A nurse is caring for a client who reports continuing problems related to migraines. The nurse is assessing the psychosocial impact of migraines on the client. Which of the following questions should the nurse include in the assessment?
(Select All that Apply.)
"Are you having any feelings of depression?"
"Are you experiencing any sensitivity to light?"
"Are you feeling any increase in your sexual drive?"
"Are you experiencing any episodes of 'panic-type' feelings?"
"Are you experiencing more fatigue as compared to before you had migraines?"
Correct Answer : A,D,E
Choice A Reason:
"Are you having any feelings of depression?". This statement is appropriate. Migraines can significantly impact mood, and depression is a common comorbidity in individuals with chronic migraines. Inquiring about feelings of depression allows the nurse to assess the client's mental health status and provide appropriate support or referrals if needed.
Choice B Reason:
"Are you experiencing any sensitivity to light?": This statement is inappropriate. This question addresses a physical symptom commonly associated with migraines rather than psychosocial impact.
Choice C Reason:
"Are you feeling any increase in your sexual drive?" Migraines are more likely to decrease sexual drive due to pain and fatigue. This question is not typically relevant to the psychosocial impact of migraines.
Choice D Reason:
"Are you experiencing any episodes of 'panic-type' feelings?" This statement is appropriate. Migraines can sometimes trigger anxiety or panic attacks in affected individuals. Inquiring about panic-type feelings allows the nurse to assess the client's emotional response to migraines and provide interventions or referrals for anxiety management if necessary.
Choice E Reason:
"Are you experiencing more fatigue as compared to before you had migraines?": This statement is appropriate. Fatigue is a common symptom associated with migraines, both during and after an attack. Assessing the client's level of fatigue helps the nurse understand the impact of migraines on the client's energy levels and overall functioning.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E"]
Explanation
Choice A Reason:
Weight control if the client's BMI is greater than 35 is correct. Obesity is a risk factor for cardiovascular disease and can exacerbate symptoms of heart failure. Weight control, particularly if the client's BMI is greater than 35, is important for managing cardiac conditions such as heart failure and reducing the risk of pulmonary edema.
Choice B Reason:
Healthy lifestyle is correct. Adopting a healthy lifestyle, including regular exercise, balanced diet, adequate hydration, and stress management, is essential for managing cardiac conditions and reducing the risk of complications such as pulmonary edema.
Choice C Reason:
Smoking cessation is correct. Smoking is a major risk factor for cardiovascular disease and can worsen heart failure symptoms. Smoking cessation is crucial for managing cardiac conditions and reducing the risk of pulmonary edema and other complications.
Choice D Reason:
Heart disease prevention is correct. Providing information about heart disease prevention strategies, such as maintaining a healthy diet, managing blood pressure and cholesterol levels, regular exercise, and regular medical check-ups, can help reduce the risk of exacerbations and complications in clients with pre-existing cardiac conditions.
Choice E Reason:
Glycemic control if the client is diabetic is correct. Diabetes is a risk factor for cardiovascular disease and can contribute to the development and progression of heart failure. Glycemic control, along with lifestyle modifications and medication management, is important for managing diabetes and reducing the risk of complications such as pulmonary edema.
Correct Answer is ["B","D","E","F"]
Explanation
Choice A Reason:
Client responds to name is incorrect. Responding to one's name is a positive sign indicating consciousness and orientation. It suggests that the client's level of consciousness is relatively intact.
Choice B Reason:
Eyes open to painful stimuli is correct. Opening the eyes in response to painful stimuli is a concerning sign, indicating a decrease in consciousness and potentially worsening neurological status. It suggests that the client's level of arousal is diminishing and may indicate a decline in condition.
Choice C Reason:
Client states day of the week is correct. Oriented behavior, such as knowing the day of the week, is a positive sign indicating intact cognition and orientation. It suggests that the client's mental status is relatively preserved.
Choice D Reason:
Client is confused is correct. Confusion is a concerning sign, indicating altered mental status and potentially worsening neurological function. It suggests that the client's cognition is impaired, which may be indicative of a decline in condition.
Choice E Reason:
Client mumbles inappropriate words is correct. Mumbling inappropriate words suggests disorientation and altered mental status, which are concerning signs indicating a decline in neurological function.
Choice F Reason:
Eyes do not open to name is incorrect. Failure to open the eyes in response to verbal stimuli, such as one's name, is a concerning sign indicating a decrease in consciousness and potentially worsening neurological status. It suggests that the client's level of arousal is diminished and may indicate a decline in condition.
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