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NTC PRC SIMULATED NLE#5-AANSWERS &RATIONALES

1 Prepared by: NTC Research Team

Facebook Account: www.facebook.com/nursing.tutor ial

Email : nur [email protected]

1. B. Headofthebedelevated45degreeswithalargepillowundertheheadandshoulders

2. D. Wrapherhandsinsoftmittenrestraints

3. A. Respondtohercrudeeffortsofspeaking

4. C. Reinforcingthedressingandnotifyingthedoctorimmediately

5. C. PreventincreasedICP

6. D. Theclientsneedsandproblems

7. C. Tofacilitateahelpingrelationship

8. C. Mrs.L.30yearsoldisadmittedtothehospitalforthefirsttimeforacuteappendicitis.

Rationale:

Thereare2factorsthatmayaffectcommunicationnamely,PersonalandEnvironmentalFactors.Personalfactorsthatcanimpedeaccuratetransmissionorinterpretationofmessagesincludeemotionalfactors(e.g.,mood,knowledgelevels,languageuse)andsocialfactors(e.g.,previousexperience,differencesinculture,language).Patientswithrightsidedhemiplegiahasdifficultyinspeaking.DifferencesinlanguageinOptionBanddifficultyinspeakinginOptionDarefactorsthatmakeitimpossibletohaveaneffectivecommunicationsincethemessagecannotbeunderstood.OptionsAandCbothdealswiththepainwhichaffectsthemoodofthepatient.ThepainofcervicalcancerisworstcomparedtoanacutepainsufferedbythepatientwithAP.Althoughpainmayaffectthemoodofthesender/receiver,themessagescanstillbeunderstoodandamongthechoicesCistheleastto

hindercommunication.

9. C. Listening

10. D. Needstounderstandthatpatientsmaytestherbeforehecanacceptandtrusther.

11. C. Smokingandlackofexercise

12. B. Lossofbonemassinthevertebraldiscs

13. B. Decreases

14. C. Islessstableandbalancedwhenwalking

15. B. Fractures

16. C. ItisaPhysiologicresponsetostress

17. C. Mild

Rationale:Levelsofanxiety

AnxietyLevel Responses

Mild Sharpenedsenses

Increasedmotivation

Effectiveproblemsolving

INCREASEDLEARNINGABILITY


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18. B. Suppression

Rationale:

Suppressionistheanswer.Suppressionisconsciouslydonewhilerepressionisunconsciouslydone.Suppressionisreplacingthedesiredgratificationwithonethatismorereadilyavailable.Repressionisexcludingemotionallypainfuloranxiety-provokingthoughtsandfeelingsfromconsciousawarenessRegressionismovingbacktothepreviousdevelopmentalstagetofeelsafeorhaveneedsmetProjectionistheunconsciousblamingofunacceptable inclinationsorthoughtsonanexternalobject

19B.Transactionbasedmodel

20. D. Mobilizeenergyneededforadaptation

21. C. Increasedsensoryinputbroughtaboutbyunlimitedvisitorsfromfamiliesandfriends

22. D. Theyshowpoorsocialjudgment

23. A. Minimaluseofdirecttouch

24.D. Standslightlyinfrontoftheclientsnondominantsideallowingtheclienttograspthenursearm

25. C. Usevisualaideandgesturestoenhancethespokenword

26.A. Denial

Rationale:

Krismanifesteddenial.Denialisthefailuretoacknowledgeanunbearablecondition;failuretoadmittherealityofasituationorhowoneenablestheproblemtocontinue Otheroptionsareinappropriate.ProjectionistheunconsciousblamingofunacceptableinclinationsorthoughtsonanexternalobjectRationalizationisexcusingownbehaviortoavoidguilt,responsibility,conflict,anxietyorlossofself-respectCompensationisoverachievementinoneareatooffsetrealorperceiveddeficienciesinanotherarea

27.B.Sublimation

Rationale:

OptionBistheanswer.Sublimationisexhibitingacceptablebehaviortomakeupforornegateunacceptablebehavior.

