A nurse is reviewing the medical record for a client who has generalized anxiety disorder. Which of the following manifestations should the nurse expect to see included in the client's medical record?

The client is preoccupied with a supposed body defect.

The client compulsively bites fingernails.

The client exhibits hoarding behaviors.

The client puts off making decisions.

Answer and Explanation

The Correct Answer is D

A. "The client is preoccupied with a supposed body defect.": This manifestation is more characteristic of body dysmorphic disorder rather than generalized anxiety disorder (GAD).

B. "The client compulsively bites fingernails.": Nail-biting is often associated with obsessive-compulsive disorder (OCD) or other stress-related behaviors rather than GAD.

C. "The client exhibits hoarding behaviors.": Hoarding is typically associated with obsessive-compulsive disorder (OCD) and not generalized anxiety disorder.

D. "The client puts off making decisions.": Individuals with generalized anxiety disorder often experience indecisiveness and procrastination due to excessive worry and fear of making the wrong choice. This is a common manifestation of GAD

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Correct Answer is D

Explanation

A) Keep client in semi-Fowler's position with right extremity flat: Semi-Fowler's position is not optimal for a client with a compound fracture of the right tibia. Elevating the affected extremity, rather than keeping it flat, can help reduce swelling and pain.

B) Manage pain with oral opioids every 6 hr: While managing pain is crucial, oral opioids may not provide immediate relief needed in acute settings. Pain management should include a combination of strategies and may require IV analgesics for quicker relief.

C) Check capillary refill hourly for the first 24 hr: Although monitoring capillary refill is important to assess circulation, it is only one aspect of monitoring. Comprehensive assessment includes checking for signs of infection, neurovascular status, and compartment syndrome.

D) Apply a compression dressing over the fracture site: Applying a compression dressing can help control bleeding and reduce swelling. In a compound fracture, managing external bleeding and providing some stability to the fracture site are immediate priorities. However, the nurse should ensure this is done without compromising circulation and should be guided by physician orders.

A. "After chewing an antacid, wait 1 hour before drinking water." B. "Plan to have a bedtime snack each evening." C. "Elevate the head of your bed 12 inches." D. "Eat a sugar-free peppermint when symptoms occur."

Correct Answer is C

Explanation

A) "After chewing an antacid, wait 1 hour before drinking water.": This is incorrect advice as drinking water after taking an antacid can help wash the medication down and ensure it reaches the stomach effectively. Waiting an hour to drink water is unnecessary and does not benefit GERD management.

B) "Plan to have a bedtime snack each evening.": Having a bedtime snack can exacerbate GERD symptoms by increasing stomach acid production just before lying down. Clients with GERD should avoid eating close to bedtime to minimize symptoms.

C) "Elevate the head of your bed 12 inches.": Elevating the head of the bed helps prevent stomach acid from flowing back into the esophagus during sleep, which can reduce nighttime GERD symptoms. This is a recommended non-pharmacological intervention for managing GERD.

D) "Eat a sugar-free peppermint when symptoms occur.": Peppermint can relax the lower esophageal sphincter, potentially worsening GERD symptoms by allowing stomach acid to reflux into the esophagus. Therefore, peppermint is not recommended for managing GERD symptoms.

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A nurse is reviewing the medical record for a client who has generalized anxiety disorder. Which of the following manifestations should the nurse expect to see included in the client's medical record?

Nursing Test Bank

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