Question

The nurse is caring for a client who is receiving Divalproex acid (Depakote). What clinical manifestation should the nurse periodically monitor for?

Answer 1

Correct Answers:

Hepatotoxicity

Rationale :

🩺Valproate/Divalproex carries a boxed warning for hepatotoxicity, especially within the first 6 months of therapy, making liver monitoring a priority.

🧪Routine assessment should include liver function tests (AST/ALT, bilirubin) and clinical checks for right upper-quadrant pain, nausea/vomiting, and malaise.

🟡Observing for jaundice, dark urine, and pale stools helps detect impaired bile excretion associated with liver injury.

⚠️Early recognition of hepatotoxicity allows prompt drug discontinuation and prevents progression to liver failure.

📋Client education should emphasize reporting hepatic symptoms immediately and adhering to scheduled LFTs to reduce risk of severe adverse outcomes.

📌Core Message

Divalproex → hepatotoxicity risk; monitor LFTs and jaundice/RUQ pain for early detection and prevention of liver failure.

Answer 2

Correct Answers:

Restless leg syndrome

Rationale :

🦵Restless leg syndrome is characterized by an urge to move the legs, often accompanied by uncomfortable sensations, that worsens during rest or at night.

🌙Symptoms worsen in the evening and with inactivity, disrupting sleep initiation and maintenance.

🚶‍♀️Movement provides relief, so clients often walk or stretch to reduce discomfort.

🧪Contributing factors can include iron deficiency or certain medications, so assessment of risk factors is important.

📌Core Message

Urge to move legs at rest, worse at night, relieved by movement → restless leg syndrome.

Answer 3

Correct Answers:

“You may feel dizzy and be prone to falls after taking this medication.”

Rationale :

💊Diazepam causes central nervous system depression, leading to sedation, dizziness, and impaired coordination that heighten fall risk in older adults.

⚠️Beers Criteria list benzodiazepines as potentially inappropriate in the elderly due to delirium, falls, and fractures.

🪑Immediate safety education should stress slow position changes, assistive devices, and avoiding alcohol or other sedatives.

📚While dependence and memory issues can occur, the most urgent priority is preventing injury from falls.

📌Core Message

In older adults on diazepam, the top priority is fall-risk safety due to sedation and dizziness.

Answer 4

Correct Answers:

Avoidant

Rationale :

🔍Avoidant personality disorder features social inhibition, feelings of inadequacy, and avoidance of new activities from fear of criticism or rejection.

🧭Remaining in the same low-risk role and declining new trips or hobbies reflects risk-avoidance to prevent potential negative evaluation.

📚This differs from schizoid personality, where individuals show limited desire for relationships rather than fear-driven avoidance.

🧱The pattern is persistent and pervasive, impairing social and occupational functioning, fitting personality disorder criteria.

📌Core Message

Fear of rejection with social inhibition and avoiding new activities points to avoidant personality disorder.

Answer 5

Correct Answers:

Lack of social support

Rationale :

🧲A weak support network removes an important protective buffer against stress, elevating risk for major depression.

📊Social isolation correlates with greater incidence and worse outcomes, making it a key modifiable risk factor.

🧩Robust interpersonal connections enhance resilience, treatment engagement, and recovery.

🛡️Nursing care should assess supports, facilitate connection to therapy and community resources, and reduce isolation.

📌Core Message

Limited social support is a major depression risk, so strengthening connections is a priority intervention.

Answer 6

Correct Answers:

Individual with somatic symptoms disorder experience real physical effects, but these manifestations are due to emotional cause rather than physical ones.

Rationale :

🩺Somatic symptom disorder involves authentically felt symptoms primarily linked to psychological factors rather than structural medical disease.

🔬Symptoms are not intentionally produced, often persist despite negative workups, and lead to functional impairment.

📚Effective management includes validation, regular visits, and CBT to reduce symptom preoccupation and health anxiety.

🧭Avoid unnecessary testing and focus on coping strategies, stress reduction, and consistent provider communication.

📌Core Message

Real symptoms, psychological drivers, not feigned; use validation, scheduled care, and CBT.

Answer 7

Correct Answers:

Echolaia

Rationale :

🗣️Echolalia is the immediate or delayed repetition of another person’s words, matching the described behavior.

🔎This differs from verbigeration, which is meaningless repetition without a preceding stimulus phrase.

📚It also differs from neologisms (creating new, nonstandard words) and circumstantiality (excessive detail before reaching the point).

🧭Recognition supports using simple, clear communication and therapeutic redirection during interactions.

📌Core Message

Exact repetition of others’ speech identifies echolalia, not verbigeration or neologisms.

Answer 8

Correct Answers:

"I use alcohol and marijuana because they help me forget my problems for a while."

Rationale :

🧭Self-medication is using substances to cope with distress or to avoid emotions, which this statement explicitly conveys.

⚠️This pattern promotes avoidance, increases tolerance and dependence, and can worsen underlying conditions.

📚Statements about cutting back or attending support groups indicate change efforts rather than reasons for use.

🤝Identification guides motivational interviewing, CBT, and referral to appropriate treatment services.

📌Core Message

Using substances to cope or escape signals self-medication and warrants behavioral treatment.

