NU273 Mood & Affect / Mental Health Concepts
A client has recently received a diagnosis of depression and has been prescribed citalopram. The nurse is providing health education and the client states, "I'm relieved to have some medication to help with my mood, because it's my daughter's wedding next weekend and I'll be feeling better." What is the nurse's best response? "You'll likely be feeling significantly better by the weekend, but remember to avoid drinking alcohol at the wedding." "Antidepressants help relieve the lack of energy and concentration during depression but your mood might not be affected." "Antidepressants will help your mood but it usually takes a few weeks to experience the benefits." "This is very good timing for you, but remember that you might have some side effects, especially for the first couple of weeks."
"Antidepressants will help your mood but it usually takes a few weeks to experience the benefits." Explanation: Peak benefits of SSRIs can take up to six weeks to be realized, and a client is unlikely to notice an effect within a few days. Antidepressants improve mood, not just energy and concentration.
The nurse is caring for a client with schizophrenia. The client tells the nurse, "My dead mother is calling me, I will finally be with her tonight. Please do not tell anyone." What is the most appropriate nursing response? "Who has influenced you with these ideas?" "Don't worry; I will keep this secret to myself." "I cannot keep this a secret. I will ensure that the staff helps keep you safe."
"I cannot keep this a secret. I will ensure that the staff helps keep you safe." Explanation: The nurse is not supposed to keep secrets, especially if the information relates to the client inflicting self-harm. The nurse should inform the client that they will be closely monitored. Asking the client who has influenced the client with these ideas indicates a poor understanding of the nature of the client's illness. For client's with schizophrenia, stimuli are internally generated and can cause emotional dysfunction. The nurse should not exhibit anger, as the nurse is supposed to be accepting of the client in any circumstances. Stating that the client will be restrained may be perceived as threatening.
A nurse is caring for a 14-year-old adolescent who states, "No one understands me." Which statement by the nurse best demonstrates empathy? "Tell me about a time you felt your parents were understanding." "Let's talk about your future plans and which courses you enjoy." "It's difficult to be a teenager. Tell me more about your experiences." "Explain why you think no one understands you. How can adults help?"
"It's difficult to be a teenager. Tell me more about your experiences." Explanation: Empathy is the ability to put oneself in another's place and experience a feeling as that person is experiencing it. The correct answer acknowledges the adolescent's feelings and conveys an understanding without intimidating the client. Asking how adults can help and reflecting on parental understanding or favorite coursework is helpful overall but does not demonstrate empathy for the client.
A client has just been diagnosed with bipolar disorder and is upset with the diagnosis. The client tells the nurse, "It is probably my mother's fault, she has bipolar too." Which is the best response by the nurse? "While bipolar disorders are genetic, the gene can only be passed on by a father." "While bipolar disorders are genetic, there are other causes as well." "Genetics are a minor factor in bipolar; it is more heavily influenced by psychological factors." "Bipolar disorders have not been found to be genetic."
"While bipolar disorders are genetic, there are other causes as well." Explanation: Although a single definitive cause has not been pinpointed, scientists agree that a combination or interaction of genes, neurobiology, environment, life history, and development can result in bipolar disorders. Bipolar disorders are highly inheritable.
A client states the following to the nurse: "I am a failure, and I wish I had died." Which statement by the nurse demonstrates a therapeutic response? "You feel like a failure; would you like to talk more about the way you feel?" "I think you have had many successes in your life and you should focus on them." "You are depressed right now so feeling like a failure is a normal manifestation." "I am glad to hear you speak about your feelings and I am glad you did not die.
"You feel like a failure; would you like to talk more about the way you feel?" Explanation: Acknowledging the client's feelings by repeating what the client states is therapeutic. It is also therapeutic for the nurse to offer to discuss the client's feelings further. The other options are incorrect because they dismiss the client's feelings.
Which is a food that might be incorporated into the plan of care for a client diagnosed in the manic phase of bipolar disorder? Spaghetti Bananas Steak Broccoli
Bananas Explanation: For a client who is unable to sit long enough to eat, snacks and high-energy foods that can be eaten while moving should be provided.
An 11-year-old client has come to the school nurse more than 15 times for somatic complaints during the first quarter of school and has subsequently left school after each visit. What should the school nurse do? Contact the child's parents to discuss the situation. Keep a log of the child's attendance and continue to monitor the situation. Make an unannounced home visit on a day the child is not in school. Talk to the student's teacher.
