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A client diagnosed with schizophrenia is prescribed an antipsychotic medication. Which of the following side effects should the nurse monitor for? Select one that doesn't apply.
- A. Tardive dyskinesia
- B. Muscle tension
- C. Orthostatic hypotension
- D. Hyperglycemia
Correct Answer: B
Rationale: Side effects of antipsychotic medications commonly include tardive dyskinesia, orthostatic hypotension, and hyperglycemia. Muscle tension is not typically associated with antipsychotic medication use. Tardive dyskinesia is characterized by involuntary movements, orthostatic hypotension refers to a drop in blood pressure upon standing, and hyperglycemia indicates high blood sugar levels. Monitoring these side effects is crucial for early detection and management, but muscle tension is not a typical side effect of antipsychotic medications.
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How should the nurse characterize the client's appraisal of the job loss stressor?
- A. Irrelevant
- B. Harm/loss
- C. Threatening
- D. Challenging
Correct Answer: D
Rationale: The client's statement reflects a positive outlook on the job loss, viewing it as a challenge and an opportunity for personal growth. This perspective suggests that the client is resilient and adaptive, focusing on new possibilities rather than dwelling on the negative aspects of the situation. Choice D, 'Challenging,' is the correct characterization as it aligns with the client's positive appraisal. Choices A, 'Irrelevant,' B, 'Harm/loss,' and C, 'Threatening,' are incorrect as they do not capture the client's adaptive response to the stressor.
Identical twins vary in their responses to stress. One twin may become anxious and irritable, while the other may withdraw and cry. How should the nurse explain these different reactions to stress to the parents?
- A. Reactions to stress are relative rather than absolute; individual responses to stress vary.
- B. It is abnormal for identical twins to react differently to similar stressors.
- C. Identical twins should share the same temperament and respond similarly to stress.
- D. Environmental influences weigh more heavily than genetic influences on reactions to stress.
Correct Answer: A
Rationale: Individual responses to stress can vary significantly due to factors such as perception, past experiences, and environmental influences, in addition to genetic factors. It is not unusual for identical twins to exhibit different reactions to stress as their individual personalities and coping mechanisms play a significant role in how they respond to stressful situations. Choice A is the correct answer because it acknowledges the variability in responses to stress among individuals. Choice B is incorrect because it wrongly labels differing reactions in identical twins as abnormal, when in reality, it is a natural phenomenon. Choice C is incorrect as it assumes that identical twins should always have the same temperament and response to stress, which is not always the case. Choice D is incorrect because it oversimplifies the complex interplay between genetic and environmental factors in shaping responses to stress.
The healthcare provider is preparing to provide medication instruction for a patient. Which of the following understandings about anxiety will be essential to effective instruction?
- A. Learning is best when anxiety is moderate to severe.
- B. Learning is enhanced when anxiety is mild.
- C. Panic-level anxiety helps the provider teach better.
- D. Severe anxiety is characterized by intense concentration and enhances the attention span.
Correct Answer: B
Rationale: Mild anxiety sharpens the senses, increases the perceptual field, and results in heightened awareness of the environment, which enhances learning. As anxiety increases, attention span decreases, making learning more difficult. Therefore, mild anxiety is more conducive to effective instruction compared to moderate to severe anxiety, panic-level anxiety, or severe anxiety. Choice A is incorrect because moderate to severe anxiety impairs learning. Choice C is incorrect as panic-level anxiety can be overwhelming and hinder the learning process. Choice D is incorrect because severe anxiety typically leads to impaired attention span rather than enhancing it.
A healthcare provider is providing care for a patient with generalized anxiety disorder (GAD) who has been prescribed an SSRI. Which SSRI is commonly used for this condition?
- A. Methylphenidate
- B. Sertraline
- C. Lithium
- D. Haloperidol
Correct Answer: B
Rationale: The correct answer is B: Sertraline. Sertraline, an SSRI, is commonly used to treat generalized anxiety disorder (GAD) due to its efficacy and tolerability. Methylphenidate is a central nervous system stimulant used for ADHD and narcolepsy, not for GAD. Lithium is mainly used for bipolar disorder, not for GAD. Haloperidol is an antipsychotic medication, not typically used for GAD.
A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data?
- A. The client is experiencing severe distress and is at risk for physical and psychological illness.
- B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness.
- C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports.
- D. The client may view these losses as challenges and perceive them as opportunities.
Correct Answer: C
Rationale: The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500 or more, indicates high stress in a client's life. However, susceptibility to stress-related physical or psychological illness cannot be accurately estimated without considering the individual's coping resources and available support systems. Positive coping mechanisms and strong social support can mitigate the risk of stress-related illnesses even in the face of significant life changes and losses. Choice A is incorrect because it makes a definitive statement about the client's state without considering individual coping mechanisms and support. Choice B is incorrect because a score of 110 does not necessarily mean no threat of stress-related illness, as individual factors play a crucial role. Choice D is incorrect as it assumes a positive outlook without acknowledging the potential impact of the experienced losses on stress levels.