A child diagnosed with autism spectrum disorder has the nursing diagnosis of disturbed personal identity. Which outcome would best address this client's diagnosis?
A. The client will name own body parts as separate from others by day 5.
B. The client will establish a means of communicating personal needs by discharge.
C. The client will initiate social interactions with caregivers by day 4.
D. The client will not harm self or others by discharge.
A
An appropriate outcome for this client is to name own body parts as separate from others. The nurse should assist the client in the recognition of separateness during self-care activities such as dressing and feeding. The long-term goal for disturbed personal identity is for the client to develop an ego identity.
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Which of the following diffuse connective tissue diseases is the result of an autoimmune reaction that results in phagocytosis, producing enzymes within the joint that break down collagen and cause edema?
A) Rheumatoid arthritis (RA) B) Systemic lupus erythematosus C) Osteoporosis D) Polymyositis
A patient has had a complete stroke as a result of a ruptured vessel in the left hemisphere. How should this patient's CVA be classified?
a. Ischemic, embolic b. Hemorrhagic, subarachnoid c. Hemorrhagic, intracerebral d. Ischemic, thrombotic
Two nursing students discuss career plans after graduation. One student wants to enter psychiatric nursing. The other student asks, "Why would you want to be a psychiatric nurse? All they do is talk. You'll lose your skills."
Select the best response by the student interested in psychiatric nursing. a. "Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient ratios must be better because of the nature of patients' problems." b. "Psychiatric nurses use complex communication skills, as well as critical thinking, to solve multidimensional problems. I'm challenged by those situations." c. "I think I'll be good in the mental health field. I do not like clinical rotations in school, so I don't want to continue them after I graduate." d. "Psychiatric nurses don't have to deal with as much pain and suffering as medical surgical nurses. That appeals to me."
A desired outcome for the maintenance phase of treatment for a manic client would be that the client will
A. exhibit optimistic, energetic, playful behavior. B. adhere to follow-up medical appointments. C. take medication more than 50% of the time. D. use alcohol to moderate occasional mood "highs."