Contact the child's parents to discuss the situation.The best approach is to involve the child and the parent. Contact with the parents can elicit additional information and provide family details that may be contributing to the child's school refusal. A home visit might make the family take a defensive stance. The teacher's information will supplement the details provided by the parents. The nurse should quickly address the signs of school refusal; waiting would not benefit the child.
Which is an anticonvulsant used as a mood stabilizer? Venlafaxine Divalproex Phenelzine Bupropion
Divalproex Explanation: Divalproex is an anticonvulsant that may be used as a mood stabilizer. Venlafaxine, bupropion, and phenelzine are antidepressants.
A client states that the client has just had an argument with the client's spouse over the phone. What can the nurse expect that the client's sympathetic nervous system has stimulated the client's adrenal gland to release? Endorphins Epinephrine Dopamine Testosterone
Epinephrine In the sympathetic-adrenal-medullary response to stress, the sympathetic nervous system stimulates the adrenal gland to release epinephrine and norepinephrine. Corticotropin-releasing factor, adrenocorticotropic hormone (ACTH), and glucocorticoids are released in the hypothalamic-pituitary response to stress.
A patient informs the nurse that she believes she has premenstrual syndrome and is having physical symptoms as well as moodiness. What physical symptoms does the nurse recognize are consistent with PMS? Select all that apply. Headache Fluid retention Hypotension Fever Low back pain
Fluid retention Low back pain Headache Explanation: Major symptoms of PMS include physical symptoms such as headache, fatigue, low back pain, painful breasts, and a feeling of abdominal fullness, caused by fluid retention. Fever and hypotension are not typical symptoms of PMS.
Which would be a finding related to perceptual disturbances during the mental status exam in the client with mania? Hallucinations Limited insight Increased motor activity Inappropriate affect
Hallucinations Explanation: Perceptual disturbances include hallucinations and delusions, anxiety, and grandiose delusions involving power, wealth, fame, or knowledge. Increased motor activity is assessed in appearance and general behavior. Inappropriate affect is assessed in mood and affect. Limited insight is part of the judgment and insight assessment.
The nurse is caring for a victim of a sexual assault. The client is fearful and experiencing flashbacks. The nurse recognizes that the client is experiencing which phase of the psychological reaction to rape? Acute disorganization phase Heightened anxiety phase Denial phase Reorganization phase
Heightened anxiety phase Explanation: During the heightened anxiety phase, the client demonstrates anxiety, hyperalertness, and psychosomatic reactions, in addition to fear and flashbacks. The acute disorganization phase is characterized by shock, disbelief, guilt, humiliation, and anger. The denial phase is characterized by an unwillingness to talk. The reorganization phase occurs when the incident is put into perspective. Some clients never fully recover from rape trauma.
A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply. Hypotension Hypertension Hypothermia Hyperventilation Hypoventilation
Hypothermia Hypotension Hypoventilation Explanation: Severe hypothyroidism is called myxedema. Advanced, untreated myxedema can progress to myxedemic coma. Signs of this life-threatening event are hypothermia, hypotension, and hypoventilation. Hypertension and hyperventilation indicate increased metabolic responses, which are the opposite of what the client would be experiencing.
The nurse is talking with parents of a depressed 16-year-old boy. Which question is of the most importance? Is there a gun in your home? How is his personal hygiene? Does he exercise? Have his sleeping and eating habits changed?
Is there a gun in your home? Explanation: He may be at risk for suicide. Firearm-related suicides have been responsible for a large number of the suicide deaths in 15- to 19-year-olds nationwide. All the other questions assess for depression and do not protect against suicide.
A 20-year-old college student presents to the campus medical clinic because of unshakable despondency in recent months and is diagnosed with depression. What treatments should the nurse expect to be prescribed? Benzodiazepines such as clonazepam that modulate his GABA receptors. Drugs that inhibit the accumulation of cyclic adenosine monophosphatase (cAMP). Cholinesterase inhibitors that potentiate the action of available acetylcholine. Medication that inhibits the reuptake of serotonin in his pre-synaptic space.
Medication that inhibits the reuptake of serotonin in his pre-synaptic space. Explanation: Selective serotonin reuptake inhibitors (SSRIs) are common pharmacologic treatment modalities for depression. Drugs that inhibit the accumulation of cAMP are usually used in the treatment of bipolar depression. Benzodiazepines address anxiety while cholinesterase inhibitors are used in the treatment of dementia.
