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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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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.
A client has had a major stroke, and she is struggling to adjust to living with the consequent changes and permanent disabilities because of problems related to speech and mobility. The nurse is making a home visit and assesses the client closely based on the understanding that the client is at increased risk for which of the following?
- A. Bipolar I disorder
- B. Major depressive disorder
- C. Generalized anxiety disorder
- D. Posttraumatic stress disorder
Correct Answer: B
Rationale: Major depressive disorder (B) is a common risk following a major stroke due to the impact of speech and mobility impairments on quality of life. Bipolar disorder (A), anxiety (C), and PTSD (D) are less directly associated with stroke-related disability.
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.
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 nurse is trying to determine whether a client is exhibiting symptoms of depression or of her medical illness. Which of the following group of symptoms would indicate to the nurse that the client may be experiencing depression in addition to being medically ill?
- A. Problems sleeping, decreased appetite, and frequent crying
- B. Low self-esteem, decreased appetite, and problems sleeping
- C. Feeling guilty, difficulty making decisions, and low self-esteem
- D. Loss of energy, difficulty making decisions, and problems sleeping
Correct Answer: C
Rationale: Feeling guilty, difficulty making decisions, and low self-esteem (C) are specific to depression, distinguishing it from medical illness symptoms like sleep issues or appetite changes (A, B, D), which can overlap with physical conditions.