Denial

is

the

failure

to

acknowledge

an

unbearable

condition;

failure

to

admit

the

reality

of

a

situation

or

how

oneenablestheproblemtocontinueDisplacementistheventilationofintensefeelingstowardspersonslessthreateningthantheonewhoarousedthosefeelingsIdentificationismodelingactionsandopinionsofinfluentialotherswhilesearchingforidentityoraspiringtoreachapersonal,socialoroccupationalgoal

28D.Regression

Rationale:

Urinatingonthepantscanbeseenintoddlers(toilettraining),thereforeMr.Pascualregresstoitspreviousdevelopmentalstage.Regressionismovingbacktothepreviousdevelopmentalstagetofeelsafeorhaveneedsmet.

SublimationisexhibitingacceptablebehaviortomakeupforornegateunacceptablebehaviorDenialisthefailuretoacknowledgeanunbearablecondition;failuretoadmittherealityofasituationorhowoneenablestheproblemtocontinueDissociationisdealingwithemotionalconflictbyatemporaryalterationinconsciousnessoridentity

29.D. Repression

Rationale:

AccordingtoFreud-Repression,anunconsciousactionthatexhibitsaforgottenhistoryisoneofthedefense


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mechanismsusedinpatientswithpersonalitydisorderRepressionisexcludingemotionallypainfuloranxietyprovokingthoughtsandfeelingsfromconsciousawareness(FixationisimmobilizationofaportionofthepersonalityresultingfromunsuccessfulcompletionoftasksinadevelopmentalstageDenialisthefailuretoacknowledgeanunbearablecondition;failuretoadmittherealityofasituationorhowoneenablestheproblemtocontinueReactionformationisactingtheoppositeofwhatonethinksorfeels

30. C. Reactionformation

Rationale:

Reactionformationisactingtheoppositeofwhatonethinksorfeels.Depressedpatientactinoppositebyactingliketheremoodiselevated(mania)althoughtheyareactuallydepressed. DisplacementisventilationofintensefeelingstowardpersonslessthreateningthantheonewhoarousedthosefeelingsDenialisthefailuretoacknowledgeanunbearablecondition;failuretoadmittherealityofasituationorhowoneenablestheproblemtocontinue.Compensationisoverachievementinoneareatooffsetrealorperceiveddeficienciesinanotherarea

31. D. Speaktoclientinshort,simplesentences

Rationale:

OptionsAandBarefalsereassuranceandadvising,thereforeuntherapeutic.Givingadetailedexplanationisinappropriatesincepatientinpanicstatelacktheabilitytoconcentrate.SpeakinginbriefstatementusingsimplewordsisthemostappropriateinterventionfortheclientexperiencingpanicanxietyOptionDistheanswer.

32.

A.Benzodiazepines

Rationale:

TheanswerisBenzodiazepines(Anxiolytic).Benzodiazepineshaveprovedtobethemosteffectiveinrelievinganxietyandarethedrugsmostfrequentlyprescribed.BenzodiazepinesproducetheireffectbybindingtoaspecificsiteonGABAreceptor.Imipramine(Tofranil)-acycliccompoundantidepressant.Thecycliccompoundsbecameavailableinthe1950sandforyearsbecomethetreatmentofchoicefordepressionalthoughtheycausevarying degreesofsedation,orthostatichypotensionandanticholinergicsideeffects.Clozapine(Clozaril)isanantipsychotic.Majoractionsofallantipsychoticsinthenervoussystemistoblockreceptorsfortheneurotransmitterdopamine.Lithiumisthemostestablishedmoodstabilizingagents.Mood-stabilizingdrugsareusedtotreatbipolardisorderbystabilizingtheclientsmood,preventingorminimizingthehighsandlowsthatcharacterizedbipolarillness,and

treatingacuteepisodesofmania

33.B.Generalizedanxietydisorderischaracterizedbyanxietythatlastlongerthan6months

Rationale:

OptionBistheanswer.Generalizedanxietydisorderischaracterizedbyatleast6monthsofpersistentandexcessiveworryandanxiety.OptionAisPosttraumaticstressdisorder(PTSD).PTSDischaracterizedbyre-experiencingofanextremelytraumaticevent,avoidanceofstimuliassociatedwiththeevent,numbingofresponsiveness,andpersistentincreasedarousal;itbeginswithin3monthstoyearsaftertheeventandmaylastafewmonthsoryearsOptionCisacharacteristicofObsessive-compulsivedisorder(OCD).OCDinvolvesobsessions(thought,impulses,orimages)thatcausemarkedanxietyand/orcompulsions(repeatedbehaviorsormentalacts)thatattempttoneutralizeanxiety

OptionDistoogeneralandmaybeapplicabletoanxiouspatients.Thereforenottheanswer.