The nurse is providing hygiene care for a 70-year-old client in a nursing home who states that the client does not like the physician. Later, when the physician enters the room, the nurse notes that the client is very friendly with the physician, complimenting the physician's care. Which defense mechanism is this client displaying? Reaction-formation Projection Rationalization Displacement
Reaction-formation Explanation: Reaction-formation is displaying a behavior, attitude, or feeling opposite to that which one would normally exhibit in the same situation. Displacement is unconsciously transferring feelings onto another person or object. Rationalization is trying logically to justify irrational, socially, or personally unacceptable behaviors or feelings. Projection is attributing to another person one's unacceptable thoughts and feelings.
The nurse is speaking with a client. The nurse sits with legs crossed and arms folded across the chest while listening to the client. How might the client interpret this posture of the nurse? Choose the best answer. The nurse may be giving utmost importance to the client's concerns. The nurse may be showing nonacceptance toward the client. The nurse may be unable to understand what the client is saying. The nurse may be paying close attention to the client
The nurse may be showing nonacceptance toward the client. Explanation: The nurse is exhibiting closed posture. A closed posture indicates indifference and a lack of attentiveness to the client. A closed posture does not indicate that the nurse is unable to understand the client but that the nurse disagrees with what the client is saying. A closed posture indicates complete disregard of the client's concerns, not that the nurse finds them important.
A pregnant teenager is not certain that she will like home care because she is afraid she will feel lonely. The nurse should suggest that: the family buy her a television set. her father buy a cell phone. everyone could eat together. the family install an intercom system.
everyone could eat together. Explanation: Helping family members adjust to home care by arranging for times for family interaction is important.
A nurse is caring for a client in the postpartum period. When observing the client's condition, the nurse notices that the client tends to speak incoherently. The client's thought process is disoriented, and she frequently indulges in obsessive concerns. The nurse notes that the client has difficulty in relaxing and sleeping. The nurse interprets these findings as suggesting which condition? postpartum panic disorder postpartum psychosis postpartum depression postpartum blues
postpartum psychosis The client's signs and symptoms suggest that the client has developed postpartum psychosis. Postpartum psychosis is characterized by clients exhibiting suspicious and incoherent behavior, confusion, irrational statements, and obsessive concerns about the baby's health and welfare. Delusions, specific to the infant, are present. Sudden terror and a sense of impending doom are characteristic of postpartum panic disorders. Postpartum depression is characterized by a client feeling that her life is rapidly tumbling out of control. The client thinks of herself as an incompetent parent. Emotional swings, crying easily—often for no reason—and feelings of restlessness, fatigue, difficulty sleeping, headache, anxiety, loss of appetite, decreased ability to concentrate, irritability, sadness, and anger are common findings are characteristic of postpartum blues.
The region of the brain involved in emotional experience and control of emotional behavior is the: Parietal lobe Occipital lobe Limbic system Cerebral hemisphere
Limbic system Explanation: The limbic region of the brain is involved in emotional experience and in the control of emotion-related behavior. Stimulation of specific areas in this system can lead to feelings of dread, high anxiety, or exquisite pleasure. It also can result in violent behaviors, including attack, defense, or explosive and emotional speech. The occipital lobe plays an important role in the meaningfulness of visual experience, including experiences of color, motion, depth perception, pattern, form, and location in space. The parietal lobe is necessary for perceiving the meaningfulness of integrated sensory information from various sensory systems, especially the perception of "where" the stimulus is in space and in relation to body parts. Axons of the olfactory nerve, or cranial nerve I, terminate in the most primitive portion of the cerebrum—the olfactory bulb, where initial processing of olfactory information occurs.
Which drug has been effective in treating aggressive clients diagnosed with bipolar disorders? Carbamazepine Lithium Valproic acid Clozapine
Lithium Explanation: Lithium, an antimanic medication, has been effective in treating aggressive clients with bipolar disorder.
A client suffers from low mood and disturbed sleep. This client is most likely experiencing a change in which neurotransmitter? Melatonin Parathyroid Serotonin Calcitonin
Serotonin Explanation: Abnormalities of serotonin are involved in mental depression and sleep disorders. Calcitonin is a hormone produced by the thyroid gland. Melatonin is a peptide hormone not a neurotransmitter. Parathyroid is a gland that secretes parathyroid hormone.
