A nurse is preparing for an interprofessional team meeting regarding a newly admitted client who has major depressive disorder.
Which of the following findings obtained during the initial assessment is the priority to report to other disciplines?

Significant weight loss.

Markedly neglected hygiene.

Poor problem-solving skills.

Psychomotor retardation.

Answer and Explanation

The Correct Answer is D

A nurse is preparing for an interprofessional team meeting regarding a newly admitted client who has major depressive disorder. Which of the following findings obtained during the initial assessment is the priority to report to other disciplines? The correct answer is Choice D: Psychomotor retardation.

Choice A rationale:

Significant weight loss may be a concerning symptom in a client with major depressive disorder, but it is not the top priority. Major depressive disorder can lead to changes in appetite, which may result in weight loss. However, psychomotor retardation, which is a significant slowing of physical and mental activities, is a more critical finding. It can be a sign of severe depression and even potential suicidal ideation. Reporting psychomotor retardation to other disciplines allows for a prompt evaluation of the client's safety.

Choice B rationale:

Markedly neglected hygiene is an important observation and may indicate the client's inability to perform self-care activities. While this should be addressed, psychomotor retardation takes precedence as it can indicate more severe symptoms associated with major depressive disorder.

Choice C rationale:

Poor problem-solving skills are a common cognitive symptom of major depressive disorder, but they are not an immediate priority. Clients with depression often struggle with decision-making and problem-solving, but psychomotor retardation is a more severe and concerning symptom that warrants immediate attention.

Choice D rationale:

Psychomotor retardation is the top priority finding in this scenario. It can be a sign of severe depression and may be associated with an increased risk of self-harm or suicide. Reporting psychomotor retardation allows the interprofessional team to assess the client's safety and initiate appropriate interventions promptly.

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Correct Answer is C

Explanation

Choice A rationale:

Having a flat affect is not a specific indicator of delirium. A flat affect may be seen in various mental health conditions and is not unique to delirium. Delirium is characterized by acute changes in cognitive function and awareness, and a flat affect alone does not fulfill the criteria for diagnosing delirium.

Choice B rationale:

The client's speech being slow and repetitious is not a specific finding that leads to a suspicion of delirium. While changes in speech can be observed in delirium, this finding alone is not sufficient to diagnose delirium. Delirium is more about changes in consciousness, attention, and cognition.

Choice D rationale:

The client's inability to recognize objects is not a specific indicator of delirium. Delirium is characterized by a fluctuating level of consciousness and changes in cognitive function. Inability to recognize objects might be a symptom of other conditions, but it is not a hallmark sign of delirium.

Choice C rationale:

The client's manifestations developing suddenly is a key indicator of delirium. Delirium is characterized by an acute and rapid onset of cognitive and perceptual disturbances. It is often caused by an underlying medical condition or medication side effects and is typically reversible. The sudden development of symptoms is a significant clue in suspecting delirium and should prompt further evaluation and intervention. .

A. Lithium. B. Valproate. C. Risperidone. D. Methylphenidate.

Correct Answer is D

Explanation

A nurse is caring for a school-age child who has a new diagnosis of attention-deficit hyperactivity disorder. The nurse should anticipate a prescription for which of the following medications? The correct answer is Choice D: Methylphenidate.

Choice A rationale:

Lithium is not a medication used to treat attention-deficit hyperactivity disorder (ADHD). It is primarily used to manage bipolar disorder.

Choice B rationale:

Valproate is also not a medication typically prescribed for ADHD. It is primarily used for seizure disorders and mood stabilization in conditions like bipolar disorder.

Choice C rationale:

Risperidone is an atypical antipsychotic medication used to treat conditions like schizophrenia and bipolar disorder but is not a first-line treatment for ADHD. It may be considered in cases of severe aggression or agitation associated with ADHD, but it is not the initial choice.

Choice D rationale:

Methylphenidate is a central nervous system stimulant and is one of the most commonly prescribed medications for the treatment of ADHD in children. It helps improve focus and reduce impulsivity and hyperactivity. It is a first-line treatment for ADHD, making it the most appropriate choice for a child with this diagnosis. .

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A nurse is preparing for an interprofessional team meeting regarding a newly admitted client who has major depressive disorder. Which of the following findings obtained during the initial assessment is the priority to report to other disciplines?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who is restless and constantly mutters to himself.Which of the following findings should lead the nurse to suspect delirium?

Correct Answer is C

Explanation

A nurse is caring for a school-age child who has a new diagnosis of attention-deficit hyperactivity disorder. The nurse should anticipate a prescription for which of the following medications?

Correct Answer is D

Explanation

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A nurse is preparing for an interprofessional team meeting regarding a newly admitted client who has major depressive disorder.
Which of the following findings obtained during the initial assessment is the priority to report to other disciplines?