow the pt to make limited choices about eating and exercise as weight gain progresses - ANSWER D Which pt statement supports the diagnosis of anorexia nervosa? a. "I'm terrified of gaining weight." b. "I wish I had a good friend to talk to" c. "I've been told I drink way too much alcohol" d. "I don't get much pleasure out of life anymore" - ANSWER A Obesity can be the end result of a binge-eating ds. The nurse understands that the best tx option in persons w/ a binge-eating ds promotes: a. bariatric surgery b. coping strategies d. avoidance of public eating

d. appetite suppression meds - ANSWER B Taylor, a psych RN, orients Regina, a pt w/ anorexia nervosa, to the room where she will be assigned during her stay. after getting Regina settled, the nurse informs Regina: a. "I need to go through the belongings you have brought w/ you" b. "you can use the scale in the back room when you need to" c. "you will be eating 5x a day here" d. "the daily structure is based around your desire to eat" - ANSWER A Safety measures are of concern in eating-disorder treatments. Pt's w/ anorexia are supervised closely to monitor: Select all that apply: a. foods that are eaten b. attempts at self-induced vomiting c. relationships w/ other pt's d. weight - ANSWER A, B, D Malika has been overweight all her life. Now as an adult, she has health problems r/t her excessive weight. Seeking weight loss assistance at a primary care facility, Malika is surprised when the nurse practitioner suggests:

a. a trial of SSRI antidepressant therapy b. mild exercise to start, increasing in intensity over time c. removing snack foods from the home d. medications x for HTN - ANSWER A Malika agrees to start losing weight according to the nurse practitioner's outlined plan. Additional teaching is warranted when Malika states: a. "I am willing to admit I am depressed" b. "psychotherapy will be part of my tx" c. "I prefer to have a gastric bypass rather than use this plan" d. "my comorbid conditions may improve w/ weight loss" - ANSWER C A pt w/ a hx of alcohol use disorder has been prescribed disulfiram (Antabuse). Which physical effects support the suspicion that the pt has relapsed? Select all that apply: a. intense nausea b. diaphoresis c. acute paranoia d. confusion e. dyspnea - ANSWER A, B, D, E

Which assessment data confirms the suspicion that a pt is experiencing opioid withdrawal? Select all the apply? a. pupils are dilated b. Pulse rate is 62 beats/min c. slow movements d. extreme anxiety e. sleepy - ANSWER A, D The nurse diagnosis "ineffective denial" is especially useful when working w/ substance use disorders and gambling. Which statements describe the diagnosis? Select all that apply: a. reports inability to cope b. does not perceive danger of substance use or gambling c. minimizes sx d. refuses healthcare attention e. unable to admit impact of disease on life pattern - ANSWER B, C, D, E Which action should you take when a female staff member is demonstrating behaviors associated w/ a substance use disorder? a. accompany the staff member when she is giving pt care b. offer to attend rehab counseling w/ her

c. refer her to a peer assistance program d. confront her about your concerns and/or report your concerns to a supervisor immediately - ANSWER D A pt diagnosed w/ opioid use disorder has expressed a desire to enter into a rehab program. What initial nursing intervention during the early days after admission will help ensure the pt's success? a. restrict visitors to family members only b. manage the pt's withdrawal sx well c. provide the pt a low stimulus environment d. advocate for at least 3 months of tx - ANSWER B Opioid use disorder is characterized by: a. lack of withdrawal sx b. intoxication sx of pupillary dilation, agitation, and insomnia c. tolerance d. rewiring smaller amounts of the drug to achieve a high over time - ANSWER C Terry is a young male in the chemical dependency program. Recently he has become increasingly distracted and disengaged. The nurse concludes that

Terry is: a. bored b. depressed c. bipolar d. not ready to change - ANSWER D Maxwell is a 30 y/o male who arrives at the ER stating, "I feel like I am having a stroke." During the intake assessment, the nurse discovers that Maxwell has been working for 36 hours straight without eating and consumes eight double espresso drinks and 12 caffeinated sodas. The nurse suspects: a. fluid overload b. dehydration and caffeine OD c. benzodiazepine OD d. sleep deprivation syndrome - ANSWER B Donald, a 49 y/o male, is admitted for inpatient alcohol detoxification. He Is cachexic, has multiple scabs on his arms and legs, and has lower extremity edema. An appropriate nursing diagnosis for Donald, along w/ an expected outcome is: a. Risk for injury/Remains free from injury b. Ineffective denial/ Accept responsibility for behavior