A nurse is reading an article about sleep and arousal that includes a discussion of a neurotransmitter. Which neurotransmitter would most likely be discussed? Serotonin GABA Norepinephrine Dopamine
Serotonin Explanation: Serotonin is an important neurotransmitter involved in arousal and sleep. GABA is important in preventing overexcitability or stimulation of nerve activity. Norepinephrine is a catecholamine involved in the fight-or-flight response. Dopamine is involved in the coordination of impulses and responses, both motor and intellectual.
A 16-year-old client is highly disruptive in class and has been in trouble at home. The parent recently found the adolescent torturing a cat. When questioned, the adolescent laughed. What condition might the client be suffering from? conduct disorder Asperger syndrome bipolar disorder Tourette syndrome
conduct disorder Adolescents with conduct disorder are often unmanageable at home and disruptive in the community. They have little empathy or concern for others. They may be callous and lack appropriate feelings of guilt, although they may express remorse superficially to avoid punishment. They often blame others for their actions. Risk-taking behaviors such as drinking, smoking, using illegal substances, experimenting with sex, and participating in crime are typical. Cruelty to animals or people, destruction of property, theft, and serious violation of rules are diagnostic criteria. Asperger syndrome is on the autism spectrum, where the child is extremely high in intelligence. Bipolar symptoms consist of wide swings between depression and mania. Tourette syndrome is a condition where motor and vocal tics occur.
Which occurrence is a biologic indicator of posttraumatic stress disorder (PTSD)? flashbacks auditory hallucinations memory difficulties a feeling of unreality about oneself
flashbacks Explanation: Biologic indicators, such as elevated pulse and blood pressure, sleep and appetite disturbances, exaggerated startle responses, flashbacks, and nightmares, may suggest PTSD or depression. Signs and symptoms of dissociation include memory difficulties, a feeling of unreality about oneself or events, a feeling that a familiar place is strange and unfamiliar, auditory and visual hallucinations, and evidence of having done things without remembering them.
The general adaptation syndrome (GAS) is a nonspecific physiologic response to a stressor. Which stage is not a part of the process? exhaustion stage resistance stage alarm stage stress awareness stage
stress awareness stage Explanation: The general adaptation syndrome can cycle many times through the alarm and resistance stages before reaching the exhaustion stage. The process occurs through the neuroendocrine and autonomic nervous systems.
Which statement regarding depression and gender is correct? Depressive disorders are more common in men than women. Depressive disorders affect young men more than older women. Depressive disorders equally affect men and women. Depressive disorders are more common in women than men.
Depressive disorders are more common in women than men. Explanation: Depressive disorders are more prevalent in women than in men. Genetics, sociocultural factors, hormones, and other elements may account for this disparity.
A nurse assesses that a patient is at increased risk for depression based on which of the following? Co-existing medical problems Supportive family Sporadic alcohol ingestion Male gender
Co-existing medical problems Explanation: Risk factors for depression include a medical comorbidity, family history, stressful situations, female gender, prior episodes of depression, an onset before age 40 years, past suicide attempts, lack of support systems, history of physical or sexual abuse, and current substance abuse. Sporadic alcohol ingestion does not indicate substance abuse.
The nurse is educating a client who insists that the newly prescribed imipramine is not working for the client's feelings of depression. When evaluating the client's statement, which question is most important to ask first? "What is the dosage of medication that you are prescribed?" "How long have you been taking the medication?" "What time of day are you taking the medication?" "Do you feel worse since taking the medication?"
"How long have you been taking the medication?" Explanation: Clients are often hopeful of positive results when a new medication is prescribed. It is frustrating to the client when symptom relief does not occur in a time frame which the client feels is acceptable. Understanding that symptom relief takes time, the nurse's next question is to ask how long they have been taking the medication. The nurse is correct to realize that one disadvantage of cyclic antidepressants is the lag time between initiation of drug therapy and relief of depressive symptoms. Nursing instruction includes maintaining the medication for at least a month before medication adjustments are made. Confirming the other questions is appropriate.
The nurse is caring for a client who has been prescribed oxazepam. What statement by the client would suggest an increased risk of CNS depression to the nurse? "I'm almost finished my course of antibiotics for this sinus infection." "I take an over-the-counter antihistamine each day for my allergies." "If I get constipated, I sometimes take a stool softener for a couple of days." "I'm also taking baby Aspirin each day for my heart.ox
"I take an over-the-counter antihistamine each day for my allergies." Explanation: Antihistamines, combined with benzodiazepines, create a heightened risk for CNS depression. Aspirin, antibiotics and stool softeners would be unlikely to have this effect.
