A nurse in an outpatient behavioral facility is caring for a client who has a substance use disorder and a history of violence. Which of the following client statements should the nurse identify as being consistent with adverse childhood experiences (ACEs)? (Select All that Apply.)

"My parents divorced when I was 13 years old."

"We always had plenty of food in the house to eat."

"I was teased at school for wearing dirty clothes every day for weeks,"

"My parents would get in physical altercations."

"My parent went to prison when I was 12 years old."

"My parent would swear often at my sibling and I."

Answer and Explanation

Correct Answer : A,C,D,E,F

A. "My parents divorced when I was 13 years old." Divorce is recognized as an adverse childhood experience (ACE) because it can create emotional instability, financial stress, and changes in family dynamics, potentially affecting long-term mental health outcomes.
B. "We always had plenty of food in the house to eat." Having consistent access to food suggests a stable home environment, which is not classified as an ACE. Adverse experiences often include neglect, which involves a lack of basic needs such as food, shelter, or medical care.
C. "I was teased at school for wearing dirty clothes every day for weeks." Persistent neglect, such as not having clean clothing, can indicate parental neglect—one of the recognized ACEs. This can contribute to feelings of shame, social isolation, and long-term psychological distress.
D. "My parents would get in physical altercations." Witnessing domestic violence is a significant ACE that can lead to long-term emotional trauma, increased risk of anxiety, depression, and difficulty forming healthy relationships later in life.
E. "My parent went to prison when I was 12 years old." Parental incarceration is a recognized ACE, as it can cause emotional distress, economic hardship, and social stigma, increasing the child's risk for mental health disorders and substance use.
F. "My parent would swear often at my sibling and I." Verbal abuse, including frequent swearing or demeaning language, is a form of emotional abuse. Emotional abuse is a major ACE that can contribute to low self-esteem, difficulty regulating emotions, and increased vulnerability to mental health conditions.

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Correct Answer is C

Explanation

A. Hyperkalemia. Clients with anorexia nervosa typically experience hypokalemia rather than hyperkalemia due to severe malnutrition, vomiting, and excessive diuretic or laxative use. Potassium depletion can lead to life-threatening cardiac complications.
B. Hyperglycemia. Anorexia nervosa is associated with hypoglycemia due to prolonged fasting, malnutrition, and depleted glycogen stores. Clients often have low blood glucose levels rather than elevated ones.
C. Lanugo. The development of fine, downy body hair (lanugo) is a classic sign of anorexia nervosa. This occurs as the body adapts to extreme weight loss and malnutrition by trying to conserve heat due to the lack of body fat.
D. Swollen parotid glands. While swollen parotid glands are common in bulimia nervosa due to frequent vomiting, they are not a defining feature of anorexia nervosa unless the client engages in purging behaviors.

A. Extrapyramidal symptoms B. Impaired ability to regulate body temperature C. Neuroleptic malignant syndrome D. Tardive dyskinesia

Correct Answer is D

Explanation

A. Extrapyramidal symptoms. Extrapyramidal symptoms (EPS) include acute dystonia, akathisia, and parkinsonism, which are movement-related side effects caused by dopamine blockade. While EPS can involve muscle rigidity and tremors, tardive dyskinesia specifically refers to chronic, involuntary, repetitive movements such as facial twitching and tongue protrusion.
B. Impaired ability to regulate body temperature. Some antipsychotics can interfere with thermoregulation, leading to heat intolerance or hypothermia. However, this is not related to jerking or twitching movements seen in tardive dyskinesia.
C. Neuroleptic malignant syndrome. Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to antipsychotics characterized by fever, muscle rigidity, autonomic instability, and altered mental status. Unlike tardive dyskinesia, NMS does not cause chronic, involuntary facial movements but rather widespread muscle stiffness and severe autonomic dysfunction.
D. Tardive dyskinesia. Tardive dyskinesia (TD) is a late-onset, irreversible movement disorder caused by long-term use of first-generation antipsychotics. It is characterized by involuntary, repetitive movements, especially in the face, tongue, and extremities (e.g., lip smacking, tongue rolling, grimacing, jerking movements). These symptoms distinguish TD from acute extrapyramidal symptoms.

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A nurse in an outpatient behavioral facility is caring for a client who has a substance use disorder and a history of violence. Which of the following client statements should the nurse identify as being consistent with adverse childhood experiences (ACEs)? (Select All that Apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has anorexia nervosa. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

A nurse is caring for a client who has schizophrenia and has been taking a first generation medication for several years. The client is exhibiting jerking movements and twitching of the face and tongue. Which of the following is the client experiencing?

Correct Answer is D

Explanation

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A nurse in an outpatient behavioral facility is caring for a client who has a substance use disorder and a history of violence. Which of the following client statements should the nurse identify as being consistent with adverse childhood experiences (ACEs)? (Select All that Apply.)

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