c. Nutrition: Less than body requirements/Maintains nutrient intake for metabolic needs D. Risk for suicide/ Expresses feelings plans for the future - ANSWER C Which response by a 15 y/o demonstrated a common sx observed in pt's diagnoses w/ major depressive disorder? a. "I'm so restless. I can't seem to sit still" b. "I spend most of my time studying. I have to get into a good college." c. "I'm not trying to diet, but i've lost about 5lbs in the past month" d. "I go to sleep around 11pm, but i'm always up by 3am and can't go back to sleep" - ANSWER D Which assessment question ask by the nurse demonstrated an understanding of comorbid mental health conditions associated w/ major depressive disorder? Select all that apply: a. "do rules apply to you" b. "what do you do to manage anxiety? c. "do you have a hx of disordered eating?" d. "have you every been arrested for committing a crime?" - ANSWER B, C, D Which nursing intervention focuses on managing a common characteristic of

major depressive disorder associated w/ the older population? a. conducting routine suicide screenings at a senior center b. identifying depression as a natural, but treatable result of aging c. identifying males as being at a greater risk for developing depression d. stressing that most individuals experience just a single episode of major depression in a lifetime - ANSWER A Which characteristic identifies during an assessment serves to support a diagnosis of disruptive mood dysregulation disorder? Select all that apply: a. female b. 7 y/o c. comorbid autism diagnosis d. outbursts occur at least once a week e. temper tantrum occur at home and in school - ANSWER B, C, E Which chronic medical condition is a common trigger for major depressive disorder? a. pain b. HTN c. hypothyroidism d. Crohn's disease - ANSWER A

Tammy, a 28 y/o w/ major depressive disorder and bulimia nervosa is ready for d/c from the county hospital after 2 weeks of inpatient therapy. Tammy is taking Citalopram (Celexa) and reports that it has made her feel more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider? a. Fluoxetine (Prozac) b. isocarboxazid (Marplan) c. amitriptyline d. Duloxetine (Cymbalta) - ANSWER A Cabot has multiple sx of depression including mood reactivity, social phobia, anxiety, and overeating. With a hx of mild HTN, which classification of antidepressants dispensed as a transdermal patch would be a safe med? a. Tricyclic antidepressants b. Selective serotonin reuptake inhibitors c. Serotonin and norepinephrine reuptake inhibitors d. Monoamine oxidase inhibitor - ANSWER D When nurse uses therapeutic communication w/ a withdrawn pt who has major depression, an effective method of managing the silence is to: a. meditate in the quiet environment

b. ask simple questions even if the pt will not answer c. use the technique of making observations d. simply sit quietly and leave when the pt falls asleep - ANSWER C The biological approach to treating depression with electrodes surgically implanted into specific areas of the brain to stimulate the regions identified to be under-active in depression is: a. Transcranial magnetic stimulation b. deep brain stimulation c. vagus nerve stimulation d. electroconclusive therapy (ECT) - ANSWER B Two months ago, Natasha's husband died suddenly and she has been overwhelmed w/ grief. When Natasha is subsequently diagnosed w/ major depressive disorder, her daughter, Nadia, makes which true statement? a. "depression often begins after a major loss. Losing dad was a major loss" b. "bereavement and depression are the same problem: c. "mourning is pathological and not normal behavior" d. "antidepressant meds will not help this type of depression" - ANSWER A Which pt statement does not demonstrate an understanding of a suicide

safety plan? a. "I know that when I start thinking about my dad, I'm going to start thinking about killing myself" b. "going for a really long, hard run helps clear my mind and stops the suicidal thoughts" c. "my sister is always there for me when I start getting suicidal" d. "I keep the suicide prevention phone number in my wallet" - ANSWER B Which interventions will help make the environment on the unit safer for suicidal pt's? Select all that apply: a. all windows are kept locked b. every shower has a breakaway shower rod c. eating utensils are counted when trays are collected d. pt doors are kept open e. staying within listening distance of the pt - ANSWER A, B, C, D What are the nursing responsibilities to a pt expressing suicidal thoughts? Select all that apply: a. instituting one-to-one observation b. documenting the pt's whereabouts and mood every 15-30mins c. ensuring that the pt has no contact w/ glass or metal utensils

d. ensuring the pt has swallowed each individual dose of med e. discussing triggers of depression - ANSWER A, B, C, D When considering community suicide prevention programs, what population should the nurse plan to service w/ regular suicide screenings? Select all that apply: a. 10- to 34- y/o b. males c. college-educated adults d. rural population e. Native American - ANSWER A, B, E Research supports which intervention implemented on a long-term basis significantly reduces the incidence of suite and suicide attempts in a pt diagnosed w. bipolar ds? a. a SSRI b. ECT c. one-on-one observation d. lithium - ANSWER D Gladys is seeing a therapist bc her husband committed suicide 6 months ago.

