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The nurse is caring for a client who reports suspecting a poor immune system due to feeling sick most of the time. Upon assessment the nurse finds the client is experiencing elevated stress levels. In addition to neurotransmitters, which chemical messenger between the client's brain and immune system is activated?
- A. Adrenalin
- B. Thyroxin
- C. Cytokines
- D. Steroids
Correct Answer: C
Rationale: Cytokines, also called immunopeptides, function in the same ways as a neurotransmitter, by relaying messages throughout the immune system and the brain. Neither adrenalin, nor thyroxin, nor steroids function as chemical messengers for the immune system.
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The nurse is reviewing ways to foster effective coping skills with a client who has an anxiety disorder. What should the nurse include in the teaching? Select all that apply.
- A. Re-establish priorities and strike a healthy balance between work and play.
- B. Engage in a daily exercise program.
- C. Learn about stress management education and join a support group.
- D. Avoid verbalizing or writing about feelings of anxiety.
- E. Delay stressful tasks as desired.
Correct Answer: A,B,C
Rationale: The nurse should suggest re-establishing priorities and striking a healthy balance between work and play, engaging in a daily exercise program, pursuing stress management education, and joining a support group as ways to foster effective coping skills. The client should be encouraged to clearly state feelings or write about them in a diary if verbalizing dramatic or angry thoughts is difficult. The nurse should also discuss time management techniques such as avoiding procrastination; therefore, delaying stressful tasks as desired would not be included in the teaching.
The nurse is caring for a client on a behavioral health unit. What would support the theory that mental illness is a psychobiologic disorder?
- A. The client needs supervision in performing self-care.
- B. The client behavior improves with group therapy.
- C. The client has an alteration in neurotransmitter levels.
- D. The client has developed inappropriate interpersonal skills.
Correct Answer: C
Rationale: The nurse is correct to confirm the biologic disorder of an alteration in neurotransmitter levels. The neurotransmitters dopamine, norepinephrine, epinephrine, serotonin, and acetylcholine often are implicated in the psychobiology of mental illness. Evaluating the client's need for personal assistance, behavior improvement with group therapy, and inappropriate interpersonal skills addresses behavior aspects alone.
The nurse is instructing a client in a physician's office. Which instruction is most accurate when advising the client on the feelings of anger?
- A. Suppressing anger and excessively expressing anger can negatively affect the body.
- B. Let your feelings of anger out so you can resolve the issues before they cause illness.
- C. Use physical exercise to channel your anger in another direction.
- D. Eliminate the sources of stress causing anger from your lifestyle.
Correct Answer: A
Rationale: It is most accurate to understand that suppressing anger and excessively expressing anger can both lead to physical symptoms including death. The nurse must continue to follow the client's actions and emotions. Expressing anger in an appropriate manner helps to prevent neurochemical changes in the brain. Using exercise is an appropriate manner to relieve stress. Eliminating sources of stress is not appropriate.
The nurse researcher and committee monitoring are working with in a research study administering study medications to study participants. If the nurse researcher is administering study medications in a double-blind study, who is knowledgeable of the specifics of the medication?
- A. The nurse researcher
- B. The study committee and research nurse
- C. The study committee, research nurse, and client
- D. The study committee
Correct Answer: D
Rationale: The study committee is knowledgeable about the study medications. The nurse researcher and clients are not aware of the components of the medication, being a therapeutic medication or placebo. Thirty percent of the individuals receiving a placebo experience a positive outcome.
The nurse is caring for a client in whom a psychological disorder is anticipated. Which assessment data would the nurse use to formulate report for the next shift? Select all that apply.
- A. Family history
- B. Mental status examination
- C. Laboratory/diagnostic testing
- D. Client statements
- E. Community report
Correct Answer: A,B,C,D
Rationale: The nurse would use verifiable data to report the client's condition to the next shift. Information from community sources may or may not be accurate.