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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 client with heart disease who had a myocardial infarction 2 months ago comes to the clinic for a follow-up visit. While assessing the client, the nurse would be alert most likely for the development of which of the following responses? Select all that apply.
- A. Personality disorder
- B. Depression
- C. Substance abuse disorder
- D. Anxiety disorder
- E. Delirium
Correct Answer: B,D
Rationale: Depression (B) and anxiety disorder (D) are common post-myocardial infarction due to emotional and physical stress. Personality disorders (A) are not typically triggered, substance abuse (C) is less directly linked, and delirium (E) is more acute and less likely 2 months post-event.
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 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.
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 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.