34.C. Severe.

35. D. Panic

Rationale:

Anxietyisavagueuneasyfeelingofdiscomfortordreadaccompaniedbyanautonomicresponseandafeelingofapprehensioncausedbyanticipation ofdanger.Panicisthe answer,itisnot amanifestationbut


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ratheranAnxietylevel.Otherchoicesaremanifestations.

36.A. Delusion

Rationale:

OptionAistheanswer.Delusionisafixedfalsebelief.Intheabovesituationthepatientisexperiencingpersecutoryorparanoiddelusion.ThismeansthattheclientbelievesthatothersareplanningtoharmhimetcOptionBisaninappropriateanswer.IllusionisamisperceptionofactualenvironmentalstimuliHallucinationisafalsesensoryperceptionsorperceptualexperiencesthatdonotreallyexistingreality.Hallucinationinvolvesthe5senses,auditoryhallucinationisthemostcommonOptionCisalsoaninappropriate,theabovesituationdoesnotmanifestvisualhallucinationsincethereisnovisualdistortionbutratherafalsebeliefthatthenurseisgoingtoharmhim.

Option

D

is

also

incorrect,

Ideas

of

reference

is

a

false

impression

that

the

external

events

have

special

meaning

foraperson

37. D. Disturbanceofthought

Rationale:

OptionDistheanswer.Thoughtprocessreferstohowclientthinks.Delusionisafixedfalsebeliefandadisturbanceofthought.Otheroptionsarewrong.Psychomotordisturbancerelatestothe psychological processes associated with muscular movement and to theproduction of voluntary movements. Delusion is not a psychological disturbance.Mania ia an example of a mood disturbance. Mania is a distinct period during which the mood is abnormally and persistently elevated, expansive and irritable.Hallucination not delusion is a disturbance of perception. Hallucination is a false sensory perceptions orperceptual experience that do not really exist

38.B.Expressdoubtanddonotargue

39.B. Itsmealtime.Letsgosothatyoucaneat.

Rationale:

OptionBistheanswer,othersareinappropriateresponse.OptionAisreinforcingtheclientsdelusion-untherapeutic.OptionCisinappropriate,thenurseshouldexerciseautonomy.OptionDisjudgmental-untherapeutic.UsingtheprocessofeliminationOptionBistheanswer.Itisaconsistentandstraightforward.Beingparticularlystraightforwardisessentialforthesuccessofthenurse-clientrelationship forparanoidpatients

40.A. Dystonia

Rationale:

Dystoniaistheanswer.Dystoniaincludesacutemuscularrigidityandcramping,astiffandthicktonguewithdifficultyinswallowingandinseverecases,laryngospasmandrespiratorydifficulties.Spasmsorstiffnessinthe musclegroupscan producetorticollis(twistedheadand neck),opisthotonus(tightnessintheentirebodywiththeheadandanarchedneck),oroculogyriccrisis(eyesrolledbackinalockedposition).NMS ispotentiallyfatal.MajorsymptomsofNMSarerigidity,highfever,autonomicinstabilitysuchasunstablebloodpressure,diaphoresis, andpallor;deliriumandelevatedlevelsofenzymes,particularlycreatinephosphokinase

Akathisiaisreportedbytheclientastheintenseneedtomoveabout.Theclienthasinabilitytositstillorrestwhichoftenleadstheclienttodiscontinuetheirmedication.PseudoparkinsonismresemblesthesymptomsofParkinsonsdiseaseand includestiff,stooped posture,amask-like

facies,

decreased

arm

swing;

a

shuffling,

festinating

gait;

cogwheel

rigidity;

drooling;

tremor;

bradycardia;

and

coarsepillrollingmovementsofthethumbandfingerswhileatrest

41D.Presenceofmania

42.C.Lithiumcarbonate(Eskalith)

Rationale:

Lithiumisthemostestablishedmoodstabilizingagents.Mood-stabilizingdrugsareusedtotreatbipolardisorder


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bystabilizingtheclientsmood,preventingorminimizingthehighsandlowsthatcharacterizedbipolarillness,andtreatingacuteepisodesofmania