Answer 9

Correct Answers:

Discussing client details only with authorized personnel

Rationale :

🔐Confidentiality limits information sharing to authorized individuals directly involved in care.

🚫Public discussions, unattended records, and social media disclosures violate privacy and professional standards.

📚Policies aligned with HIPAA principles require secure documentation and private communication.

🛡️Nurses model ethical practice by restricting access and safeguarding records at all times.

📌Core Message

Protect confidentiality by sharing only with authorized staff and avoiding public disclosure.

Answer 10

Correct Answers:

Respect the client’s cultural identity and include family in care planning

Rationale :

🌍In collectivist cultures, family participation in decisions reflects cultural values and identity.

🧭Culturally responsive care honors preferences, obtains consent, and integrates family, while preserving client autonomy.

📚Discouraging family involvement can erode trust and reduce adherence to the plan of care.

🤝The nurse should facilitate shared decision-making, clarify legal consent, and ensure the client’s voice remains central.

📌Core Message

Provide culturally sensitive care by including family appropriately and maintaining autonomy.

1 :
The nurse is caring for a client who is receiving Divalproex acid (Depakote). What clinical manifestation should the nurse periodically monitor for?

2 :
Choose the sleep disorder a person has when they experience overwhelming urges to move legs during sleep.

3 :
An older adult reporting concerns of anxiety is prescribed diazepam (Valium) by a health care provider. The provider asks the office nurse to explain the problematic side effects of this medication to the client. Which instruction is most important for the nurse to emphasize about this drug?

4 :
A 40-year-old who works at the same entry level job for many years without seeking advancement and politely declines when friends ask her to try new vacation spots or hobbies may be suffering from which personality disorder?

5 : Which of the following is a major risk factor for the development of major depressive disorder?

6 :
A nurse is providing education about somatic symptom disorder to a client’s family. Which of the following pieces of information should the nurse include in the education?

7 :
The nurse is caring for a patient in an inpatient mental health setting. The nurse notices that when conversing with other patients, the patient repeats what they are saying word for word. The nurse interprets this finding and documents it as which condition?

8 :
A nurse is assessing a client who reports using alcohol and marijuana daily to "calm down" and "deal with stress." Which of the following statements by the client most clearly indicates self-medication behavior related to substance use?

9 :
Which of the following actions aligns with maintaining client confidentiality in a therapeutic milieu?

10 :
An RN is caring for a client from a collective culture notices the client frequently defers decisions to their family. What is the most appropriate response by the nurse?

1 : The nurse is caring for a client who is receiving Divalproex acid (Depakote). What clinical manifestation should the nurse periodically monitor for?

2 : Choose the sleep disorder a person has when they experience overwhelming urges to move legs during sleep.

3 : An older adult reporting concerns of anxiety is prescribed diazepam (Valium) by a health care provider. The provider asks the office nurse to explain the problematic side effects of this medication to the client. Which instruction is most important for the nurse to emphasize about this drug?

4 : A 40-year-old who works at the same entry level job for many years without seeking advancement and politely declines when friends ask her to try new vacation spots or hobbies may be suffering from which personality disorder?

5 : Which of the following is a major risk factor for the development of major depressive disorder?

6 : A nurse is providing education about somatic symptom disorder to a client’s family. Which of the following pieces of information should the nurse include in the education?

7 : The nurse is caring for a patient in an inpatient mental health setting. The nurse notices that when conversing with other patients, the patient repeats what they are saying word for word. The nurse interprets this finding and documents it as which condition?

8 : A nurse is assessing a client who reports using alcohol and marijuana daily to "calm down" and "deal with stress." Which of the following statements by the client most clearly indicates self-medication behavior related to substance use?

9 : Which of the following actions aligns with maintaining client confidentiality in a therapeutic milieu?

10 : An RN is caring for a client from a collective culture notices the client frequently defers decisions to their family. What is the most appropriate response by the nurse?

1 :
The nurse is caring for a client who is receiving Divalproex acid (Depakote). What clinical manifestation should the nurse periodically monitor for?

2 :
Choose the sleep disorder a person has when they experience overwhelming urges to move legs during sleep.

3 :
An older adult reporting concerns of anxiety is prescribed diazepam (Valium) by a health care provider. The provider asks the office nurse to explain the problematic side effects of this medication to the client. Which instruction is most important for the nurse to emphasize about this drug?

4 :
A 40-year-old who works at the same entry level job for many years without seeking advancement and politely declines when friends ask her to try new vacation spots or hobbies may be suffering from which personality disorder?

6 :
A nurse is providing education about somatic symptom disorder to a client’s family. Which of the following pieces of information should the nurse include in the education?

7 :
The nurse is caring for a patient in an inpatient mental health setting. The nurse notices that when conversing with other patients, the patient repeats what they are saying word for word. The nurse interprets this finding and documents it as which condition?

8 :
A nurse is assessing a client who reports using alcohol and marijuana daily to "calm down" and "deal with stress." Which of the following statements by the client most clearly indicates self-medication behavior related to substance use?

9 :
Which of the following actions aligns with maintaining client confidentiality in a therapeutic milieu?

10 :
An RN is caring for a client from a collective culture notices the client frequently defers decisions to their family. What is the most appropriate response by the nurse?