Nokea
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.
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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 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.
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.
A female client is being treated for depression that has occurred secondary to a chronic cardiopulmonary condition. Which antidepressant would the nurse anticipate being prescribed for this client?
- A. Trazodone (Desyrel)
- B. Bupropion (Wellbutrin)
- C. Fluoxetine (Prozac)
- D. Amitriptyline (Elavil)
Correct Answer: C
Rationale: Fluoxetine (Prozac) (C), an SSRI, is often prescribed for depression in clients with cardiopulmonary conditions due to its favorable side effect profile and minimal cardiac impact. Trazodone (A) is sedating, bupropion (B) may increase seizure risk, and amitriptyline (D), a tricyclic, has significant cardiac side 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.