Amitriptyline(Elavil)isanantidepressant.Itisthoughttoactprimarilybyblockingthereuptakeofnorepinephrineandtoalesserdegree,serotoninPhenelzine(Nardil)isanantidepressant (MAOI).TheyactbyinhibitingtheenzymeandinterferinginthedestructionofthemonoamineneurotransmittersDiazepam(Valium)isusedtotreatextrapiramidalsideeffectsofneurolepticsValiumhastheabilitytobindtospecificreceptorsadjacenttotheGABAreceptors

43. C. Psychoanalysis

44C. Describeacceptablebehaviorandsetrealisticlimitswiththeclient

45. D. Cleaningthedayroomtables

46. A. Tremor

47.B. Maintainingasafeenvironment

Rationale:

IndealingwithpatientwithParkinsonsdiseaseSAFETYisthepriority.Maintainingbalanceinnutrition,restandactivity,nutrition,hydrationandeliminationcomesnext.OptionCisinappropriate,Parkinsonsdiseasedoesnotaffecttheimmunesystem.AlthoughDiversionalactivityisappropriatepatientssafetyisthepriority

48.D. Tocoincidewithpeakactionofdrugtherapy

49. D. Tomaintainoptimalbodyfunction

Rationale:

OptionDistheanswer.Oneofthegoalsforpatientswithdementiaistomaintainanadequatebalanceofactivityandrest,nutrition,hydration,andelimination.OptionsAandBarewrong,medicationsonlyslowsdown,notstoporcure,thedisease.AlthoughOptionCcanbeappropriate,OptionDoffersthebestandmorespecificanswer.

50.C. Praisetheclientforherdesiretobeindependentandgiveherextratimeandencouragement

Rationale:

Oneofthegoalsforpatientswhohasdementiaisforthemtofunctionasindependentlyaspossible.PraisingtheclientforherdesiretobeindependentistheBESTINITIALresponseforthenurse.Thiswillreinforcetheclientsdesiretobeindependentandwillpromotecooperation.OptionsBandDiscontrarytothenursinggoals.Option

maybecorrectbutitdoesntreinforceindependence

51. B. Limitthenumberofhandwashings

Rationale:

BasedonMaslowshierarchyofNeedsitisphysiologicfirstbeforepsychologic.Sincethepatientalreadyhadareddened,scalyandcrackedhandsthenurseshouldlimithandwashingtopreventfurtherskinbreakdown.OptionDisonlyappropriateifthepatientsskinintegrityisokay.OptionsAandCaredistractors,anappointmentwasnotstatedintheabovesituation

52A. Astructuredscheduleofactivities

53. A. Allowheracertainamountoftimeeachshifttoengageinthisbehavior

54. C. Drinking8ozwatereveryhourbetweenmeals

55.B. Limitsherhandandfacewashingtofewtimesaday

56.A.Tellhimfirmlythatifhedoesnotcontrolherself,thestaffwillhelphimcontrolherself

57.C.Severeparenteralrejection

58. D. Lackofparentalloveanddiscipline


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59.B. Protectsothersfrombeingmanipulated

60. B. Consistency

61.B.Focuseslightraysintotheretina

62C. Blurredandhazyvision

63.A.Dilatationofthepupilsandconstrictionofbloodvessels

64. D. Medicatetheclientwithantiemetic,asordered

65B. Wearingeyepatchesforthefirst72hours

66. D. Mychildhadanaccidentwhileriddingatricycle

Rationale:

Warningsignsofchildabuseincludesunusualinjuriesforthechildsageandlevelofdevelopment(Videbeck,201).OptionDistheanswer.OptionDisonlyappropriatefora3yearoldchildotheroptionsareconsistentwiththechildsdevelopmentalstage.

67.B.Tellthechildtogettoherregularactivities

Rationale:

OptionBisthebestanswer.OptionsA,CandDaretoojudgementalandadvisingisuntherapeutic.

68. A. Policestation

Rationale:

OptionAisthecorrectanswer.Thepoliceisthepropergovernmentagencywhohastheauthorityoverthiscase.BantayBataisa24/7hotlinewhichprovidestelephonecounselingandreferralofreportedcasesofchildabuse.Moreimportantly,itprovidesrescueservicesinresponse tocrisissituations, withlocalgovernmentandpoliceassistance.Trainedsocialworkersfieldabout5,000callseveryday,withalmost1.3%ofthesecallsnecessitatingattention.Theschoolandtheparisharenottheproperagencytocall.

