NURS 2872 Unit 5 Test With
Complete Solution
A patient at a general medical clinic tells the nurse, "I have so many ailments
that I need to see six different doctors. None of them has discovered what is
really wrong with me." Which comment should the nurse offer next?
a. "Let's review all the medications you currently take."
b. "Tell me about allergic reactions you've had to medication."
c. "Selecting one primary care provider would be better for you."
d. "I'm not sure I understand how you can afford these expenses." - ANSWER
a. "Let's review all the medications you currently take."
Safety is the nurse's first concern. One serious risk associated with
doctor-shopping is medication interactions and duplicate medications.
A combat veteran from two tours of the war in Afghanistan tells the nurse,
"Some guys in my unit have posttraumatic stress disorder, but I never had
any problems other than my hearing is not as good as it once was." Which
explanation for this comment should the nurse consider?
a. The veteran wants to demonstrate toughness and strength.
b. The veteran shows indicators of derealization and depersonalization.
c. The veteran may be rationalizing this reaction to memories of combat.
d. The veteran may have amnesia associated with the combat experience. -
ANSWER d. The veteran may have amnesia associated with the combat
,experience.
War is a traumatic experience for anyone. The veteran's comments about his
peers and hearing deficit clearly indicate that he was exposed to explosives.
Some studies show that between 5% and 20% of veterans are amnesic for
their combat experiences.
A patient diagnosed with dissociative identity disorder is hospitalized on an
acute care psychiatric unit after a suicide attempt. During a team meeting,
which staff nurse's comment should prompt the nursing supervisor to
intervene?
a. "I have never taken care of a patient diagnosed with this disorder."
b. "I think this patient was misdiagnosed and probably has schizophrenia."
c. "I find myself more fascinated and engaged with this patient than others."
d. "I recently read an autobiographical book about someone with this
problem." - ANSWER c. "I find myself more fascinated and engaged with this
patient than others."
Working with people who have somatic symptom disorders can be
frustrating as well as fascinating. The correct response presents a comment
indicating that the nurse may have lost objectivity regarding the patient.
Guidance from the nursing supervisor is needed.
A nurse in an outpatient medical clinic talks to a patient with a long history
of malingering and doctor-shopping. The patient continues to express
complaints of multiple problems. Select the nurse's best comment to the
patient.
a. "The treatment team believes you would benefit more from seeing a
,mental health professional."
b. "The treatment team discussed your case and wants to begin a special case
management program for you."
c. "Because you take a number of medications, it would be safer to have
them all filled at the same pharmacy."
d. "Diagnostic testing has shown no medical problems and you are using
more than your fair share of health care services." - ANSWER b. "The
treatment team discussed your case and wants to begin a special case
management program for you."
It's important for the nurse to convey compassion and support to the
patient but without reinforcing the symptoms. Case management can help to
limit health care costs. Seeing the patient at regular intervals can instill
security and avoid frantic and frequent demands. The patient who establishes
a relationship with the case manager often feels less anxiety because he or
she has an advocate and feels that someone is managing and aware of his or
her care.
A patient in the emergency department was seen for the third time in a
month with complaints of tremors and paresthesia in the lower extremities.
Conversion disorder was diagnosed. While preparing for discharge, the
patient says, "Now I'm having chest pain but it's probably nothing." How
should the nurse respond?
a. Assess the patient's most current laboratory values.
b. Interrupt the discharge and arrange additional medical evaluation of the
patient.
, c. Remind the patient, "The diagnostic tests showed you did not have a
medical problem."
d. Tell the patient, "Being in the emergency department a long time can be
very distressing." - ANSWER b. Interrupt the discharge and arrange
additional medical evaluation of the patient.
A paresthesia is a tingling or pricking sensation. Conversion disorder
(functional neurobiological symptom disorder) usually involves weakness or
paralysis, abnormal movement, swallowing or speech difficulties, seizures or
attacks, and sensory problems. Patients may be distressed or show la belle
indifference (a lack of emotional concern). Despite the diagnosis, the
patient's complaints must be taken seriously. Further evaluation is needed.
The school nurse assesses four adolescents, all of whom outwardly appear
healthy. Which adolescent meets one criterion for anorexia nervosa with mild
severity?
a. 5'2" tall; weight 104 pounds
b. 5'7" tall; weight 110 pounds
c. 5'5" tall; weight 114 pounds
d. 5'8" tall; weight 127 pounds - ANSWER b. 5'7" tall; weight 110 pounds
Body mass index (BMI) is used to gauge the level of severity, degree of
functional disability, and need for supervision for persons diagnosed with
anorexia nervosa. BMI is calculated as weight in kilograms divided by height
in meters squared. Ideal BMIs are between 19 and 25. A person whose BMI is
over or equal to 17 kg/m2 meets one criterion for anorexia nervosa with mild
severity. The BMI for the correct response is 17.2.
