A patient says, I feel detached and weird all the time, like I'm looking at life through a cloudy window. Everything seems unreal. These feelings really interfere with my work and study. Which term should the nurse use to document this complaint?

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Health Assessment Neurological System NCLEX Questions Questions

Question 1 of 5

A patient says, I feel detached and weird all the time, like I'm looking at life through a cloudy window. Everything seems unreal. These feelings really interfere with my work and study. Which term should the nurse use to document this complaint?

Correct Answer: A

Rationale: Correct Answer: A. Depersonalization Rationale: 1. Depersonalization involves feeling detached from oneself or reality, as described by the patient. 2. The patient's description of feeling like they are looking through a cloudy window aligns with depersonalization symptoms. 3. Interference with work and study suggests significant distress, a common feature of depersonalization disorder. Summary of other choices: B. Hypochondriasis: Involves excessive worry about having a serious illness, which is not indicated in the patient's complaint. C. Dissociation: While depersonalization is a type of dissociative symptom, it specifically refers to feeling detached and unreal, not necessarily a broader dissociative disorder. D. Malingering: Involves feigning or exaggerating symptoms for secondary gain, which is not evident in the patient's genuine distress and impairment.

Question 2 of 5

After receiving a change-of-shift report at 7:00 am, which of these patients will you assess first?

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 3 of 5

Mr. Smith develops signs of increased intracranial pressure. Which of the following medications is likely to be ordered for Mr. Smith?

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 4 of 5

Mrs. Moore is a client with Parkinson disease. The nurse can anticipate that Mrs. Moore's major nursing needs will be

Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 5 of 5

In the acute phase following a cerebrovascular accident, patients have a tendency to develop pressure lesions for all of the following reasons EXCEPT

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

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