69.D.Helpingtheclientdevelopsafetyplan

Rationale:

OptionDistheanswer.SAFETYisthepriority.Thefirstpartoftreatmentforchildabuseorneglectistoensurethechildssafetyandwell-being.Thismayinvolveremovingthechildfromthehome,whichalsocanbetraumatic.Giventhehighriskforpsychologicalproblems,athoroughpsychiatricevaluationisalsoindicatedOtheroptions,althoughapplicable,canbedonelateraftertheclientssafetyisensure

70. C. Powerlessnessrelatedtoabusivehusband,asevidencedbyinabilitytomakedecisions

71. D. Hyperactivity,talkativeness,euphoria

Rationale:

OptionDistheanswer.Intoxicationfromstimulantsdevelopsrapidly;effectsincludethehighoreuphoricfeeling,hyperactivity,talkativeness,anxiety,grandiosity, hallucinations,anger,fighting,andimpairedjudgment

OptionCisfor

inhalant

intoxication;

other

choices

does

not

refer

tostimulant

intoxication.

72B. ThismedicationwillblocktheeffectsofanyopioidsubstanceItake.

73C. Assessingtheclientsbloodpressure

Rationale:

OptionCisthebestanswer.Clonidinewasinitiallymarketedforhighbloodpressure,butitisalsoaneffectivesomatictreatmentforsomechemicallydependentindividualswhencombinedwithnaltrexone.


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74.B.Mostnursesareexposedtovarioussubstancesandbelievetheyarenotriskto developthedisease

75. C. Physicaldependence

76C. Considerableassistancewithactivitiesdailyliving

77B. Askingtheclienttodoonestepofthetaskatatime

78C. Youareinahospital.Wearenursestryingtohelpyou.

79.B. Givefeedbackontheinappropriatenessofthebehaviors

80 D. IwokeupthismorninghopingthatmyoldDadwouldbeback.

Rationale:

Psychotropics,orpsychotropicmedications,aredrugsthataffectthemind/perception,behaviorandmood.

81.B.Catapres

Rationale:

OptionBistheanswer.Clonidine(Catapres)wasinitiallymarketedforhighbloodpressure,butitisalsoaneffectivesomatictreatmentforsomechemicallydependentindividualswhencombinedwithnaltrexone.Clonidineisanonopioidsuppresserofopioidwithdrawalsymptoms.Itisalsononaddicting.Otherchoicesarenotantihypertensive drugs.

A

nicotine

patch

is

a

transdermal

patch

that

releases

nicotine

into

the

body

through

the

skin.

It

is

usually

used

asamethodtoquitsmoking.Naltrexone(Revia)isarelativelypureantagonistthatblockstheeuphoriceffectsofopioids.Ithaslowtoxicitywithfewsideeffects.Ithasalsobeenapprovedforthetreatmentofalcoholismbecauseitdecreasesthepleasant,reinforcingeffectsofalcoholMethadone(dolophine)isasyntheticopiatethatatcertaindosesblocksthecravingfor,andeffectsof,heroin.Methadoneistheonlymedicationcurrentlyapprovedforthetreatmentofthepregnantopioidaddict

82.A.Cottagecheese

Rationale:

Foods(containingtyramine)toavoidwhentakingMAOIs:

Agedmeatssuchaspepperoniandsalami.

Italianbeans,tofu,bananapeel,overripefruit,avocado

Alltapbeersandmicrobrewerybeer

Soysauceorsoybeancondiment

Yogurt,sourcream,PEANUTS,brewersyeast,MSG

Matureoragedcheeseordishesmadewithcheese,suchasLASAGNAorPIZZA.Allcheeseisconsidered

aged

EXCEPT

for

COTTAGE

CHEESE,creamcheese,ricotta cheeseandprocessed cheeseslices.OptionAistheanswer.

83.C. Hypertensivecrisis

Rationale:

HypertensiveCrisisistheanswer.ParticularconcernwithMAOIsisthepotentialforalife-threatening

hypertensive

crisis

if

the

client

ingests

food

that

contains

tyramine

or

takes

sympathomimetic

drugs.

