Question 1

A client has been diagnosed with pathological gambling. The client's family inquires about their brother's behavior that led to this diagnosis. Which of the following information should the clinic nurse provide? (Select all that apply.)

Accepted Answer

Pathological gambling is characterized by preoccupation with gambling, increased amounts of money spent on gambling to generate excitement, inability to control gambling despite efforts to stop, and deception of family and friends about the extent of gambling behavior. Mania is not typically implicated in the diagnostic criteria for pathological gambling. Therefore, options A, B, C, and E are all appropriate pieces of information to share with the client's family.

Question 2

A client has been extremely nervous ever since a person died as a result of the client's drunk driving. When assessing for the diagnosis of adjustment disorder, within what timeframe should the nurse expect the client to exhibit these symptoms?

Accepted Answer

According to the DSM-IV criteria for adjustment disorder, the client should exhibit symptoms within 3 months of the stressful event, such as the accident in this scenario. Therefore, choice B is the correct answer.

Question 3

After a spouse dies, a client is diagnosed with adjustment disorder with depressed mood. Client symptoms include chronic migraines, feelings of hopelessness, social isolation, and self-care deficit. Which outcome would be most appropriate to direct the focus of this client's care?

Accepted Answer

The client's symptoms suggest that the focus of care should be on improving self-care deficits. The outcome related to accomplishing activities of daily living independently would address this need and is therefore the most appropriate option. The other outcomes focus on coping behaviors, body image, or impulsivity, which are not as relevant to the client's current symptoms.

Question 4

A nurse is caring for a client who is suspected of having the diagnosis of trichotillomania. What condition must be ruled out prior to a definitive diagnosis of this disorder?

Accepted Answer

Alopecia areata must be ruled out before a definitive diagnosis of trichotillomania can be made because both conditions involve hair loss. Trichotillomania is a compulsive disorder that causes individuals to pull out their own hair, while alopecia areata is an autoimmune disorder that causes patchy hair loss. Other conditions such as bipolar disorder, post-traumatic stress disorder, and body dysmorphic disorder can have similar symptoms to trichotillomania but do not involve hair loss as a primary symptom.

Question 5

Which individual would most likely be diagnosed with intermittent explosive disorder?

Accepted Answer

Intermittent explosive disorder is characterized by sudden episodes of unwarranted anger and aggression. The client with diabetes mellitus and a history of multiple severe assaultive acts fits this pattern, as their aggression is not linked to a personality disorder, hallucinations, or substance influence.

Question 6

During her aunt's wake, before a mother can stop her 4-year-old child, the child runs up to the casket. An appointment is made with a nurse practitioner when the child starts twisting and pulling out hair. Which nursing diagnosis should the nurse practitioner assign to this child?

Accepted Answer

Ineffective coping is the most appropriate nursing diagnosis for this scenario since the child is exhibiting behaviors that indicate distress and difficulty managing their emotions. The twisting and pulling of hair can be seen as a physical manifestation of the child's emotional turmoil. While complicated grieving, altered family processes, and body image disturbance may be relevant to this situation, they are not as applicable as ineffective coping.

Question 7

A 20-year-old client and a 60-year-old client have had drunk driving accidents and are both experiencing extreme anxiety. From a psychosocial theory perspective, which of these clients would be predisposed to the diagnosis of adjustment disorder?

Accepted Answer

According to psychosocial theory, individuals in their early adulthood stage have the task of establishing a sense of identity, while individuals in their later adulthood have the task of achieving a sense of integrity. Therefore, the 20-year-old client is more likely to be predisposed to the diagnosis of adjustment disorder due to their lack of developmental maturity and limited experience in coping with stressful situations.

Question 8

A client is diagnosed with intermittent explosive disorder. The clinic nurse should anticipate teaching about which medication?

Accepted Answer

Intermittent explosive disorder is a condition characterized by impulsive and aggressive outbursts. Risperidone (Risperdal), an atypical antipsychotic, is one of the medications that can help control these urges.

Question 9

A nursing instructor is teaching about the correlation between pathological gambling and abnormalities in the neurotransmitter system. What statement by the nursing student indicates that learning has occurred?

Accepted Answer

Pathological gambling has been linked to decreased levels of serotonin, which is involved in regulating mood, impulse control, and decision-making. It has also been associated with increased levels of norepinephrine, which can stimulate the brain's reward system and increase arousal and attention. Finally, it has been linked to increased levels of dopamine, which is involved in the experience of pleasure, reward, and motivation. Therefore, option A correctly summarizes the abnormalities in the neurotransmitter system seen in pathological gambling.

Question 10

A 15-year-old who is angry about not being chosen as the basketball team's captain, spray paints obscene words on the newly chosen captain's car. What information would cause a school nurse to consider a diagnosis of intermittent explosive disorder?

Accepted Answer

Intermittent explosive disorder is characterized by recurrent, sudden outbursts of aggressive behavior that are disproportionate to the situation. Therefore, the destruction of property being grossly out of proportion to not being chosen as captain could indicate this disorder. The other answer choices are not directly related to intermittent explosive disorder.

Question 11

A client has discovered that her husband is having an affair with a neighbor. During a visit to the neighbor's home, the wife steals the neighbor's diamond ring from the kitchen windowsill. What information would cause a nurse to rule out a diagnosis of kleptomania?

Accepted Answer

Kleptomania is characterized by an irresistible impulse to steal items that are not necessary for personal use or their monetary value. However, in this scenario, the stealing was committed to express emotions of anger and not due to an irresistible impulse or a desire for personal gain. Therefore, ruling out kleptomania would be appropriate in this case.

Question 12

A client diagnosed with an adjustment disorder asks the nurse, "Tell me about medications that will cure this problem." Which of the following are appropriate nursing replies? (Select all that apply.)

Accepted Answer

A, B, and C are appropriate nursing replies because they accurately reflect the limited role that medications play in treating adjustment disorders. Medications are not always necessary or appropriate, and they may not address the underlying issues that contribute to the disorder. D is also an appropriate response, as it acknowledges the potential risks and limitations of psychoactive drugs. Together, these responses help to educate the client about the limitations of medication and encourage them to explore other treatment options. E is not an appropriate response because it suggests that medication will be prescribed after a specific amount of time has passed, which is not necessarily true for all cases of adjustment disorder.

Question 13

In evaluating nursing interventions, which of the following types of questions would a nurse use to gather information from a client diagnosed with an impulse control disorder? (Select all that apply.)

Accepted Answer

These questions are relevant to evaluating impulse control disorders as they assess the client's ability to delay gratification, recognize tension before acting impulsively, and acknowledge the unacceptability of their behaviors.

Question 14

A 13-year-old client's father has recently been deployed to Afghanistan. Since deployment, the client has begun to participate in isolative behaviors, truancy, vandalism, and fighting. The pediatric nurse practitioner should identify this behavior with which adjustment disorder?

Accepted Answer

The answer of A 13-year-old client's father has recently been...

Question 15

A client, who recently delivered a stillborn baby, has a diagnosis of adjustment disorder unspecified. The nurse case manager should expect which client presentation that is characteristic of this diagnosis?

Accepted Answer

The answer of A client, who recently delivered a stillborn...

Quiz 33: Adjustment and Impulse Control Disorders