The nurse is evaluating pain of several clients who had hip replacement surgery. Which client is most likely to have the greatest perceived pain? Client listening to favorite music Client who is anxious about discharge Client who sleeps through the night without waking Client who feels in control of the situation
Client who is anxious about discharge Explanation: Anxiety, lack of sleep, and feelings of powerlessness decrease a client's ability to cope with pain and increase the perception of pain. Therefore, the client most likely to have the greatest perceived pain is the client who is anxious about discharge. The client who feels in control of the situation is likely to feel in control of the pain. A client listening to music is using a diversional activity to control pain. Sleeping through the night without waking suggest a lower perception of pain.
A community health nurse follows many clients, several of whom have depression and who are taking antidepressants. What assessment finding should the nurse prioritize for reporting to the care provider? A client taking isocarboxazid with whom the nurse needed to review dietary restrictions A client who began taking escitalopram two weeks ago says her mood has worsened since starting the drug A client who takes amitriptyline reports a dry mouth and occasional urinary hesitation A client who takes sertraline 24 mg PO daily says he has noticed some sexual dysfunction since starting the drug
A client who began taking escitalopram two weeks ago says her mood has worsened since starting the drug Explanation: Worsening mood that accompanies the use of an SSRI could constitute an increased risk for suicidality. The nurse should communicate this to the provider promptly so the client can be reassessed. The client taking amitriptyline is experiencing anticholinergic effects which the nurse can likely manage. A client's sexual dysfunction should be addressed but this is not a safety risk. The fact that the nurse needed to review a client's dietary restrictions is not necessarily problematic and could indicate the client's firm commitment to adhering to the restrictions.
Which individual is most likely to benefit from brief cognitive therapy? A hospitalized client who has a diagnosis of schizophrenia, paranoid type A client with major depression who is scheduled to begin electroconvulsive therapy A client who has been diagnosed with anorexia nervosa A college freshman who is experiencing intense anxiety in the days before the client's final exams
A college freshman who is experiencing intense anxiety in the days before the client's final exams Explanation: Candidates for brief cognitive therapy are described as educated, verbal, and psychologically minded. Individuals with severe symptoms or protracted mental health problems are less likely to benefit from this mode of treatment.
A female client is admitted to the hospital with hypoglycemia, nausea, muscle weakness, and depression. What is the most likely cause? Addison disease Cushing disease Hypertension Stroke
Addison disease Explanation: Characteristics of Addison disease include those related to glucocorticoid deficiency, such as hypoglycemia, anorexia, nausea, vomiting, flatulence, diarrhea, hyperpigmentation of skin, anxiety, depression, and loss of mental acuity, and those related to mineralocorticoid deficiency, such as fluid and electrolyte imbalance, orthostatic hypotension, hyponatremia, hyperkalemia, general malaise, muscle weakness, muscle pain, and cardiac arrhythmias. Hypertension, stroke, and Cushing disease are not associated with this array of signs and symptoms.
The nurse is seeing a 26-year-old client and the client's family. The client's family describes the client as being "very, very different." The family describes a history of periods of unpredictable behavior and disregard for consequences occurring a few times each year. The client has recently been diagnosed with bipolar I disorder, a condition that is characterized by what? An elevated mood that lasts for at least 1 week Failure to respond to conventional pharmacological treatments for mood disorders The presence of objective signs of depression without the presence of anhedonia The client's admission of a mood disorder
An elevated mood that lasts for at least 1 week Explanation: During manic episodes that characterize bipolar disorder, the individual exhibits an abnormal, persistently elevated, or irritable mood that lasts for at least 1 week. Failure to respond to treatment, the presence of signs of depression without anhedonia, and the client's admission of a mood disorder are neither diagnostic nor typical of bipolar disorder.
Low levels of the neurotransmitter serotonin lead to which of the following disease processes? Myasthenia gravis Parkinson's disease Depression Seizures
Depression Explanation: A decrease of serotonin leads to depression. A decrease in the amount of acetylcholine causes myasthenia gravis. Parkinson's disease is caused by a depletion of dopamine. Decreased levels of GABA may cause seizures.
