A patient with schizophrenia tells the community mental health nurse, "I threw away my pills because they interfere with God's voice." The nurse identifies the cause of the patient's ineffective management of the medication regime as:
a. inadequate discharge planning
b. poor therapeutic alliance with clinicians
c. dislike of the side effects of antipsychotic medications
d. impaired reasoning secondary to the schizophrenia
ANS: D
The patient's ineffective management of the medication regime is most closely related to impaired reasoning. The patient believes in being an exalted personage who hears God's voice, rather than an individual with a serious mental disorder who needs medication to control symptoms. Data do not suggest that any of the other factors often relate to medication nonadherence.
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A patient is experiencing an anaphylactic reaction. Which action by the nurse takes priority?
A. Determine what the patient is allergic to. B. Listen to the patient's lung sounds. C. Maintain the patient's airway. D. Provide oxygen at 4 L nasal cannula.
The nurse uses palpation of the chest in order to assess the client for:
A) retractions and bulging. B) use of accessory muscles. C) tactile fremitus. D) pleural rub.
You should not give medications orally to individuals who are:
a. unconscious. b. unable to swallow. c. vomiting. d. all of the above.
An older adult with dementia lives with family and attends day care. After observing poor hygiene, the nurse at the center talks with the patient's adult child. This caregiver becomes defensive and says,
"It takes all my time and energy to care for my mother. She's awake all night. I never get any sleep." Which nursing intervention has priority? a. Teach the caregiver more about the effects of dementia. b. Secure additional resources for the mother's evening and night care. c. Support the caregiver to grieve the loss of the mother's ability to function. d. Teach the family how to give physical care more effectively and efficiently.