Gladys tells her therapist, "I know he was in pain, but why didn't he leave me a note?" The therapist's best response would be: a. "he probably acted quickly on his impulse to kill himself" b. "he did not want to think about he pain he would cause you" c. "he was not able to think clearly due to his emotional pain" d. "he thought you may think it was an accident if there was no note" - ANSWER C Martin is a 23y/o male w/ a new diagnosis of schizophrenia, and his family is receiving info from a home health nurse. The topic of education is suicide prevention, and the nurse recognizes effective teaching when the mother says: a. "persons w/ schizophrenia rarely commit suicide" b. "suicide risk is greater in the first few years after diagnosis" c. "suicide is not common in schizophrenia due to confusion" d. "most persons diagnosed w/ schizophrenia die of suicide" - ANSWER B Sigmund Freud, Karl Menninger, and Aaron Beck theorized that hopelessness was an integral part of why a person commits suicide. A more recent theory suggest suicide results from: a. elevated serotonin levels b. the diathesis-stress model

c. outward aggression turned inward d. a lack of perfectionism - ANSWER B Which person is at the highest risk for suicide? a. a 50 y/o married white male w/ depression who has a plan to OD if circumstances at work do not improve b. a 45 y/o married white female who recently lost her parents, suffers from bipolar disorder, and attempted suicide once as a teen c. a young single white male who is alcohol dependent, hopeless, impulsive, has just been rejected by his girlfriend, and has ready access to a gun he has hidden d. an older Hispanic male who is Catholic, is living w/ a debilitating chronic illness, is recently widowed, and who states, "I wish that God would take me too" - ANSWER C Kara is a 23 y/o pt admitted w/ depression and suicide ideation. Which intervention(s) would be therapeutic for Kara? Select all that apply: a. focus primarily on developing solutions to the problems leading the pt to feel suicidal b. assess the pt thoroughly and reassess the pt at regular intervals as levels of risk fluctuate c. avoid talking about the suicidal ideation as this may increase the pt's risk for suicidal behavior

d. meet regularly w/ the pt to provide opportunities for the pt to express and explore feelings e. administer antidepressant meds cautiously and conservatively bc of their potential to increase the suicide risk in Kara's age group f. help the pt to identify positive self-attributes and to question negative self-perceptions that are unrealistic - ANSWER B, D, E, F Which statement made to the grieving pt demonstrates effective therapeutic communication? Select all that apply: a. "your loves one was irreplaceably special" b. "it must be comforting to know they are with God now" c. "you can very very grateful for the time you had together" d. "I would like to take the flowers from the funeral home to your house" e. "your loss must be devastating. I can't imagine how you must be feeling right now" - ANSWER A, D, E Considering the subject of medically assisted death, which statements identify the pros and cons of the argument associated w/ the issue of nonmaleficence? Select all that apply: a. from the pt's perspective, there is no different between ending life by providing a lethal prescription and by stopping treatment that prolongs life b. assisted death violates the oath to "do no harm" and destroys trust

between pt and nurse c. there is equal protection under the law that allows the right to refuse or withdraw tx and to commit suicide d. every competent person has the right to make decisions based on personal convictions e. him beings are the stewards but not the absolute masters of the gift of life

• ANSWER A, B Which statement made by a pt demonstrated acceptance of criteria required of hospice care? a. "I want my family to be with me" b. "there is no cure for my illness. I have accepted that" c. "it's important to me that I die in my own home" d. "I don't want my family to bear the burden of caring for me" - ANSWER B Which statement made by a widow demonstrates that her grief work has been effective? Select all that apply: a. "I can remember how much my deceased husband loved chocolate chip ice cream" b. "painting is my new passion, and I really enjoy learning the various strokes" c. "Jim could be very stubborn when he thought he was right"

d. "I don't know why he had to die" e. "I just can't believe he's gone" - ANSWER A, B, C Which factor has the greatest influence on the hospice nurse's ability to provide respectful professional care? a. acceptance that death Is a natural part of life b. possession of excellent care giving nursing skills c. the existence of a healthy, well-balanced personal life d. the desire to work w/ both the pt and the family - ANSWER C There is conflict surrounding the dying experience in modern medicine. The medical model of treatment in the U.S. has traditionally been focused on the prolongation of life. What intrinsic factor plays into this medical model? a. healthcare workers do not want their pt's to die b. medicare is a fee-for-service model c. palliative care is expensive to administer d. keeping people alive as long as possible is the ethical thing to do - ANSWER D Holly is a 53 y/o female w/ terminal breast cancer. Holly's nurse int he hospital brings up the subject of hospice care, Holly becomes upset and