A nurse is developing a plan of care for a patient diagnosed with post-traumatic stress disorder (PTSD). Which of the following would be the priority? Assisting the patient to work through the traumatic experience Teaching coping skills for self-care Administering prescribed drug therapy Establishing a trusting nurse-patient relationship
Establishing a trusting nurse-patient relationship Explanation: The priority when caring for a patient with PTSD is establishing a trusting nurse-patient relationship, because the patient is physically compromised and struggling emotionally with situations that are not considered part of the normal human experience. Once trust is established, then the nurse can assist the patient in working through the traumatic experience, teach coping skills for recovery and self-care, and administer prescribed medications.
A nurse is caring for clients with posttraumatic stress disorder (PTSD). Negative alterations in cognition and mood associated with the traumatic event are important features of PTSD. Knowing this, which symptoms is the nurse likely to find in such clients? Select all that apply. Getting angry with little or no provocation Inability to remember important aspects of the traumatic event Seeking company of others Having negative beliefs about oneself Trying to help people who have been victims of the traumatic incident
Having negative beliefs about oneself Getting angry with little or no provocation Inability to remember important aspects of the traumatic event Explanation: Clients with PTSD have persistent and exaggerated negative beliefs or expectations about themselves. They have a persistent inability to experience positive emotions, that is, inability to experience happiness, satisfaction, or loving feelings. These clients have hyperarousal and get angry with little provocation. They are unable to remember important aspects of the traumatic event because of dissociative amnesia. Such patients have feelings of detachment from others and do not seek the company of others. Trying to help people who have been victims of the traumatic incident is a positive behavior that is not commonly seen in clients with PTSD.
A 9-year-old boy was in a car accident. The child is suffering from posttraumatic stress disorder. Which would be the best approach for treatment? Individual psychotherapy sessions Antipsychotic medications Psychostimulant medications Sensory integration technique
Individual psychotherapy sessions Explanation: Management of anxiety disorders consists of the use of medication at times but can also include cognitive behavioral therapy and individual, family, or group psychotherapy sessions. Psychostimulants would be used in ADHD. Antipsychotics help with children who have aggressive or repetitive behaviors. Sensory integration has been tried for the treatment of autism.
A 28-year-old client in her first trimester of pregnancy reports conflicting feelings. She expresses feeling proud and excited about her pregnancy while at the same time feeling fearful and anxious of its implications. Which action should the nurse do next? Schedule the client a consult with a psychiatric health care provider. Provide the client with information about pregnancy support groups. Determine if the client's significant other is experiencing similar feelings about the pregnancy. Inform the client this is a normal response to pregnancy that many women experience.
Inform the client this is a normal response to pregnancy that many women experience. Explanation: The maternal emotional response experienced by the client is ambivalence. Ambivalence, or having conflicting feelings at the same time, is universal and is considered normal when preparing for a lifestyle change and new role. Pregnant women commonly experience ambivalence during the first trimester.
The nurse recognizes which statement is true of chronic pain? It is always present and intense. It can be easily described by the client. It may cause depression in clients. It disappears with treatment.
It may cause depression in clients. Explanation: Chronic pain may lead to withdrawal, depression, anger, frustration, and dependency. Clients have difficulty describing chronic pain because it may be poorly localized. Moreover, health care personnel have difficulty assessing it accurately because of the unique responses of individual clients to persistent pain. Chronic pain is commonly characterized by periods of remission and exacerbation.
A 6-year-old with leukemia is placed on reverse isolation. What nursing actions could prevent depression and loneliness in this client? Select all that apply. Quickly exit the room when possible. Do all nursing tasks at one time. Play a game while in the room. Spend extra time to talk while in the room. Read a story while in the room.
Spend extra time to talk while in the room. Read a story while in the room. Play a game while in the room. Explanation: A child on isolation is subject to loneliness, which can be prevented by arranging to spend extra time in the room during treatments. Also, while in the room the nurse might read a story, play a game, or just talk to the child. Quickly exiting the room and providing cluster care will increase social isolation and may make the child feel punished.
In collecting data on a 7-year-old child with a possible diagnosis of school phobia, the nurse directs questions related to the following topics. Which would most likely be a cause of the child having school phobia? The child may have a language barrier. The child may be a poor student and be afraid of failing grades. The child may be bored and feels more intellectually stimulated at home. The child may have a fear of being separated from the parent.
