A nurse is caring for an adolescent client who has a recent diagnosis of conduct disorder.
The client has demonstrated episodic aggression toward animals and humans, and has been known to threaten individuals with a knife and has sexually assaulted another adolescent.
Nurses' Notes: - 09:00: Client showed signs of agitation during group therapy.
- 13:00: Client had a verbal altercation with another client.
- 17:00: Client participated in one-on-one counseling, showed some signs of remorse.
Medical History: - Numerous instances of property destruction (breaking windows, damaging cars, and setting small fires) of family members as well as neighbors.
- Guardians are fearful of the client being around their other children.
Select the three findings that indicate the client is experiencing positive outcomes from the prescribed treatment:
Expression of guilt feelings
Statement regarding unit rules
Renewed relationship with uncle
Positive attitude toward school .
Correct Answer : A,B,D
Choice A rationale: Expression of guilt feelings is a positive outcome in the treatment of conduct disorder. Guilt is an emotional response to one’s actions that are perceived as wrong or inappropriate. It is a self-conscious emotion that often involves a
sense of tension and regret. In the context of conduct disorder, the expression of guilt feelings can be seen as a sign of developing empathy and understanding the consequences of one’s actions. This is a crucial step in the process of behavior change and rehabilitation. The client showing signs of remorse during one-on-one counseling is a positive sign indicating that the treatment is having an effect.
Choice B rationale: A statement regarding unit rules is another positive outcome in the treatment of conduct disorder. Understanding and acknowledging the rules of the unit indicates that the client is beginning to accept the boundaries and norms set by the authority. This is a significant step towards improving their behavior, as individuals with conduct disorder often have difficulties following rules and respecting authority. The verbal altercation with another client could be seen as a negative event, but it also could indicate that the client is engaging with others, which could be a step towards improvement, depending on the context of the altercation.
Choice C rationale: A renewed relationship with an uncle does not necessarily indicate a positive outcome from the treatment of conduct disorder. While family support can be beneficial in the treatment process, it does not directly indicate that the client’s conduct disorder is improving. More information would be needed to determine if this is a positive outcome related to the treatment.
Choice D rationale: A positive attitude toward school is a positive outcome in the treatment of conduct disorder. School is a structured environment where rules and expectations are clearly laid out, and a positive attitude towards school can indicate that the client is beginning to accept these structures. This can be a sign of improvement in their behavior and attitude.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2"]
Explanation
Step 1: Identify the required dose of lithium, which is 300 mg.
Step 2: Identify the available dose of lithium carbonate, which is 150 mg per capsule.
Step 3: Calculate the number of capsules needed using the formula: Number of capsules = Required dose ÷ Available dose.
Numberofcapsules=300 mg150 mg/capsule
\(Number\ of\ capsules = {300\ mg \over 150\ mg/capsule}\)
Step 4: Solve the equation.
Numberofcapsules=2 capsulesNumberofcapsules=2capsules
So, the nurse should administer 2 capsules per dose to achieve the required lithium dose of 300 mg.
Correct Answer is B
Explanation
Choice A rationale: The statement “My arms often feel weak and spastic” does not indicate obsessive-compulsive disorder (OCD). This could be a symptom of a physical condition or a different mental health disorder, but it does not align with the common symptoms of OCD. OCD is characterized by unwanted, recurring thoughts and repetitive behaviors.
Choice B rationale: The statement “I check where my car keys are ten times” is indicative of OCD. One of the key symptoms of OCD is the need to check things repeatedly due to persistent, unwanted thoughts and fears. The individual may check something over and over again, such as whether the door is locked or where their car keys are, even if they know they’ve already checked. This behavior is a compulsion - an act the person feels compelled to perform to alleviate the distress caused by the obsessive thought.
Choice C rationale: The statement “I’m embarrassed to go out and speak in public” could be indicative of social anxiety disorder, not OCD. Social anxiety disorder is characterized by a fear of social situations and interactions, particularly those involving the possibility of scrutiny or judgment by others. While people with OCD can also have social anxiety disorder, embarrassment about going out and speaking in public is not a typical symptom of OCD12.
Choice D rationale: The statement “I keep reliving a car accident almost every day” is more indicative of post- traumatic stress disorder (PTSD) than OCD. PTSD is a mental health disorder that can develop after experiencing or witnessing a traumatic event, such as a car accident. Symptoms of PTSD include flashbacks, nightmares, and severe anxiety, as well as uncontrollable thoughts about the event. While people with OCD can have intrusive thoughts, these thoughts are typically related to themes like contamination or orderliness, rather than reliving past traumas.
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