The nurse caring for a client with schizophrenia would assess for manifestations of this disorder, including (Select all that apply)
a. disorganized speech and behavior.
b. excessive and rapid speech.
c. flat or inappropriate affect.
d. sad moods and crying spells.
A, C
Disorganized speech and behavior and flat or inappropriate affect are two manifestations of schizophrenia. Excess, rapid speech reveals the mania of bipolar disorder, while sad moods and crying spells signal depression or the depressive phase of bipolar disorder.
Cognitive Level: Application/Applying
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A nurse cares for a client with end-stage heart failure who is awaiting a transplant. The client appears depressed and states, "I know a transplant is my last chance, but I don't want to become a vegetable." How should the nurse respond?
a. "Would you like to speak with a priest or chaplain?" b. "I will arrange for a psychiatrist to speak with you." c. "Do you want to come off the transplant list?" d. "Would you like information about advance directives?"
The nurse is assessing a male client who has epididymitis. Which statement by the nurse would provide appropriate education regarding this condition?
1. "You will have a decrease in testosterone production." 2. "Your sperm maturity may be affected." 3. "There will be a decrease in blood flow to your penis." 4. "There may be erectile difficulties."
According to developmental theory, which nursing intervention for the childbearing family is most important?
a. Assess cultural, economic, and physiologic issues confronting the family. b. Assist the family to adapt to changing roles and functions of its individuals. c. Identify external resources to meet the needs of the childbearing family. d. Assist the family members in developing new coping mechanisms.
The nurse is preparing to give an injection in the ventrogluteal injection site. Which pair of anatomical landmarks does the nurse use for this site?
a. Greater trochanter and knee b. Acromion process and axilla c. Anterior superior iliac spine and iliac crest d. Posterior superior iliac spine and iliac crest