Chart is reviewed.
Choose the most likely options for the information missing from the statement by selecting from the lists of options provided.
The nurse determines the client's symptoms are most likely caused by
The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"B","dropdown-group-3":"A"}
Rationale for correct choices:
- Seasonal affective disorder (SAD): The client exhibits depressive symptoms that occur in a recurrent seasonal pattern, specifically during fall and winter, with improvement in spring and summer. Symptoms include hypersomnia, carbohydrate cravings, weight gain, fatigue, and difficulty concentrating. This pattern is characteristic of SAD rather than atypical depression or major depressive disorder, which do not follow a strict seasonal pattern.
- Flat affect: The psychiatric examination notes monotone speech, lack of facial expressions, and emotionless demeanor, consistent with a flat affect. Flat affect is a diminished emotional expression, commonly seen in depressive disorders.
- Persistent sadness: The client reports ongoing feelings of sadness and hopelessness during the fall and winter months, which aligns with persistent sadness as a primary symptom of SAD.
Rationale for incorrect choices:
- Atypical depression: While SAD shares some features with atypical depression (e.g., hypersomnia, increased appetite), atypical depression is not defined by a strict seasonal pattern. The key seasonal recurrence makes SAD the more accurate diagnosis.
- Major depressive disorder: MDD is characterized by depressive episodes lasting at least two weeks and can occur at any time of year. The seasonal pattern and symptom improvement in spring make SAD more likely.
- Disruptive mood regulation disorder: This is diagnosed in children and adolescents and involves chronic irritability and temper outbursts, which do not match this adult client’s presentation.
- Blunted affect: Blunted affect is a reduction in emotional expression but not as severe as flat affect. The client’s almost complete lack of facial expression and monotone speech aligns more with flat affect.
- Euthymic: Euthymic refers to a normal, non-depressed mood. The client’s symptoms clearly indicate depression, so this is incorrect.
- Psychomotor agitation: There is no evidence of restlessness, fidgeting, or pacing; the client appears fatigued and emotionally flat.
- Suicidal ideation: The client explicitly denies suicidal thoughts, making this option incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}
Explanation
Rationale for correct choices:
- New onset angina: The client presents with chest pain described as pressure and tightness that started during activity (mowing the lawn) and worsened despite rest, which is consistent with unstable or new-onset angina. The ECG shows ST depression, indicating myocardial ischemia without infarction. Normal troponin levels confirm that no myocardial cell death has occurred, differentiating angina from myocardial infarction.
- Troponin: Troponin T and I are specific biomarkers for myocardial injury. In this client, troponin levels are within normal limits, indicating that myocardial necrosis has not occurred. This supports the diagnosis of angina rather than myocardial infarction.
Rationale for incorrect choices:
- Myocardial infarction: MI typically presents with prolonged chest pain and ST-segment changes on ECG plus elevated troponin, indicating cardiac muscle damage. This client’s troponin levels are normal, making MI unlikely at this time.
- Aortic aneurysm: Usually presents with sudden, severe, tearing chest or back pain, often radiating to the back. ST depression on ECG is not associated with aortic aneurysm.
- Prothrombin time (PT) or C-reactive protein (CRP): PT assesses coagulation, and CRP is a marker of general inflammation. Neither is specific for myocardial ischemia, so normal levels do not confirm or exclude angina. Troponin is the key biomarker for cardiac injury.
Correct Answer is A
Explanation
A. This is the most appropriate action. Sliding fingers inside the glove to remove it can directly contaminate the UAP’s hands, defeating the purpose of wearing gloves. The nurse should intervene immediately to correct the technique, ensuring proper glove removal, which involves grasping the outside of one glove at the wrist, rolling it inside out over the hand, then using the inside-out glove to remove the second glove without contaminating the hands.
B. Rolling both gloves off at the same time is incorrect and can increase the risk of contamination. Proper technique is sequential removal, one glove at a time, with the second glove removed using the first glove to avoid hand contact with the contaminated surface.
C. Using double gloves may be necessary in certain high-risk procedures, but the primary issue here is incorrect glove removal technique, not the number of gloves. Teaching proper removal is the correct intervention.
D. Discarding gloves in the biohazard container is part of standard practice, but it does not address the immediate risk of hand contamination due to improper removal technique.
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