Nokea
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.
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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.
After teaching a group of nursing students about the connections between mental health and medical disorders on clients and families, the instructor determines the need for additional teaching when the students identify which of the following as an effect?
- A. Increased motivation for self-care
- B. Prolonged hospitalization
- C. Delayed recovery
- D. Increased financial strain
Correct Answer: A
Rationale: Increased motivation for self-care (A) is not a typical effect of combined mental health and medical disorders; these conditions often reduce motivation. Prolonged hospitalization (B), delayed recovery (C), and increased financial strain (D) are recognized effects.
A client visits the clinic and complains of chronic pain in her leg as a result of a fall 6 months ago. Which of the following would be most important for the nurse to do first when developing the client?s plan of care?
- A. Acknowledge the client?s pain.
- B. Identify situations that increase the pain.
- C. Have the client rate her pain from 1 to 10.
- D. Review the client?s current medications.
Correct Answer: A
Rationale: Acknowledging the client?s pain (A) is the first step to build trust and validate the client?s experience, essential for effective care planning. Identifying pain triggers (B), rating pain (C), and reviewing medications (D) follow but are secondary to establishing rapport.
The nurse is caring for a client diagnosed with HAND resulting from AIDS. Which of the following would be most important for the nurse to assess?
- A. Sensory impairment
- B. Cognitive impairment
- C. Social behaviors
- D. Anxiety state
Correct Answer: B
Rationale: HIV-associated neurocognitive disorder (HAND) primarily affects cognitive function, making cognitive impairment (B) the most critical assessment. Sensory impairment (A), social behaviors (C), and anxiety (D) may be present but are less central to HAND?s core pathology.
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.