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Ati nur 212 life span 3 final assessment exam
Total Questions : 50
Showing 10 questions, Sign in for moreDay 1 1030:
A 35-year-old client who has schizophrenia is admitted. Diagnosed 15 years ago. Brought in by partner and states client has remained in room for the last several days and movements are delayed.
Day 1 1730:
Client refuses to eat or drink. Client appears withdrawn and does not engage in conversation. Client has flat affect. Does not want to go to therapy session and wants to sleep. Client's movements are slow.
Day 1 1030:
- Temperature 37° C (98.6° F)
- Heart rate 72/min
- Respiratory rate 20/min
- Blood pressure 132/38 mm Hg
- Oxygen saturation: 99% on room air
A nurse is caring for a client who has schizophrenia.
Select the "3" findings that should indicate to the nurse the client is experiencing negative symptoms related to their schizophrenia.
A nurse is caring for a client who is 8 hr postoperative following a subtotal thyroidectomy. In which of the following positions should the nurse keep the client?
Client admitted to facility by court order for evaluation following arrest for driving under the influence of alcohol and resisting arrest.
Client has history of legal altercations since teenage years including automobile theft, vandalism, shoplifting, and arson. Diagnosed with ADHD at age 6 and conduct disorder (CD) at age 9.
History of bullying and aggressive behavior.
History of animal cruelty.
Expelled from high school at age 17 for possession of a weapon on school grounds.
Frequently ran away from parents' home, lived most of their childhood years with grandmother who provided a more stable environment. The grandmother is now deceased.
Psychotherapy notes from adolescent years indicates parental neglect. Parental history of bipolar disorder, conduct disorder, and substance use disorder.
Currently employed by fast food chain store. Does not have a permanent residence since grandmother's death.
Day 1:
1500:
Client oriented to person, place, and time, [EW1] [MM2] displaying anxiety. Restless and pacing around the room. States "I'm locked up with loonies. I wasn't that drunk! That judge just has it out for me!"
Oriented to room, meal, and group therapy schedules. States, "Forget it, just forget it! I'm not doing your crazy group therapy!"
1800:
Client comes to dinner in cafeteria. Sits alone, does not interact with other clients. Immediately goes back to room following meal, does not join other clients in dayroom.
Day 2:
1000:
Client escorted to group therapy by assistant personnel. Refuses to interact with other clients. Responds with eye rolling and snickering when other clients speak.
Following therapy, client confronted about their inappropriate behavior. Client refers to the other group members as "babies" and states, "They don't have a clue what having a hard life is like."
1400:
Client running on treadmill in the client gym. Requests to be allowed to run outside on the grounds, stating "running calms me down."
A nurse is caring for a young adult client who is being evaluated for antisocial personality disorder.
Click to highlight the findings in the client's medical record that are indicators of conduct disorder (CD) that can lead to antisocial personality disorder. To deselect a finding, click on the finding again.
Substance use
Comorbidities in childhood
Living with grandmother in childhood
Treatment of animals
School history
Parental history
Employment history
Living arrangements
Interactions with other clients
Engagement in physical activity
Explanation
Rationale for correct choices:
- Substance use: Early and repeated substance use, especially involving legal violations, reflects poor impulse control and disregard for rules—both central to conduct disorder. Such behaviors frequently persist into adulthood, contributing to antisocial traits.
- Comorbidities in childhood: The presence of ADHD and conduct disorder by age 9 is a strong predictor of adult antisocial behavior. Early-onset symptoms are particularly concerning due to their association with persistent aggression and poor emotional regulation.
- Treatment of animals: Cruelty to animals is a diagnostic hallmark of conduct disorder and indicates lack of empathy or remorse. This behavior, when persistent, often evolves into more serious antisocial actions and violent tendencies in adulthood.
- School history: Expulsion for possessing a weapon demonstrates serious rule violations and aggressive behavior. These are core features of conduct disorder and increase the risk for future antisocial or criminal patterns without intervention.
