Nokea
A nursing instructor is describing how pain can impact a client psychosocially. As part of the discussion, the instructor explains the pain response. Which of the following would the instructor include as excitatory amino acids involved? Select all that apply.
- A. Somatostatin
- B. Substance P
- C. L-glutamate
- D. Serotonin
- E. N-methyl-D-aspartate
- F. Endorphins
Correct Answer: B,C,E
Rationale: Substance P (B), L-glutamate (C), and N-methyl-D-aspartate (E) are excitatory amino acids involved in pain transmission. Somatostatin (A) and endorphins (F) are inhibitory, and serotonin (D) modulates pain but is not an excitatory amino acid.
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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 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 nurse is trying to determine whether a client is exhibiting symptoms of depression or of her medical illness. Which of the following group of symptoms would indicate to the nurse that the client may be experiencing depression in addition to being medically ill?
- A. Problems sleeping, decreased appetite, and frequent crying
- B. Low self-esteem, decreased appetite, and problems sleeping
- C. Feeling guilty, difficulty making decisions, and low self-esteem
- D. Loss of energy, difficulty making decisions, and problems sleeping
Correct Answer: C
Rationale: Feeling guilty, difficulty making decisions, and low self-esteem (C) are specific to depression, distinguishing it from medical illness symptoms like sleep issues or appetite changes (A, B, D), which can overlap with physical conditions.
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.
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.