The nurse is caring for a client with complex somatic symptom disorder. When assessing this client, the nurse would be especially alert for symptoms of which of the following?

Correct Answer: A

Rationale: The correct answer is A: Depression. In complex somatic symptom disorder, individuals experience persistent, distressing physical symptoms without an underlying medical cause. Depression commonly coexists with this disorder due to the significant emotional distress and impact on daily functioning. The nurse would be alert for symptoms of depression such as persistent sadness, lack of interest in activities, changes in appetite or sleep, and feelings of worthlessness. Summary: - A: Depression is correct as it commonly coexists with complex somatic symptom disorder due to emotional distress. - B: Avoidant personality disorder is incorrect as it is a separate personality disorder characterized by avoidance of social interactions and feelings of inadequacy. - C: Delirium is incorrect as it is an acute confusional state with altered consciousness and attention. - D: Bipolar disorder is incorrect as it is a mood disorder characterized by episodes of mania and depression.

Correct Answer: D

Rationale: The correct answer is D because a large group is more effective for dealing with a specific issue due to the diversity of perspectives and experiences that can be shared. In a large group, there are more opportunities for brainstorming, problem-solving, and support. This leads to a richer discussion and more comprehensive exploration of the issue at hand. Choice A is incorrect because transference and countertransference issues can still arise in a large group setting. Choice B is incorrect as group cohesiveness may actually be harder to achieve in a larger group. Choice C is incorrect as a large group offers more potential interactions and relationships, not limited ones.

Correct Answer: D

Rationale: The correct answer is D: Bathing Self-Care Deficit related to symptoms of schizophrenia. The priority nursing diagnosis should address the most immediate and essential need for the client's well-being. In this case, the client's disheveled appearance, uncombed and matted hair, and strange odor indicate a lack of self-care in terms of personal hygiene, specifically bathing. This can lead to physical health issues and negatively impact the client's self-esteem and social interactions. Addressing the bathing self-care deficit is crucial to improving the client's overall health and well-being. A: Ineffective Role Performance related to symptoms of schizophrenia - While this is a valid concern, addressing the client's basic self-care needs should take precedence over role performance. B: Social Isolation related to auditory hallucinations - While social isolation is important, the immediate focus should be on addressing the client's personal hygiene needs. C: Dysfunctional Family Processes related to psychosis - While involving the family is important, the priority

Correct Answer: A

Rationale: The correct answer is A: Id. According to psychoanalytic theory by Freud, the Id is the primitive and instinctual part of the mind that operates on the pleasure principle, seeking immediate gratification of needs and desires without considering consequences. In this scenario, the child grabbing toys impulsively and demanding immediate satisfaction aligns with the characteristics of the Id. The Ego, on the other hand, mediates between the Id and the external world, considering reality and consequences. The Superego represents internalized societal and parental values, regulating moral and ethical behavior. The Preconscious refers to thoughts that are not currently in awareness but can be easily brought to consciousness.

Correct Answer: A

Rationale: The correct answer is A: Herpes simplex viruses. Chronic stress can weaken the immune system, leading to increased susceptibility to viral infections. Elevated antibody titers to herpes simplex viruses would be expected due to the reactivation of latent infections during periods of stress. The other choices (B: Herpes zoster viruses, C: Acquired immune deficiency viruses, D: Influenza viruses) are less likely to be affected by chronic stress in the same way as herpes simplex viruses. Herpes zoster viruses typically reactivates due to decreased immunity in older age, acquired immune deficiency viruses are related to HIV infection, and influenza viruses are more commonly associated with acute infections rather than chronic stress.

Correct Answer: A

Rationale: The correct answer is A because referring clients for aftercare services like day treatment programs can provide ongoing support and resources for managing severe or chronic mental illness, aiming to reduce residual defects. This intervention helps individuals access specialized care and therapies that target their specific needs, promoting recovery and minimizing long-term consequences. Choice B is incorrect as it focuses on providing care after assessing symptoms, which may not necessarily address residual defects associated with severe or chronic mental illness. Choice C is incorrect as it targets a different population and goal unrelated to reducing residual defects in severe mental illness. Choice D is incorrect as teaching mental health concepts to groups in the community may raise awareness but does not directly address reducing residual defects in severe or chronic mental illness.

Correct Answer: B

Rationale: The correct answer is B: The nurse expresses a sense of discomfort and limits behaviors. This is the appropriate intervention because it establishes clear boundaries and communicates the nurse's discomfort while maintaining a therapeutic relationship. By expressing discomfort and setting limits, the nurse asserts their personal space and ensures a safe environment for both parties. Choice A is incorrect because ignoring the behavior doesn't address the issue and may compromise the nurse's well-being. Choice C is incorrect as it passively accepts the invasion of personal space without addressing the discomfort. Choice D is incorrect as it immediately escalates the situation to a confrontational level, which may not be necessary at this stage and could harm the therapeutic relationship.

Correct Answer: A

Rationale: The correct answer is A: One effective type of behavioral therapy used for tics is CBIT. This is correct because Comprehensive Behavioral Intervention for Tics (CBIT) is a well-established and evidence-based therapy for managing tics in individuals with tic disorders, including Tourette syndrome. CBIT focuses on teaching individuals techniques to monitor and control their tics through behavioral strategies. Choice B is incorrect because there are treatments available for Tourette syndrome, including medications and behavioral therapies like CBIT. Choice C is incorrect because not all people with tic disorders will have them for their entire lives; some may see improvement over time. Choice D is incorrect because Tourette syndrome typically starts in childhood, usually between the ages of 2 and 12 years old, not after age eighteen.

Correct Answer: C

Rationale: The correct answer is C because it focuses on de-escalation by providing reassurance and support to the patient. By telling the patient to stop running and take a deep breath, the nurse acknowledges the patient's distress and offers assistance. This approach aims to help the patient regain control in a calming manner. Choice A is incorrect because asking for an example may not address the immediate need for de-escalation. Choice B is incorrect as physically restraining the patient could escalate the situation further. Choice D is incorrect as it may provoke feelings of fear or lack of control in the patient by mentioning seclusion.