The child may have a fear of being separated from the parent. Explanation: School-phobic children may have a strong attachment to one parent, usually the mother, and they fear separation from that parent, perhaps because of anxiety about losing her or him while away from home. Being a poor student and worrying about grades would be more common in the later school age and adolescence. A child may be anxious about language but that is generally not enough to cause phobias. If the child is bored at school the parents should ask to meet the teacher and define the child's needs. Many children need extra stimulation but that is not the same as having a phobia.
What should the nurse tell a client who is about to begin chemotherapy and is anxious about hair loss? Alopecia related to chemotherapy is relatively uncommon. The hair will grow back within 2 months post therapy. The hair will grow back the same as it was before treatment. The client should consider getting a wig or cap prior to beginning treatment.
The client should consider getting a wig or cap prior to beginning treatment. Explanation: If hair loss is anticipated and causing the client anxiety, a wig, cap, or scarf should be purchased before therapy begins. Alopecia develops because chemotherapy affects the rapidly growing cells of the hair follicles. Hair usually begins to grow again within 4 to 6 months after therapy. Clients should know that new growth may have a slightly different color and texture.
A female client has been diagnosed with depression. She also has a history of alcoholism. She has been sober now for 4 months, but at her last physical examination, the health care provider noted right-upper-quadrant tenderness and elevated liver enzyme levels. The provider has prescribed sertraline to treat the client's depression. Which factor would need to be considered prior to administering this medication? The client should have monthly evaluation of liver function to monitor the disease progression. The client should not take any medications because of her liver dysfunction. She should have an ultrasound of the liver to check for disease. The medication should be started at a lower dose due to liver dysfunction, and the client should be monitored for side effects.
The medication should be started at a lower dose due to liver dysfunction, and the client should be monitored for side effects.Explanation:Sertraline should be administered with caution in clients with compromised liver function. Adjustments such as a lower dosage or less-frequent dosing schedule may be made for these clients.
The nurse is caring for a child with special health needs. The nurse is aware that which risks are increased by the parents in this population? Select all that apply. The parents may struggle with finding appropriate educational services for the child. The parents have a higher risk of developing depression. The father is probably most burdened by the child's care. The parents may be experiencing financial difficulties. The parents are more likely to participate in health screening activities
The parents have a higher risk of developing depression. The parents may be experiencing financial difficulties. The parents may struggle with finding appropriate educational services for the child. Explanation: Parents of children with special health needs have an elevated risk for developing depression, experiencing financial difficulties, and obtaining the educational services that are appropriate for the child. Mothers carry most of the burden of care. Parents of children with special health needs are less likely to perform health promotion activities.
The nurse is working on a psychiatric unit with new admissions with suicidal ideation. What characteristic is being described by a client who states, "I want to live, but maybe the answer is to die"? frustration ambivalence remorse psychosis
ambivalence Explanation: One of the characteristics most commonly shared by suicidal persons is ambivalence, an internal struggle between self-preserving and self-destructive forces. These doubts are expressed when a person threatens or attempts suicide and then tries to get help to save their life. When the possible consequences of suicide are discussed, such persons commonly describe life-related outcomes such as relief from an unhappy situation. Many people consider suicide an alternative to present circumstances, but they may not have considered the implications of no longer being alive. A psychotic person may or may not have suicidal tendencies. Remorse and anger may be associated with depression but aren't universally present in suicidal persons. Frustration isn't specifically associated with suicidal ideation.
The general adaptation syndrome (GAS) is a nonspecific physiologic response to a stressor. Which stage is not a part of the process? exhaustion stage stress awareness stage alarm stage resistance stage
stress awareness stage Explanation: The general adaptation syndrome can cycle many times through the alarm and resistance stages before reaching the exhaustion stage. The process occurs through the neuroendocrine and autonomic nervous systems.
The nurse is explaining the workings of selective serotonin reuptake inhibitors (SSRIs) to a client with a diagnosis of depression. Within the teaching, the nurse mentions that in the nervous system, the transmission of information by neurotransmitters is: paracrine signaling. endocrine signaling. synaptic signaling. autocrine signaling.
synaptic signaling. Explanation: Synaptic signaling occurs in the nervous system, where neurotransmitters act only on adjacent nerve cells through special contact areas called synapses. Endocrine signaling relies on hormones carried in the bloodstream to cells throughout the body. Autocrine signaling occurs when a cell releases a chemical into the extracellular fluid that affects its own activity. With paracrine signaling, enzymes rapidly metabolize the chemical mediators and therefore act mainly on nearby cells.
