Which patient has the greatest risk for the development of a psychiatric emergency?
a. The schizophrenic older adult living on the streets
b. The anorexic young adult hospitalized for treatment
c. The orphaned teenager who lives with grandparents
d. The teenager who has a problem with authority figures
ANS: A
Populations at high risk for psychiatric emergencies include those with chronic mental pa-thologies, such as chronic schizophrenia, because their emotional stability can be easily dis-rupted. The other patients lack that element of emotional and cognitive fragility and have a responsible support system.
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Which of the following laboratory studies is performed because the client is taking lithium?
1. Hemoglobin 2. CBC 3. Liver function 4. Thyroid function
A patient tells you that the usual dose of an opioid drug for cancer pain no longer relieves the pain. What is your best response?
a. "We have to be careful about increasing opioid drug dosages to prevent drug addiction." b. "You may be developing dependence on the drug and that is why it no longer relieves your pain." c. "Your body may be adjusting to the drug, eliminating it more rapidly, and thus you will need a higher dose to achieve pain relief." d. "The danger of increasing your opioid drug dosage is that you may experience respiratory failure."
The nurse is assisting with collecting a biophysical profile, which includes: (Select all that apply.)
A) ultrasound. B) amniocentesis. C) nonstress test. D) maternal serum alpha-fetoprotein. E) Leopold's maneuver.
What is the best choice of diagnosis for this adnexal swelling?
An 18-year-old college freshman comes to your clinic, complaining of severe left-sided lower abdominal pain and a foul yellow discharge. The pain began last night while she was having intercourse with her boyfriend. Afterward the pain became more severe and the discharge started. By this morning she had a fever of 101 degrees and walking was making the pain worse. Only lying very still makes the pain better. She has tried ibuprofen and acetaminophen without any improvement. She denies any nausea, vomiting, diarrhea, or constipation. Her past medical history is unremarkable. She has had two past sexual partners. She uses the birth control patch instead of condoms. She smokes a half pack of cigarettes a day and drinks four to five beers per weekend night. She denies any illegal drug use. Her parents are both healthy. On examination you find a young woman who appears ill. Her temperature is 102 degrees and her pulse is elevated at 110. She is tender in the left lower quadrant but has no guarding or rebound. Speculum examination reveals yellow purulent drainage from the os. On palpation there is cervical motion tenderness and the left adnexa is swollen and tender. A urine analysis is unremarkable and the urine pregnancy test is pending. A) Ovarian cyst B) Tubal pregnancy C) Pelvic inflammatory disease