- Parental history: A parental background involving bipolar disorder, conduct disorder, and substance use creates both genetic vulnerability and a dysfunctional home environment. These risk factors compound the child’s chance of developing CD and later ASPD.
Rationale for incorrect options:
- Living with grandmother in childhood: Living with a more stable caregiver suggests a potentially positive influence, not a risk factor for CD. Although the change indicates past instability, it doesn't meet behavioral criteria for the disorder.
- Employment history: Being employed, even in a low-income job, does not signal conduct disorder. Many individuals with and without behavioral disorders maintain jobs, especially when motivated by basic needs or independence.
- Living arrangements: Lack of stable housing after a caregiver’s death reflects social vulnerability, not CD. It may suggest neglect or instability but is not a behavioral symptom of conduct disorder or antisocial personality disorder.
- Interactions with other clients: Mocking others in group therapy shows lack of empathy, common in antisocial traits, but on its own it lacks the repetitive and aggressive nature required for a conduct disorder diagnosis.
- Engagement in physical activity: Using physical activity like running to manage emotions is an adaptive coping skill. It may indicate self-awareness or effort to control anger, not a sign of pathology such as CD.
A nurse is caring for a client who is hospitalized for the treatment of severe depression. Which of the following nursing approaches is therapeutic to include in the client's plan of care?
A nurse is monitoring a client who is postoperative following a thyroidectomy. Which of the following data should the nurse identify as the priority to monitor?
A nurse on a long-term care unit is creating a plan of care for a client who has Alzheimer's disease. Which of the following interventions should the nurse include in the plan?
Borderline personality disorder
Alcohol use disorder
History of suicidal ideation
Fluoxetine 20 mg PO daily
1500:
Client admitted for evaluation and treatment following arrest for driving while under the influence of alcohol.
Client reports recent breakup of romantic relationship and subsequent job loss. States, "I was too upset to go to work, and then they fired me. Like I needed that stress, too."
1700:
Noted client has several superficial cuts on arms and legs and there is a broken mirror with blood on it on the floor. Client states, "I feel so alone. There is no one that cares about me."
The nurse is planning care for the client.
For each potential nursing action, click to specify if the potential action Is anticipated, nonessential, or contraindicated for the client.
Explanation
Rationale:
- Offer the client opportunities for physical exercise: Exercise is a healthy coping mechanism that can reduce stress, improve mood, and redirect impulsive energy. It also supports therapeutic engagement in structured settings.
- Encourage the client to talk about feelings prior to maladaptive behavior: This action supports emotional regulation and helps the client recognize triggers before acting out. It fosters insight and strengthens therapeutic coping strategies.
- Maintain same staff members caring for the client: Consistency in staffing helps establish trust and reduces feelings of abandonment common in borderline personality disorder. It also minimizes splitting behaviors.
- Instruct the client to avoid foods with tyramine: Tyramine restrictions apply to MAOIs, which are not prescribed here. The client is on fluoxetine (an SSRI), so this dietary instruction is unnecessary in this case.
- Explore feelings of abandonment with the client: Clients with borderline personality disorder often struggle with intense fear of abandonment. Exploring these feelings is therapeutic and can prevent self-harm behaviors.
- Offer sympathy and attention to maladaptive behavior: Providing attention for self-injury reinforces the behavior through secondary gains. Instead, staff should maintain a neutral, non-reinforcing stance after ensuring safety.
- Initiate suicide precautions: Given the recent self-harm, suicidal ideation, and crisis event, suicide precautions are a necessary safety measure to reduce risk and monitor the client closely.
- Apply wrist restraints: Physical restraints are not appropriate for self-injury in borderline personality disorder unless the client poses immediate danger. Restraints can escalate distress and trauma.
A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?
A nurse is assessing a client who is admitted for elective surgery and has a history of Addison's disease. Which of the following findings should the nurse expect?
A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect?
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