Which of the following symptoms are commonly seen in an adolescent with depression? Select all that apply
1. Agoraphobia
2. Poor self-care
3. Focus on violence
4. Somatic complaints
5. Poor school performance
2, 3, 5
Rationale:
1. Agoraphobia, which is a fear of being in places or situations from which escape might be difficult or embarrassing, is seen in children with a panic disorder, not with depression.
2. Poor self-care can be associated with depression in an adolescent.
3. Focus on violence can be associated with depression in the adolescent.
4. Somatic complaints are more commonly associated with depression in the younger school-age child.
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The perinatal nurse knows that the lowest portion of the true pelvis is which of the following anatomical landmarks?
A. Pelvic outlet B. Linea terminalis C. Sacral promontory D. Sacrum
The nurse is obtaining a pain history. The client reports pain in the right ear. Which response by the nurse is the most appropriate?
1. "Is the pain minor?" 2. "Do you have anything else that hurts?" 3. "Tell me more about the pain and what you do for it when it hurts." 4. "I'll note that in the record. Is there anything else I should know?"
A patient with suspected neurogenic shock after a diving accident has arrived in the emergency department. A cervical collar is in place. Which actions should the nurse take (select all that apply)?
a. Prepare to administer atropine IV. b. Obtain baseline body temperature. c. Infuse large volumes of lactated Ringer's solution. d. Provide high-flow oxygen (100%) by non-rebreather mask. e. Prepare for emergent intubation and mechanical ventilation.
A client asks the nurse, "Can you explain to us how to use the basal body temperature method to detect ovulation and prevent pregnancy?" What response by the nurse is best?
1. "Take your temperature every evening at the same time and keep a record for a period of several weeks. A noticeable drop in temperature indicates that ovulation has occurred." 2. "Take your temperature every day at the same time and keep a record of the findings. A noticeable rise in temperature indicates ovulation." 3. "Take your temperature each day, immediately upon awakening, and keep a record of each finding. A noticeable rise in temperature indicates that ovulation is about to occur." 4. "This is an unscientific and unproven method of determining ovulation, and is not recognized as a means of birth control."