Mr. Gonzales develops hepatic encephalopathy. Which clinical manifestation is most common with this condition?

Correct Answer: B

Rationale: The correct answer is B: Altered level of consciousness. Hepatic encephalopathy is characterized by cognitive impairment and changes in consciousness due to liver dysfunction. It is the most common clinical manifestation seen in patients with this condition. Increased urine output (A), decreased tendon reflex (C), and hypotension (D) are not typical features of hepatic encephalopathy. Altered level of consciousness is directly related to the toxic effects of ammonia on the brain, which is the underlying mechanism in hepatic encephalopathy.

Correct Answer: D

Rationale: The correct answer is D: Somatoform Pain Disorder. This disorder is characterized by persistent, severe pain without any identifiable physical cause. In this case, the individual's low back pain has been investigated with negative results, indicating no physical basis for the pain. This aligns with the criteria for somatoform pain disorder. A: Somatization Disorder involves a history of multiple, recurrent physical complaints across various organ systems, not just focused on pain. B: Hypochondriasis is characterized by excessive fear of having a serious illness, whereas this individual's pain is the primary concern. C: Conversion Disorder involves neurological symptoms that cannot be explained by medical evaluation, such as paralysis or blindness, which is not the case here. In summary, the individual's unexplained, persistent pain fits the criteria for Somatoform Pain Disorder, making it the correct choice among the options provided.

Correct Answer: D

Rationale: The correct answer is D: Severe. This classification is based on the child's IQ score of 45, which falls within the range for severe mental retardation. Children with severe mental retardation typically have significant limitations in communication, social skills, and daily living activities. The IQ score of 45 indicates a significant intellectual impairment affecting the child's overall functioning. Choices A, B, and C are incorrect because they correspond to different levels of mental retardation that do not align with the child's IQ score and functional limitations.

Correct Answer: B

Rationale: The correct answer is B: Cocaine. The symptoms described align with acute cocaine intoxication, including hallucinations, agitation, and nasal irritation from snorting it. Heroin (A) typically causes drowsiness, LSD (C) hallucinations without agitation, and marijuana (D) does not typically lead to hallucinations or nasal irritation. Identifying the correct substance can guide appropriate medical interventions and ensure the client's safety.

Correct Answer: B

Rationale: The correct answer is B: Weight gain. In anorexia nervosa, weight gain is a key indicator of improvement as it signifies the client is increasing their nutritional intake and addressing their malnourishment. This is a tangible and measurable sign of progress in treatment. Choices A, C, and D may also be positive indicators, but weight gain directly addresses the core issue of the disorder by improving physical health and reversing the effects of malnutrition. Eating in the dining room (A) may not necessarily mean the client is consuming adequate calories. Attending ward activities (C) and having a more realistic self-concept (D) are important psychosocial aspects but do not directly address the physical health aspect of anorexia nervosa.