LP, a patient diagnosed with Borderline Personality Disorder…

LP, a patient diagnosed with Borderline Personality Disorder is asked to leave the pantry area as patients are not permitted in the area for infection control purposes. LP replies: “the nurse last night, Sarah completely understands what I need. She always lets me go into the pantry after hours and make coffee for myself and thinks the rules are stupid. You obviously don’t care about me. She is so much more understanding and considerate.” The patient is using which primitive defense mechanisms?

BC, a 34-year-old male works at a bank downtown. At 1930, he…

BC, a 34-year-old male works at a bank downtown. At 1930, he is found unresponsive in his office. According to his co-worker, he appeared “OK”, talkative and friendly when he arrived at work. He went to lunch, returned to the office, and continued to work well into the evening.  A member of the housekeeping team found him laying behind his desk, unresponsive with a laceration on his forehead. She called 911 and security for help. He is taken to the emergency room via ambulance. His secretary is called as his contact. She states he is usually very productive at work, but recently has seemed preoccupied and anxious. She notes he always has a lot of energy but lately has been coming into work late, seems agitated and sluggish, and continually complains about how “expensive” things are.  She says he is in good health yet has had several nose bleeds at work. He says he always gets nose bleeds when it’s dry outside.  In the emergency room the admitting nurse takes his VS and conducts her assessment:Vital Signs: BP: 197/120 mmHg P: 125/minute R: 24/minute T: 39C (102.4F) O2 sat: 98% (FiO2=0.21)Eyes: Pupils mydriatic, equalHeart: Tachycardia, no murmursLungs: Equal bilaterally, clear to auscultationAbdomen: Bowel sounds normalNeurologic: Moaning unintelligibly, flailing all extremities, spontaneously opens eyesSkin: Flushed, diaphoretic  The admitting nurse states: “I need some help to control this guy!” “He’s going to fall off the bed!” The patient then has what appears to be a tonic-clonic seizure lasting approximately 60 seconds. She suspects the patient has been using an illicit substance and is experiencing toxicity. She immediately rules out narcotic overdose due to the presence of the following signs and symptoms: Select all that apply.   

BJ is a college student concerned about her finals. Last sem…

BJ is a college student concerned about her finals. Last semester, she tried crushing her roommate’s ADHD medication and snorting it because she had heard that it helps you stay awake and maintain focus for long periods of time. It definitely helped her focus on her school work. This semester, her grades have really dropped because of her extracurricular activities and she needs to perform well on the exams. Her boyfriend gave her some pills to help her study. She decided to use them all week before exams by crushing and snorting them like she did last semester.  Her roommate noticed that she didn’t seem to be sleeping and confronted BD. BJ responded: “I’m fine. I’m just studying a lot.” One the night before her big exam, BJ woke up her roommate stating: “My heart feels like it jumping out of my chest. I feel a lot of pressure and sharp pain here (points to her chest). Her roommate reaches out to comfort BJ and noticed she was hot to the touch and seemed to be sweating profusely. BJ hen grabbed her chest and collapsed on the floor. Her roommate called 911 and public safety. She (BJ) was taken to the emergency room. Care in the ED will focus on: Select all that apply.   

PL is admitted to the chemical dependency unit for polysubst…

PL is admitted to the chemical dependency unit for polysubstance use disorder.  During the skin assessment, you find a baggy of a sticky black substance in the shape of a small rock sewn into the lining of his jacket. You immediately call security.  You believe this substance is: 

BY is a 44-year-old male admitted to the emergency room afte…

BY is a 44-year-old male admitted to the emergency room after a motor vehicle accident involving three cars. He has a broken arm, bruises to his chest, a superficial head wound, and a BAL (blood alcohol level) of 0.187 mg%. He has no previous history of alcohol use/abuse but recently learned that his wife was having an affair with a neighbor. The nurse might expect all of the following symptoms except: