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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 newly admitted client diagnosed with obsessive-compulsive disorder (OCD) washes hands continually. This behavior prevents unit activity attendance. Which nursing statement best addresses this situation?
- A. Everyone diagnosed with OCD needs to control their ritualistic behaviors.
- B. It is important for you to discontinue these ritualistic behaviors.
- C. Why are you asking for help if you wont participate in unit therapy?
- D. Lets figure out a way for you to attend unit activities and still wash your hands.
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the client's need to wash their hands due to OCD while also addressing the issue of missing unit activities. By suggesting finding a way for the client to attend activities while still accommodating their need to wash hands, it promotes a collaborative approach and respects the client's autonomy. Option A is incorrect as not everyone with OCD can completely control their behaviors. Option B is too directive and may increase resistance. Option C is confrontational and may discourage the client from seeking help.
What is the priority nursing action during the orientation (introductory) phase of the nurseclient relationship?
- A. Acknowledge the clients actions and generate alternative behaviors.
- B. Establish rapport and develop treatment goals.
- C. Attempt to find alternative placement.
- D. Explore how thoughts and feelings about this client may adversely impact care.
Correct Answer: B
Rationale: The correct answer is B: Establish rapport and develop treatment goals. During the introductory phase of the nurse-client relationship, establishing rapport is essential to build trust and a therapeutic alliance. Developing treatment goals collaboratively with the client sets the foundation for the care plan. This action promotes client engagement and empowerment. Acknowledging client actions and generating alternative behaviors (A) is more suited for later phases. Attempting to find alternative placement (C) is not appropriate in the introductory phase. Exploring how thoughts and feelings impact care (D) is important but not the priority during the orientation phase.
At what point should the nurse determine that a client is at risk for developing a mental disorder?
- A. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria
- B. When maladaptive responses to stress are coupled with interference in daily functioning
- C. When the client communicates significant distress
- D. When the client uses defense mechanisms as ego protection
Correct Answer: B
Rationale: The correct answer is B. When maladaptive responses to stress are coupled with interference in daily functioning, the nurse should determine that a client is at risk for developing a mental disorder. This is because maladaptive responses to stress, such as excessive worry or avoidance behaviors, can be early signs of mental health issues. When these responses start impacting daily functioning, such as affecting work or relationships, it indicates a higher level of risk for a mental disorder. Choices A, C, and D are incorrect because they do not specifically address the combination of maladaptive responses to stress and interference in daily functioning, which are key indicators of potential mental health issues.
During a group session, which client statement demonstrates that the group has progressed to the middle, or working, phase of group development?
- A. Its hard for me to tell my story when Im not sure about the reactions of others.
- B. I think Joes Antabuse suggestion is a good one and might work for me.
- C. My situation is very complex, and I need professional, not peer, advice.
- D. I am really upset that you expect me to solve my own problems.
Correct Answer: B
Rationale: The correct answer is B because it shows the client actively engaging in problem-solving and considering specific strategies, indicating progress to the working phase. Choice A reflects the initial phase where trust and sharing are still developing. Choice C suggests a dependency on professional advice, not group collaboration. Choice D demonstrates resistance and a lack of ownership over personal growth, indicating an earlier phase of group development.
A nurse understands that the abnormal secretion of growth hormone may play a role in which illness?
- A. Schizophrenia
- B. Anorexia nervosa
- C. Alzheimers disease
Correct Answer: B
Rationale: The correct answer is B: Anorexia nervosa. Growth hormone abnormalities can contribute to the development of anorexia nervosa by affecting metabolism and body composition. Increased levels of growth hormone can lead to muscle wasting and weight loss, which are common symptoms of anorexia nervosa. In contrast, schizophrenia is primarily associated with neurotransmitter imbalances, Alzheimer's disease is linked to neurodegeneration, and diabetes is often related to insulin abnormalities.