Complete Solution
A patient at a general medical clinic tells the nurse, "I have so many ailments
that I need to see six different doctors. None of them has discovered what is
really wrong with me." Which comment should the nurse offer next?
a. "Let's review all the medications you currently take."
b. "Tell me about allergic reactions you've had to medication."
c. "Selecting one primary care provider would be better for you."
d. "I'm not sure I understand how you can afford these expenses." - ANSWER
a. "Let's review all the medications you currently take."
Safety is the nurse's first concern. One serious risk associated with
doctor-shopping is medication interactions and duplicate medications.
A combat veteran from two tours of the war in Afghanistan tells the nurse,
"Some guys in my unit have posttraumatic stress disorder, but I never had
any problems other than my hearing is not as good as it once was." Which
explanation for this comment should the nurse consider?
a. The veteran wants to demonstrate toughness and strength.
b. The veteran shows indicators of derealization and depersonalization.
c. The veteran may be rationalizing this reaction to memories of combat.
d. The veteran may have amnesia associated with the combat experience. -
ANSWER d. The veteran may have amnesia associated with the combat
,experience.
War is a traumatic experience for anyone. The veteran's comments about his
peers and hearing deficit clearly indicate that he was exposed to explosives.
Some studies show that between 5% and 20% of veterans are amnesic for
their combat experiences.
A patient diagnosed with dissociative identity disorder is hospitalized on an
acute care psychiatric unit after a suicide attempt. During a team meeting,
which staff nurse's comment should prompt the nursing supervisor to
intervene?
a. "I have never taken care of a patient diagnosed with this disorder."
b. "I think this patient was misdiagnosed and probably has schizophrenia."
c. "I find myself more fascinated and engaged with this patient than others."
d. "I recently read an autobiographical book about someone with this
problem." - ANSWER c. "I find myself more fascinated and engaged with this
patient than others."
Working with people who have somatic symptom disorders can be
frustrating as well as fascinating. The correct response presents a comment
indicating that the nurse may have lost objectivity regarding the patient.
Guidance from the nursing supervisor is needed.
A nurse in an outpatient medical clinic talks to a patient with a long history
of malingering and doctor-shopping. The patient continues to express
complaints of multiple problems. Select the nurse's best comment to the
patient.
a. "The treatment team believes you would benefit more from seeing a
,mental health professional."
b. "The treatment team discussed your case and wants to begin a special case
management program for you."
c. "Because you take a number of medications, it would be safer to have
them all filled at the same pharmacy."
d. "Diagnostic testing has shown no medical problems and you are using
more than your fair share of health care services." - ANSWER b. "The
treatment team discussed your case and wants to begin a special case
management program for you."
It's important for the nurse to convey compassion and support to the
patient but without reinforcing the symptoms. Case management can help to
limit health care costs. Seeing the patient at regular intervals can instill
security and avoid frantic and frequent demands. The patient who establishes
a relationship with the case manager often feels less anxiety because he or
she has an advocate and feels that someone is managing and aware of his or
her care.
A patient in the emergency department was seen for the third time in a
month with complaints of tremors and paresthesia in the lower extremities.
Conversion disorder was diagnosed. While preparing for discharge, the
patient says, "Now I'm having chest pain but it's probably nothing." How
should the nurse respond?
a. Assess the patient's most current laboratory values.
b. Interrupt the discharge and arrange additional medical evaluation of the
patient.
, c. Remind the patient, "The diagnostic tests showed you did not have a
medical problem."
d. Tell the patient, "Being in the emergency department a long time can be
very distressing." - ANSWER b. Interrupt the discharge and arrange
additional medical evaluation of the patient.
A paresthesia is a tingling or pricking sensation. Conversion disorder
(functional neurobiological symptom disorder) usually involves weakness or
paralysis, abnormal movement, swallowing or speech difficulties, seizures or
attacks, and sensory problems. Patients may be distressed or show la belle
indifference (a lack of emotional concern). Despite the diagnosis, the
patient's complaints must be taken seriously. Further evaluation is needed.
The school nurse assesses four adolescents, all of whom outwardly appear
healthy. Which adolescent meets one criterion for anorexia nervosa with mild
severity?
a. 5'2" tall; weight 104 pounds
b. 5'7" tall; weight 110 pounds
c. 5'5" tall; weight 114 pounds
d. 5'8" tall; weight 127 pounds - ANSWER b. 5'7" tall; weight 110 pounds
Body mass index (BMI) is used to gauge the level of severity, degree of
functional disability, and need for supervision for persons diagnosed with
anorexia nervosa. BMI is calculated as weight in kilograms divided by height
in meters squared. Ideal BMIs are between 19 and 25. A person whose BMI is
over or equal to 17 kg/m2 meets one criterion for anorexia nervosa with mild
severity. The BMI for the correct response is 17.2.
