Nokea
A client has had a major stroke, and she is struggling to adjust to living with the consequent changes and permanent disabilities because of problems related to speech and mobility. The nurse is making a home visit and assesses the client closely based on the understanding that the client is at increased risk for which of the following?
- A. Bipolar I disorder
- B. Major depressive disorder
- C. Generalized anxiety disorder
- D. Posttraumatic stress disorder
Correct Answer: B
Rationale: Major depressive disorder (B) is a common risk following a major stroke due to the impact of speech and mobility impairments on quality of life. Bipolar disorder (A), anxiety (C), and PTSD (D) are less directly associated with stroke-related disability.
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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.
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.
The nurse is caring for four clients who are simultaneously being treated for chronic medical conditions and psychiatric conditions. Which client would the nurse anticipate as being most resistive to taking medications for both conditions?
- A. Male client who is exhibiting push of speech
- B. Female client who is having difficulty sleeping
- C. Male client who is convinced he is the president?s twin brother
- D. Female client who cannot establish and maintain eye contact
Correct Answer: C
Rationale: The male client with delusions of being the president?s twin brother (C) is likely experiencing psychosis, which often leads to medication resistance due to lack of insight. Push of speech (A) suggests mania but less resistance, sleep issues (B) and poor eye contact (D) are less indicative of non-compliance.
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.
A nurse is reviewing the medication history of a client with a medical illness who is also exhibiting signs and symptoms of depression and agitation. Which medications would the nurse identify as possibly contributing to the client?s current state? Select all that apply.
- A. Clonidine
- B. Ibuprofen
- C. Acetaminophen
- D. Baclofen
- E. Carvedilol
Correct Answer: A,D,E
Rationale: Clonidine (A), baclofen (D), and carvedilol (E) can contribute to depression or agitation due to their CNS effects. Ibuprofen (B) and acetaminophen (C) are less likely to cause these psychiatric symptoms.