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A nurse is talking with the guardian of a school-aged child recently diagnosed with intermittent explosive disorder (IED). The guardian says. "My child is impulsive, acts out aggressively, and then seems pleased with themselves. How can my child be happy?" Which of the following responses should the nurse make?

"Appearing pleased after an aggressive or impulsive act has not been directly linked to intermittent explosive disorder."

"Appearing pleased after an aggressive or impulsive act can be a sense of relief rather than being happy."

"Appearing pleased after an aggressive or impulsive act is a manifestation of lack of empathy or compassion."

"Appearing pleased after an aggressive or impulsive act is within the control of your child."

Answer and Explanation

The Correct Answer is B

A. "Appearing pleased after an aggressive or impulsive act has not been directly linked to intermittent explosive disorder.": This statement is incorrect because individuals with IED may indeed feel a sense of relief or satisfaction following an outburst.

B. "Appearing pleased after an aggressive or impulsive act can be a sense of relief rather than being happy." This response is appropriate because it acknowledges that the satisfaction or pleasure observed is more likely related to relief from tension rather than genuine happiness.

C. "Appearing pleased after an aggressive or impulsive act is a manifestation of lack of empathy or compassion.": While empathy and compassion can be impaired in some cases of mental health disorders, this statement doesn't directly address the observed behavior in IED.

D. "Appearing pleased after an aggressive or impulsive act is within the control of your child.": This statement oversimplifies the complex nature of IED, which involves difficulties in controlling aggressive impulses.

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Correct Answer is C

Explanation

A. Xerostomia: Dry mouth, not typically associated with DIC.

B. Bradycardia: Not typically seen in DIC; usually, there is tachycardia due to the underlying condition.

C. Epistaxis. Epistaxis is a common physical finding in DIC due to bleeding tendencies. DIC leads to consumption of clotting factors and platelets, resulting in bleeding manifestations like epistaxis.

D. Hypertension: Hypotension is more common due to widespread clotting and bleeding.

A. Hyperextend the client's neck. B. Instruct the client to deep breathe every 4 hr. C. Place the head of the client's bed in the flat position. D. Check the client's voice every 2 hr.

Correct Answer is B

Explanation

A. Hyperextend the client's neck: Incorrect; this can strain the surgical site. Neck should be supported in a neutral position.

B. Instruct the client to deep breathe every 4 hr: Deep breathing exercises prevent respiratory complications and promote lung expansion postoperatively. Helps prevent atelectasis and pneumonia.

C. Place the head of the client's bed in the flat position: Incorrect; semi-Fowler's position is preferred to reduce risk of airway compromise and edema.

D. Check the client's voice every 2 hr: Monitoring voice changes helps detect recurrent laryngeal nerve injury, a complication of thyroidectomy. Changes in voice quality can indicate vocal cord paralysis or injury.

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Naxlex Comprehensive Predictor Exams

The nurse is assessing a client and suspects the client is experiencing DIC. Which of the following physical findings should the nurse anticipate?

Correct Answer is C

Explanation

A nurse is planning care for a client who is postoperative following a thyroidectomy. Which of the following interventions should the nurse include in the plan?

Correct Answer is B

Explanation

Which of the following is a warning sign that someone may be at immediate risk for attempting suicide?

A nurse is interviewing a school-age child who has intermittent explosive disorder (IED). Which of the following behaviors should the nurse expect the client to exhibit?

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A nurse is caring for a newly admitted adolescent client. When asked to describe their social support system, the client responds. "My mom died last year. and I have been in foster care ever since. I don't have many friends." Which of the following actions should the nurse take?

Which of the following is a risk factor for shaken baby syndrome?

Which of the following factors increases a client's risk of experiencing a crisis?