Exhibits

The nurse reviews the clinical findings.

For each of the findings listed, click to indicate which are consistent with the disease process of major depressive disorder, generalized anxiety disorder, or posttraumatic stress disorder. Each column must have at least one response selected.

Avoidance

Suicidal ideation

Nightmares

Feelings of guilt

Lack of interest

Sleep disturbance

Answer and Explanation

The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"C"},"D":{"answers":"B,C"},"E":{"answers":"B"},"F":{"answers":"A,B,C"}}

Rationale:

Avoidance: Avoidance of reminders of the trauma, including people, places, or conversations related to the event, is a core diagnostic criterion for PTSD. The client avoids visiting fellow platoon members, suggesting avoidance behavior linked to her combat trauma.
Suicidal ideation: Thoughts of death or suicide are hallmark symptoms of MDD. The client was found writing a suicide note and planning to shoot herself, which strongly supports the diagnosis of MDD.
Nightmares: Recurrent distressing dreams or nightmares related to the traumatic event are common in PTSD. The client reports frequent nightmares linked to her war experience.
Feelings of guilt: Excessive guilt is common in MDD, often irrational and self-deprecating. In PTSD, survivors’ guilt is prevalent, especially when others died in the traumatic event, as expressed by the client lamenting that her life was spared over her comrades'.
Lack of interest: Markedly diminished interest or pleasure in previously enjoyed activities is a core symptom of MDD. The client’s withdrawal from social connections reflects this loss of interest.
Sleep disturbance: Insomnia is prevalent in GAD due to excessive worry, in MDD due to mood dysregulation, and in PTSD due to nightmares and hyperarousal. The client’s reported insomnia applies to all three conditions.

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Correct Answer is C

Explanation

Rationale:

A. Manages activities of daily living independently: Preserving functional independence is not a direct clinical outcome related to managing chronic pyelonephritis. The primary concern with this condition is preserving renal function and preventing long-term complications like hypertension.

B. Measures oral temperature daily: Monitoring temperature can help detect infections early, but chronic pyelonephritis may not always present with fever. It’s a short-term strategy and less critical than preventing progression to renal damage or cardiovascular complications.

C. Maintains blood pressure within normal limits: Chronic pyelonephritis can lead to kidney scarring, which often contributes to secondary hypertension. Controlling blood pressure is vital in slowing renal deterioration and preventing cardiovascular events, making it the most important long-term goal.

D. Restricts fluid intake to 1 L/day: Fluid restriction is not appropriate unless the client is in advanced kidney failure with fluid overload. Adequate hydration is usually encouraged to help flush bacteria from the urinary tract and support renal function.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

Rationale for Correct Choices:

Hyponatremia: The client shows signs of neurological impairment (confusion and altered LOC), which are common symptoms of hyponatremia. The significant, concentrated urine output despite normal IV fluid intake suggests water retention and sodium dilution.
Syndrome of inappropriate antidiuretic hormone (SIADH): A hypothalamic tumor can disrupt normal ADH regulation, leading to SIADH. In SIADH, excessive ADH causes water retention without sodium retention, resulting in dilutional hyponatremia. The high urine output relative to intake further supports inappropriate ADH secretion.

Rationale for Incorrect Choices:

Hypernatremia: This condition is associated with dehydration, increased serum osmolality, and symptoms like thirst and dry mucous membranes, not confusion with preserved fluid intake and high urine output seen here.
Hypokalemia: This typically presents with muscle weakness, cramping, or arrhythmias. It does not account for the client’s confusion or link directly to hypothalamic tumors and fluid imbalance.
Diabetes insipidus: Although linked to hypothalamic or pituitary damage, diabetes insipidus causes hypernatremia due to water loss and low urine osmolality, not confusion from fluid retention and hyponatremia.
Addison’s disease: Addison’s typically presents with hypotension, hyperkalemia, and fatigue. It is an adrenal insufficiency condition, not primarily linked to hypothalamic tumors or SIADH-like fluid handling.

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Focused Assessment Area	Clinical Finding
Musculoskeletal	Ambulates with a walker Flaccidity of left arm Passive range of motion of the left leg
Psychosocial	Fits of laughter Angry outbursts Tearful sharing of stories
Neurological	Drinks with repetitive cough Decorticate posturing Speaks in short sentences

Exhibits The nurse reviews the clinical findings. For each of the findings listed, click to indicate which are consistent with the disease process of major depressive disorder, generalized anxiety disorder, or posttraumatic stress disorder. Each column must have at least one response selected.

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Naxlex Comprehensive Predictor Exams

Which long-term outcome is most important for the nurse to include in the plan of care for an older adult client with chronic pyelonephritis?

Correct Answer is C

Explanation

Patient Data Exhibits Choose the most likely options for the information missing from the statement by selecting from the lists of options provided. The client is showing signs of dropdown related to dropdown.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

While changing a client's postoperative dressing, the nurse observes purulent drainage at the site. Before reporting this finding to the healthcare provider, the nurse should note which of the client's laboratory values?

The nurse is caring for a client with elevated parathyroid hormone levels. Which safety precaution should the nurse include in the plan of care?

A client received a thrombolytic medication following a myocardial infarction. When the client has a bowel movement, which action should the nurse implement?

Which information is most important for the nurse to obtain when determining a client's risk for obstructive sleep apnea syndrome (OSAS)?

A client who has been taking colchicine calls the clinic with reports of an acute gout attack of the right great toe. The client has a history of kidney stones and esophageal reflux. Which finding warrants immediate intervention by the nurse?

Patient Data Exhibits The nurse reviews the findings in the history and physical. Drag from Word Choices to complete the sentence. The nurse recognizes that dropdown , dropdown and dropdown are findings consistent with elder mistreatment.

Exhibits

The nurse reviews the clinical findings.

For each of the findings listed, click to indicate which are consistent with the disease process of major depressive disorder, generalized anxiety disorder, or posttraumatic stress disorder. Each column must have at least one response selected.