The nurse is caring for a client who has recently lost a spouse. Which question asked by the nurse is essential in guarding the client's immune system?
- A. Do you have friends and family to support you?
- B. Do you live alone in a one-story house?
- C. Are you able to prepare nutritious meals?
- D. Are your neighbors able to check on you?
Correct Answer: A
Rationale: When a client has very intense stress, such as the loss of a spouse, stress can lower the number of white blood cells impacting the immune system. There is also a connection between poorer immune function and loneliness. Asking the client about friends and family who are available to provide support is most helpful. Friends and family allow the client to share emotions and immune function improves. The other questions provide helpful data but not as pertinent to the immune system.
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The nurse is admitting a client into a mental health facility and completing a mental status examination. Which assessment criteria would the nurse document to complete a total score? Select all that apply.
- A. Thought content
- B. Family report
- C. Physical appearance
- D. Attention
- E. History of abuse
- F. Memory
Correct Answer: A,C,D,F
Rationale: A mental status examination is one component of a thorough neurologic examination. It is an array of observations and questions that elicit information about a person's cognitive and mental state. The examination does not document a family report or a past history of physical abuse.
What intervention should a nurse recommend for fostering effective coping skills and a sense of hardiness?
- A. Balanced diet
- B. Periodic checkup
- C. Nonprescribed sedative drug
- D. Daily exercise
Correct Answer: D
Rationale: A nurse should recommend a daily exercise program to reduce stimulating neurotransmitters and release endorphins and enkephalins. Diet and periodic checkups are not essential to foster effective coping skills and a sense of hardiness. It is essential for the client to avoid a nonprescribed sedative drug for self-treatment because it does not foster effective coping skills and a sense of hardiness.
The nurse is caring for a client diagnosed with Parkinson disease. The nurse is most correct to correlate the client's uncontrolled tremors as a physical characteristic of a lack of which neurotransmitter?
- A. Serotonin
- B. Norepinephrine
- C. Dopamine
- D. Acetylcholine
Correct Answer: C
Rationale: Parkinson disease is a neurodegenerative disorder and the most common movement disorder. It is characterized by progressive loss of muscle control, which leads to trembling of the limbs and head while at rest, stiffness, slowness, and imbalance. Low levels of the neurotransmitter dopamine have been linked to the uncontrollable tremors. The other neurotransmitters are not related to Parkinson disease.
The nurse is caring for a client who is taking a medication that affects the function of the neurotransmitter norepinephrine. The client asks 'What does norepinephrine normally do in the body?' What should the nurse include in the response? Select all that apply.
- A. Affects attention and concentration
- B. Raises energy level
- C. Heightens arousal
- D. Assists memory storage
- E. Decreases seizure potential
Correct Answer: A,B,C
Rationale: The nurse should inform the client that norepinephrine affects attention and concentration, raises energy level, and heightens arousal. It does not assist memory storage or decrease seizure potential.
The nurse is instructing a community education class on stress. The nurse asks the participants, 'Is all stress bad for you?' Which answer by the participants indicates that teaching has been effective?
- A. No, all stress has negative effects on the body systems.
- B. Yes, all stress is bad but in varying degrees depending on the nature.
- C. No, not all stress is bad, but all stress can make a person sick.
- D. No, the right amount of stress can be motivating to accomplish goals.
Correct Answer: D
Rationale: Teaching has been effective if participants state that not all stress is bad because the right amount of stress can be motivating. Just the right amount of stress, called eustress, is what maintains a healthy balance in life. The other statements are not accurate.
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