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The nurse is caring for four clients who are simultaneously being treated for chronic medical conditions and psychiatric conditions. Which client would the nurse anticipate as being most resistive to taking medications for both conditions?
- A. Male client who is exhibiting push of speech
- B. Female client who is having difficulty sleeping
- C. Male client who is convinced he is the president?s twin brother
- D. Female client who cannot establish and maintain eye contact
Correct Answer: C
Rationale: The male client with delusions of being the president?s twin brother (C) is likely experiencing psychosis, which often leads to medication resistance due to lack of insight. Push of speech (A) suggests mania but less resistance, sleep issues (B) and poor eye contact (D) are less indicative of non-compliance.
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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.
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 client visits the clinic and tells the nurse about experiencing chronic stress on the job for the past 3 months. When teaching the client about chronic stress, which of the following would the nurse include as a possible result?
- A. Lung disorders
- B. Renal disorders
- C. Infections
- D. Thyroid disorders
Correct Answer: C
Rationale: Chronic stress weakens the immune system, increasing susceptibility to infections (C). Lung (A), renal (B), and thyroid disorders (D) are less directly linked to chronic stress, though prolonged stress may exacerbate existing conditions.
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.