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The nurse continues to care for the client.

Exhibits

For each assessment finding, click to specify if the finding is consistent with psychosis or mania. Each finding may support more than one diagnosis.

A.

Excessive spending habits

B.

Hallucinations

C.

Pressured speech

D.

Lack of sleep

E.

Disorganized thought process

Answer and Explanation

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

Rationale:

  • Excessive spending habits: This behavior is hallmark for mania, where impaired judgment, impulsivity, and inflated self-esteem lead to reckless financial decisions.
  • Hallucinations: Hallucinations, especially visual or auditory ones, are classic signs of psychosis. They indicate a break from reality and are not a diagnostic feature of mania alone unless psychotic features are present.
  • Pressured speech: Pressured, rapid, and loud speech is a diagnostic feature of mania, reflecting heightened psychomotor activity and racing thoughts.
  • Lack of sleep: Insomnia without fatigue is typical in mania. Clients may stay awake for days with increased energy levels and no perceived need for rest.
  • Disorganized thought process: This can appear in both mania and psychosis. In mania, it stems from flight of ideas and distractibility. In psychosis, it results from impaired reality testing and cognitive disintegration.


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Related Questions

Correct Answer is D

Explanation

Rationale:

A. Ritualistic behavior: Ritualistic or compulsive behaviors are most commonly associated with obsessive-compulsive personality disorder or obsessive-compulsive disorder, not narcissistic personality disorder.

B. Suspicious of others: Suspiciousness and distrust are hallmark features of paranoid personality disorder. While individuals with narcissistic traits may be sensitive to criticism, they are not generally suspicious in a paranoid sense.

C. Exhibits separation anxiety: Separation anxiety and fear of being alone are typically seen in dependent personality disorder and sometimes borderline personality disorder, not narcissistic personality disorder.

D. Preoccupied with aging: Clients with narcissistic personality disorder are often highly concerned with maintaining a youthful and admired image. They may fear aging due to its association with loss of beauty, status, or power, making this the expected finding.

Correct Answer is C

Explanation

Rationale:

A. Fibrinogen level: Fibrinogen is a clotting factor that can reflect coagulation activity, but it is not used to monitor warfarin therapy. It is more relevant in conditions like DIC or liver disease, not for warfarin dose adjustments.

B. aPTT: Activated partial thromboplastin time (aPTT) is used to monitor heparin therapy. Warfarin, which affects the extrinsic pathway of coagulation, does not significantly impact aPTT levels.

C. INR: The international normalized ratio (INR) is the standard test used to monitor warfarin therapy. It reflects the effect of warfarin on prothrombin time and guides safe and effective dosing to maintain therapeutic anticoagulation.

D. Platelet count: While platelet count helps evaluate bleeding risk and detect thrombocytopenia, it is not used to guide warfarin dosing. Warfarin works by inhibiting vitamin K–dependent clotting factors, not by affecting platelet production.

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