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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.
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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.
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.
A group of nursing students is reviewing information about barriers to pain management. The group demonstrates the need for additional study when they identify which of the following as a barrier?
- A. Fear of tolerance
- B. Adequate reimbursement
- C. Concern for being a good client
- D. Reluctance to report pain
Correct Answer: B
Rationale: Adequate reimbursement (B) is not a barrier to pain management; it facilitates access to care. Fear of tolerance (A), concern for being a 'good client' (C), and reluctance to report pain (D) are recognized barriers due to patient fears and behaviors.
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.
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.