states, "I am not ready to give up and die." You respond that hospice is: a. a model of healthcare that emphasizes quality of life for you and your family b. the end of curative treatments and pain management c. a multidisciplinary team providing curative and therapeutic treatment d. an aggressive medical plan to end suffering and hasten death - ANSWER A Guadalupe is the matriarch of. a large family. She is terminally ill and none of her family members know her end-of-life wishes. The best action for the nurse is to: a. discuss durable power of attorney b. organize a family meeting w/ Guadalupe's permission to discuss her goals and wishes c. have a family meeting without Guadalupe so as to not upset her d. ask the doctor to tell Guadalupe that she is dying - ANSWER B A bereavement group run by a local hospice includes a woman who is distraught over her supervisor's death. The woman appears severely distressed. She has trouble functioning with activities of daily living and making the simplest of decisions. The group facilitator recognizes that this woman is suffering from disenfranchised grief after learning: a. the woman was in love with her married supervisor

b. she has not taken enough time off work to grieve properly c. the supervisor died over a year ago d. her family is not involved enough to support her - ANSWER A The dying patient w/ a neurocognitive disorder such as Alzheimer's dx is especially challenging to provide care for. They may have sx or pain that they are unable to adequately describe or define. Reversible conditions that respond to treatment that may affect level of consciousness, anxiety, or agitation include: a. inability to communicate b. distended bladder, constipation, or nausea c. reduced urinary output d. weakness due to the dying process - ANSWER B Which nursing response demonstrates accurate information that should be discussed with the female pt diagnosed w/ bipolar and her support system? Select all that apply: a. "remember that alcohol and caffeine can trigger a relapse of your symptoms" b. "due to the risk of your manic episode, antidepressant therapy is never used with bipolar disorder" c. "it's critical to let your healthcare provider know immediately if you aren't

sleeping well" d. "Is your family prepare to be actively involved in helping manage this disorder?" e. "the sx then to come and go and so you need to be able to recognize the early signs" - ANSWER A, C, D, E Which statement made by the pt demonstrated an understanding of the effective use of newly prescribed lithium to manage bipolar mania? Select all that apply: a. "I have to keep reminding myself to consistently drink 6-12 oz glasses of fluid every day" b. "I discussed the diuretic my cardiologist prescribed with my psychiatric care provider" c. "lithium may help me lose the few extra pounds I tend to carry around" d. "I take my lithium on an empty stomach to help w/ absorption" e. "I've already made arrangements for my monthly lab work" - ANSWER A, B, E The nurse is providing medication education to a pt who has be prescribed lithium to stabilize mood. Which early signs and sx of toxicity should the nurse stress to the pt? Select all that apply: a. increased attentiveness

b. getting up at night to urinate c. improved vision d. an upset stomach for no apparent reason e. shaky hands that make holding a cup difficult - ANSWER D, E a male pt calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially? a. reinforce that the level is considered therapeutic b. instruct the pt. to gold the next dose of medication and contact the prescriber c. have the pt go to the hospital ER immediately d. alert the pt to the possibility of seizures and appropriate precautions - ANSWER B Which intervention should the nurse implement when caring for a pt demonstrating a manic behavior? Select all that apply: a. monitor the pt's vital signs frequently b. keep the pt distracted w/ group-oriented activities c. provide the pt with frequent milkshakes and protein drinks d. reduce the volume on the television and dim bright lights in the environment

e. use a firm but calm voice to give specific concise directions to the pt - ANSWER A, C, D, E Substance abuse is often present in people diagnosed w. bipolar disorder. Laura, a 28y/o with a diagnosis of bipolar, drinks alcohol instead of taking her prescribed meds. The nurse caring for this pt recognizes that: a. anxiety may be present b. alcohol ingestion is a form of self-medication c. the pt is lacking a sufficient number of neurotransmitters d. the pt is using alcohol bc she is depressed - ANSWER B Ted, the former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I eight years go. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted's wife and his blood tests confirm. To reduce Ted's mania the psychiatric nurse practitioner recommends: a. Clonazepam (Klonopin) b. Fluoxetine (Prozac) c. Electroconclucisve therapy (ECT) d. Lurasidone (Latuda) - ANSWER C A 33 y/o female diagnosed with bipolar 1 has been functioning well on

lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, "You are ready to enter the maintenance therapy staff, so at this time I am goin to adjust your dosage by prescribing": a. a higher dosage b. once a week dosing c. a lower dosage d. a different drug - ANSWER C Tatiana has been hospitalized for an acute manic episode. On admission, the nurse suspects lithium toxicity. What assessment findings would indicate the nurse's suspicion as correct? a. SOB, GI distress, chronic cough b. ataxia, severe hypotension, large volume of dilute urine c. GI distress, thirst, nystagmus d. Electroencepaholigc changes, chest pain, dizziness - ANSWER B Luc's family comes home one evening to find him extremely agitated and they suspect he is in a full manic episode. The family called emergency medical services, While one medic is talking with Luc and his family, the other medic is counting something on his desk. What is the medic most likely counting? a. hypodermic needles

b. fast food wrappers c. empty soda cans d. energy drink containers - ANSWER D