Because

theenzymeMAOIisnecessarytobreakdownthetyramineincertainfoods,itsinhibitionresultsinincreasedserumtyraminelevels,whichcausesseverehypertension,hyperpyrexia,tachycardia,diaphoresis,andcardiacdysrhythmias.RenalFailureisatoxiceffectoflithium.EPSisaseriousneurologicsideeffectofantipsychoticdrugs.Sedationisasideeffectofbenzodiazepines.
http://en.wikipedia.org/wiki/Tobacco_smokinghttp://en.wikipedia.org/wiki/Tobacco_smokinghttp://en.wikipedia.org/wiki/Tobacco_smokinghttp://en.wikipedia.org/wiki/Tobacco_smokinghttp://en.wikipedia.org/wiki/Tobacco_smoking


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84.C. Tardivedyskenisia

Rationale:Tardivedyskenisiaistheanswer.Tardivedyskenisia isasyndromeofpermanentinvoluntarymovements.Onceithasdeveloped,TDisirreversible,althoughdecreasingordiscontinuingantipsychoticmedicationscanarrestitsprogression.ThesymptomsofTDincludesinvoluntarymovementsofthetongue,facialandneckmuscles,upperandlowerextremitiesandtruncalmusculature.Otherchoicesarereversible.Dystoniaincludesmuscularrigidityandcramping,astiffandthicktonguewithdifficultyofswallowingandinseverecases,laryngospasmandrespiratorydifficulties.

Akathisiaisreportedbytheclientastheintenseneedtomoveabout.Theclienthasinabilitytositstillorrestwhichoftenleadstheclienttodiscontinuetheirmedication.NMSispotentiallyfatal.MajorsymptomsofNMSarerigidity,highfe

ver,autonomicinstabilitysuchasunstablebloodpressure,diaphoresis, andpallor;deliriumandelevatedlevelsofenzymes,particularlycreatine

phosphokinase.

85. C. Akathisia

Rationale:

Akathisiaistheanswer.Akathisiaisreportedbytheclientastheintenseneedtomoveabout.Theclienthasinabilitytositstillorrestwhichoftenleadstheclienttodiscontinuetheirmedication.Dystoniaincludesmuscularrigidityandcramping,astiffandthicktonguewithdifficultyofswallowingandinseverecases,laryngospasmandrespiratorydifficulties.NMSispotentiallyfatal.MajorsymptomsofNMSarerigidity,highfever,autonomicinstabilitysuchasunstablebloodpressure,diaphoresis, andpallor;deliriumandelevatedlevelsofenzymes,particularlycreatinephosphokinase.PseudoparkinsonismresemblesthesymptomsofParkinsonsdiseaseand includestiff,stooped posture,amask-likefacies,decreasedarmswing;ashuffling,festinatinggait;cogwheelrigidity;drooling;tremor;bradycardia;andcoarsepillrollingmovementsofthethumbandfingerswhileatrest

86.C. Beginanytimewithinthenext1-2days

Rationale:

OptionCistheanswer.OptionsAandDaretoolate;OptionBistooearly.Symptomsofwithdrawalusuallybegin4-12hoursaftercessationormarkedreductionofalcoholintake.Symptomsincludecoarsehandtremors,sweating,elevatedpulseandbloodpressure,insomnia,anxiety,andnauseaorvomiting

87. C. Providingaquiteenvironmentandadministeringmedicationasneededandprescribed

88. A. Heartrateof120to140beats/minute

Symptomsofwithdrawalusuallybegin4-12hoursaftercessationormarkedreductionofalcoholintake.Symptomsincludecoarsehandtremors,sweating,ELEVATEDPULSEandbloodpressure,insomnia,anxiety,andnauseaorvomiting.OptionAistheanswer.OptionBiswrong,itshouldbetachycardianotbradycardia.OptionsCandDarenormal.

89.B. Aftershavelotion

Rationale:

Disulframshouldalwaysbeprescribedwiththefullknowledgeandconsentoftheclient.Theclientneedstobetoldaboutthesideeffectsandmustbewellawarethatanysubstancethatcontainsalcoholcantriggeranadversereaction.Threeprimarysourcesofhiddenalcoholexist-food,medicationandpreparationsthatareappliedtotheskin.OptionBistheanswer.Aftershaveisalotion,gel,orliquidusedmainlybymenaftertheyhavefinishedshaving.

It

may

contain

an

antiseptic

agent

such

as

alcohol

to

prevent

infection

from

cuts

as

well

as

numb

damaged

skin,

aperfumetoenhancescent,andamoisturizertosoftentheskin.Toothpastes,cheeseandcarbonatedbeveragesdoesnotcontainalcohol.Activeingredientfortoothpasteisfluoride,andmilkforcheese.Thename"softdrink"specifiesalackofalcohol.

