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A 22-year-old college student was involved in an automobile accident that resulted in permanent cognitive and physical disability. The night of the accident, the client and his friends had been celebrating a friend?s birthday at a local bar. The friend who was celebrating a birthday had been driving, and he was killed during the accident. The client feels guilty about his friend?s death. Which of the following would be a priority assessment for this client?
- A. Risk for suicide
- B. Level of depression
- C. Social support systems
- D. Financial status
Correct Answer: A
Rationale: Risk for suicide (A) is the priority due to the client?s guilt and trauma from the accident, which increase suicidality in the context of new disabilities. Depression level (B), social support (C), and financial status (D) are important but secondary to ensuring safety.
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A nurse is assessing a client with HIV who has developed HAND. The nurse determines that the client?s extrapyramidal system has been affected when the client exhibits which of the following? Select all that apply.
- A. Ataxia
- B. Inattention
- C. Tremors
- D. Spasticity
- E. Memory loss
Correct Answer: A,C,D
Rationale: HAND can affect the extrapyramidal system, leading to ataxia (A), tremors (C), and spasticity (D). Inattention (B) and memory loss (E) are cognitive symptoms, not specific to extrapyramidal dysfunction.
A client visits the emergency department after she was raped in her apartment. The nurse assesses the client?s ability to adapt to the trauma by assessing her social support systems and which of the following?
- A. Ability to effectively activate coping strategies
- B. Evidence of body image disturbance
- C. Type of affect reflected in nonverbal communication
- D. Degree of fear response reflected in nonverbal communication
Correct Answer: A
Rationale: Assessing the ability to activate coping strategies (A) is critical for evaluating adaptation to trauma, alongside social support. Body image disturbance (B), affect (C), and fear response (D) may be relevant but are less directly tied to adaptive capacity.
A client visits the clinic and tells the nurse about experiencing chronic stress on the job for the past 3 months. When teaching the client about chronic stress, which of the following would the nurse include as a possible result?
- A. Lung disorders
- B. Renal disorders
- C. Infections
- D. Thyroid disorders
Correct Answer: C
Rationale: Chronic stress weakens the immune system, increasing susceptibility to infections (C). Lung (A), renal (B), and thyroid disorders (D) are less directly linked to chronic stress, though prolonged stress may exacerbate existing conditions.
A group of nursing students is reviewing information about barriers to pain management. The group demonstrates the need for additional study when they identify which of the following as a barrier?
- A. Fear of tolerance
- B. Adequate reimbursement
- C. Concern for being a good client
- D. Reluctance to report pain
Correct Answer: B
Rationale: Adequate reimbursement (B) is not a barrier to pain management; it facilitates access to care. Fear of tolerance (A), concern for being a 'good client' (C), and reluctance to report pain (D) are recognized barriers due to patient fears and behaviors.
The nurse is developing a plan of care for a client with chronic pain caused by osteoarthritis. The client?s pain has been severe and prolonged. Which of the following would the nurse identify as a priority assessment?
- A. Grief
- B. Panic disorder
- C. Bulimia
- D. Depression
Correct Answer: D
Rationale: Chronic pain, especially from osteoarthritis, is strongly associated with depression (D) due to its impact on quality of life and functioning. Grief (A) may occur but is less prevalent, panic disorder (B) is not directly linked, and bulimia (C) is unrelated to chronic pain.