Shortly after the parents announced that they were divorcing, a 15-year-old became truant from school and assaulted a friend. The adolescent told the school nurse, 'I'd rather stay in my room and listen to music. It's easier than thinking about what is happening in my family.' Which nursing diagnosis is most applicable?

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 aggression towards a friend indicates they are using defensive coping mechanisms to avoid dealing with the stress of their parents' divorce. This diagnosis focuses on the maladaptive coping strategies being used by the individual. A: Chronic low self-esteem is not the most applicable diagnosis in this case as the behavior described is more indicative of avoidance and coping mechanisms rather than self-esteem issues. B: Decisional conflict related to compliance with school requirements does not address the underlying emotional distress the adolescent is experiencing due to the family situation. D: Disturbed personal identity related to self-perceptions of changing family dynamics is not the most appropriate diagnosis as it does not directly address the defensive coping mechanisms being used by the adolescent in response to the family changes.

Correct Answer: A

Rationale: The correct answer is A because Oppositional Defiant Disorder (ODD) is characterized by negative, hostile behavior towards authority figures like parents. Blaming others for misbehavior is a common trait in individuals with ODD. Choice B describes symptoms of Tourette syndrome, not ODD. Choice C describes conduct disorder behaviors, not specific to ODD. Choice D is more indicative of anxiety or trauma-related disorders, not ODD. Therefore, negative, hostile behavior towards parents and blaming others for misbehavior are key assessment findings that support a diagnosis of ODD.

Correct Answer: A

Rationale: The priority nursing diagnosis for a client diagnosed with bipolar disorder who intentionally overdoses on sertraline is "A: Risk for suicide R/T hopelessness." This is because the client's actions indicate a high risk for self-harm, which takes precedence over other diagnoses. The client's depressive episode, anorexia, insomnia, and recent job loss all contribute to feelings of hopelessness and can increase the risk of suicide. Choice B, anxiety related to hyperactivity, is not the priority because the client's intentional overdose is a more immediate concern than anxiety symptoms. Choice C, imbalanced nutrition due to refusal to eat, is not the priority because the risk of suicide is a more urgent and life-threatening issue. Choice D, dysfunctional grieving related to job loss, is not the priority as the client's immediate safety from self-harm takes precedence over grieving.

Correct Answer: B

Rationale: The correct answer is B because bipolar disorder is indeed more prevalent in higher socioeconomic groups. This is because individuals with higher socioeconomic status may have better access to resources like mental health services, leading to higher rates of diagnosis. Option A is incorrect as bipolar disorder is not typically associated with lower socioeconomic groups. Option C is incorrect because the prevalence of bipolar disorder does vary across socioeconomic groups. Option D is incorrect as there is a known correlation between higher socioeconomic status and increased prevalence of bipolar disorder.

Correct Answer: D

Rationale: The correct answer is D because medication non-adherence is a critical challenge in treating bipolar disorder. Clients may experience relapses, worsened symptoms, and increased risk of hospitalization without proper medication management. Clients may have various reasons for not taking their medications, such as side effects or denial of illness. On the other hand, choices A, B, and C, while important factors, do not directly impact treatment outcomes as significantly as medication non-adherence. Difficulty sleeping, irritability, and lack of insight can be addressed through therapeutic interventions and support.