An adolescent diagnosed with a CD stole and wrecked a neighbor's motorcycle. Afterward, the adolescent was confronted about the behavior but expressed no remorse. Which variation in the central nervous system best explains the adolescent's reaction?

Correct Answer: C

Rationale: The correct answer is C because reduced gray matter in the cortex and dysfunction of the amygdala can lead to decreased feelings of empathy. The adolescent's lack of remorse for stealing and wrecking the neighbor's motorcycle suggests a deficit in empathy, which is controlled by the amygdala and the cortex. The amygdala is responsible for processing emotions, including empathy, while the cortex plays a role in higher cognitive functions like decision-making and understanding consequences. Dysfunction in these areas can result in a lack of emotional response or understanding of the impact of one's actions, leading to a lack of remorse. Choice A is incorrect because while serotonin dysregulation and increased testosterone activity can affect behavior, they are not directly linked to remorse. Choice B is incorrect as neuron destruction in the hippocampus is associated with memory and learning, not empathy. Choice D is incorrect because disturbances in the occipital lobe are related to visual processing, not empathy or remorse.

Correct Answer: C

Rationale: The correct answer is C: Weight gain is a common but troubling side effect. Weight gain is a well-known side effect of lithium, commonly seen in individuals taking this medication for bipolar disorder. It is essential for the nurse to acknowledge the client's concern and provide accurate information about the medication's potential side effects. Choices A, B, and D are incorrect because weight gain is a known side effect of lithium, and denying or downplaying the client's experience could lead to misunderstanding and lack of trust in the healthcare provider.

Correct Answer: C

Rationale: Rationale: The correct answer is C because the recommended dosage range for lamotrigine in bipolar I disorder is typically 100-400 mg/day. Since the client is prescribed 400 mg three times a day, the total daily dose would be 1200 mg, which is more than twice the upper limit of the recommended range. This high dosage may increase the risk of adverse effects, such as skin rash or dizziness. Summary: A: Incorrect - The dosage is higher than the recommended range. B: Incorrect - The dosage is not lower but higher than the recommended range. D: Incorrect - The dosage is not four times higher but more than twice the recommended range.

Correct Answer: B

Rationale: The correct answer is B: Take the child swimming at the facility's pool. This is the priority action because the client is exhibiting signs of agitation and potential aggression, and physical activity like swimming can help release pent-up energy and reduce stress. It can also serve as a distraction and help de-escalate the situation. A: Asking the child about their feelings may not be effective in this moment of agitation. C: Establishing a behavioral contract requires a calm and cooperative state from the client, which is not the case currently. D: Administering an anxiolytic medication should not be the initial response unless the client's behavior becomes a safety concern and other interventions have failed.

Correct Answer: C

Rationale: The correct answer is C: Defensive coping related to adjustment to changes in family relationships. The adolescent's behavior of truancy and assault is a coping mechanism to avoid dealing with the stress and turmoil caused by the parents' divorce. This choice addresses the underlying issue of struggling to adjust to the changes in family dynamics and using defensive coping mechanisms to deal with the emotional distress. A: Chronic low self-esteem is not the most appropriate diagnosis in this case as the behavior exhibited is more related to coping with family changes rather than self-esteem issues. B: Decisional conflict related to school compliance is not the best choice as the behavior is not primarily driven by conflicts related to school requirements. D: Disturbed personal identity related to changing family dynamics is not the most suitable diagnosis as the primary issue lies in the coping mechanism and adjustment to family changes rather than personal identity disturbances.