90.A.Thiaminedeficiency

Rationale:

OptionAistheanswer.Thiamine(VitaminB1)deficiencyisoftenpresentinpateientswhohasalcohol
http://en.wikipedia.org/wiki/Shavinghttp://en.wikipedia.org/wiki/Shavinghttp://en.wikipedia.org/wiki/Shavinghttp://en.wikipedia.org/wiki/Perfumehttp://en.wikipedia.org/wiki/Perfumehttp://en.wikipedia.org/wiki/Perfumehttp://en.wikipedia.org/wiki/Shaving


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withdrawal.ThiaminereplacementisgiveninordertopreventWernickessyndrome.Wernickessyndromeischaracterizedbynystagmus,ptosis,ataxia,confusion,comaandpossibledeath

91.C. Blankstare

Rationale:

Phencyclidinepiperidine(PCP)isalsoknownasangeldust,horsetranquilizer,orpeacepill.ThesignsandsymptomsofPCPintoxicationrangefromacuteanxietytoacutepsychosis. Thecardinalsignsincludeablankstare,ataxia,musclerigidity,nystagmusandhypertensionnothypotension. Otherchoicesareinappropriate. Dilatedpupilsandparanoiaare seeninpeoplewho abusedhallucinogensHypotensionisseeninopiateabusers

92.D.Denial

Rationale:

Denialistheanswer.Substanceusetypicallyincludestheuseofdefensemechanisms,especiallydenialDenialisthefailuretoacknowledgeanunbearablecondition;failuretoadmittherealityofasituationorhowoneenablestheproblemtocontinue. Suppressionisreplacingthedesiredgratificationwithonethatismorereadilyavailable.Sublimationisexhibitingbehaviortomakeupforornegateunacceptablebehavior. Repressionisexcludingemotionallypainfuloranxietyprovokingthoughtsandfeelingsfromconsciousawareness

93. B.Methadone(Dolophine)

Rationale:

OptionBistheanswer.Opiatewithdrawalisusuallytreatedbymethadonetapering.MethadoneisasyntheticopiatethatatcertaindosesblocksthecravingandeffectsofheroinDopamineagonistisusedfortreatmentofcocaine-crackwithdrawal.Adopamineagonistisacompoundthatactivatesdopaminereceptors,mimickingtheeffectoftheneurotransmitterdopamine.Phencyclidinepiperidine (PCP)isahallucinogenthataltersonesmentalstateinashortperiod.Buspironeisadrugthatreducesanxiety,withouthavngastrongsedative-hypnotic properties

94.A.Marijuana

Rationale:

Marijuanaistheanswer.Physiologiceffectofmarijuanaincludesbloodshoteyes,drymouth,hypotension,increasedappetiteandtachycardia.Otherchoicesareinappropriate.

Amphetamineintoxicationmayresulttodilatedpupilsnotbloodshoteyes.Othersignsincludetachycardia,elevatedBP,Nauseaandvomitingandinsomnia.Barbiturates

intoxication

may

produce

symptoms

like

slurred

speech,

drowsiness

and

decreased

BP

LSD(Lysergicaciddiethylamide)mayresulttodilatedpupils,tachycardia,diaphoresis,palpitationsandtremors,elevatedtemperature,pulseandrespiration

95. B.Tachycardia

Rationale:

OptionBistheanswer.IntoxicationofAmphetaminemayresulttotachycardia;elevatedBPnothypotension;dilatedpupilsnotconstrictedandinsomnianothypersomnia

96. D. CranialNerveVII

Rationale:

Bellspalsyaffectsthemotoraspectofthefacialnerve,theseventhcranialnerve.Bellspalsyresultsinaunilateralparalysisofthefacialmusclesofexpression(Black,2154).

97. C. Becauseyoucannotblinktheaffectedeye,itcanbecomedryandirritated.

98. B.Riskforinjuryrelatedtocorneallaceration

99.B. Placinganeyepatchovertheeye

100.D. Alloftheabove
http://en.wikipedia.org/wiki/Dopaminehttp://en.wikipedia.org/wiki/Dopaminehttp://en.wikipedia.org/wiki/Dopaminehttp://en.wikipedia.org/wiki/Dopamine