Which client statement reflects an understanding of the effect of circadian rhythms on a person?
- A. When I dream about my mothers horrible train accident, I become hysterical. B. I get really irritable during my menstrual cycle.C. Im a morning person. I get my best work done in the a.m.
- B. Every February, I tend to experience periods of sadness.
Correct Answer: C
Rationale: The correct answer is C because the client statement "I'm a morning person. I get my best work done in the a.m." reflects an understanding of circadian rhythms. Circadian rhythms are the body's internal clock that regulates the sleep-wake cycle and influences energy levels and productivity throughout the day. Being a morning person indicates that this individual's peak productivity aligns with their body's natural circadian rhythm, which typically results in better performance during the morning hours.
Choice A is incorrect as it relates to a traumatic dream triggering hysteria, not circadian rhythms. Choice B is incorrect as it mentions experiencing sadness in February, which is more likely related to seasonal affective disorder rather than circadian rhythms.
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A nurse is caring for a hospitalized client who is quarrelsome and opinionated and has little regard for others. According to Sullivans interpersonal theory, the nurse should associate the clients behaviors with a previous deficit in which stage of development?
- A. Childhood
- B. Early adolescence
- C. Late adolescence
- D. Infancy
Correct Answer: A
Rationale: According to Sullivan's interpersonal theory, childhood is the stage where the foundation of interpersonal relationships is formed. Quarrelsome and opinionated behaviors with little regard for others can be associated with deficits in early childhood development. During this stage, individuals learn emotional regulation, empathy, and social skills. If these skills are not adequately developed in childhood, it can result in maladaptive behaviors in adulthood. Therefore, the correct answer is A.
Choice B, early adolescence, focuses more on identity formation and peer relationships. Choice C, late adolescence, emphasizes the transition to adulthood and independence. Choice D, infancy, is too early in development to have a significant impact on the client's current behavior.
A despondent client, who has recently lost her husband of 30 years, tearfully states, Ill feel a lot better if I sell my house and move away. Which nursing reply is most appropriate?
- A. Im confident you know whats best for you.
- B. This may not be the best time for you to make such an important decision.
- C. Your children will be terribly disappointed.
- D. Tell me why you want to make this change.
Correct Answer: B
Rationale: The correct answer is B because it acknowledges the client's emotions and gently suggests caution in making a big decision during a vulnerable time. It shows empathy and encourages the client to reconsider the decision later. Choice A lacks exploration of client's feelings, Choice C introduces unnecessary guilt, and Choice D focuses on the change rather than the emotional state.
A client diagnosed with somatic symptom disorder is most likely to exhibit which personality disorder characteristics?
- A. Uses splitting and manipulation in relationships
- B. Is socially irresponsible, exploitative, and guiltless and disregards rights of others
- C. Expresses heightened emotionality, seductiveness, and strong dependency needs
- D. Uncomfortable in social situations; perceived as timid, withdrawn, cold, and strange
Correct Answer: C
Rationale: The correct answer is C because individuals with somatic symptom disorder often display characteristics of heightened emotionality, seductiveness, and strong dependency needs. These traits are consistent with histrionic personality disorder, which is commonly comorbid with somatic symptom disorder. Choice A (splitting and manipulation) is more indicative of borderline personality disorder. Choice B (socially irresponsible, exploitative) aligns with antisocial personality disorder. Choice D (uncomfortable in social situations) is more in line with schizoid or avoidant personality disorder. Thus, choice C is the most appropriate match for individuals with somatic symptom disorder.
A family member is seeking advice about an elderly parent who seems to worry unnecessarily about everything. The family member states, Should I seek psychiatric help for my mother? Which is an appropriate nursing reply?
- A. My mother also worries unnecessarily. I think it is part of the aging process.
- B. Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning.
- C. From what you have told me, you should get her to a psychiatrist as soon as possible.
- D. Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications.
Correct Answer: B
Rationale: The correct answer is B because it provides a clear and accurate explanation of when anxiety is considered abnormal. It states that anxiety is abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning. This response shows understanding of the situation and suggests seeking professional help based on specific criteria.
Choice A is incorrect as it dismisses the concerns as part of the aging process without addressing the possibility of abnormal anxiety. Choice C is incorrect as it jumps to the conclusion of seeking psychiatric help without evaluating the level of anxiety or impairment. Choice D is incorrect as it oversimplifies anxiety treatment by suggesting it can only be treated with medications, ignoring the importance of therapy and other interventions.
A client is taking chlordiazepoxide (Librium) for generalized anxiety disorder symptoms. In which situation should a nurse recognize that this client is at greatest risk for drug overdose?
- A. When the client has a knowledge deficit related to the effects of the drug
- B. When the client combines the drug with alcohol
- C. When the client takes the drug on an empty stomach
- D. When the client fails to follow dietary restrictions
Correct Answer: B
Rationale: The correct answer is B: When the client combines the drug with alcohol. Combining chlordiazepoxide with alcohol can potentiate the central nervous system depression effects, leading to respiratory depression, sedation, and potential overdose. Alcohol can enhance the sedative effects of chlordiazepoxide, increasing the risk of overdose. A, C, and D are incorrect because a knowledge deficit, taking the drug on an empty stomach, or failing to follow dietary restrictions are not directly related to increasing the risk of drug overdose in this specific scenario.