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 .

Answer and Explanation

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.

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Correct Answer is A

Explanation

Rationale:

A. Agoraphobia: This choice directly aligns with the client's presentation of being afraid to leave her home alone. Agoraphobia is a specific phobia characterized by an intense fear of situations that the individual perceives as inescapable or that might potentially lead to panic or embarrassment. Common triggers for agoraphobic individuals include crowded spaces, open spaces, public transportation, or being alone outside of the home. The client's inability to leave her home for weeks due to fear is a classic symptom of agoraphobia.

B. Xenophobia: This choice refers to the fear of strangers or foreigners. While the client may experience anxiety in unfamiliar situations, the primary focus of her fear is being outdoors alone rather than encountering unfamiliar people. Additionally, the daughter's description of the client's fear specifically mentions being alone, further supporting agoraphobia as the more likely diagnosis.

C. Mysophobia: This choice refers to an extreme or obsessive fear of germs or contamination. While anxiety related to cleanliness could coexist with agoraphobia, the primary presenting complaint in this case is the fear of being outdoors, not specifically germs or contamination.

D. Aerophobia: This choice refers to the fear of flying or being in high places. There is no indication in the scenario that the client's fear is specifically related to heights or flying, making this choice less likely.

Therefore, based on the specific nature of the client's fear and the limited information provided, agoraphobia is the most probable diagnosis and the one the nurse should anticipate planning care for.

A. Sweating and fever B. Discolored urine C. Decreased appetite D. Hallucinations.

Correct Answer is D

Explanation

Choice A rationale: Sweating and fever are not typically associated with buspirone use. These symptoms could be indicative of another underlying condition or a different medication side effect.

Choice B rationale: Discolored urine is not a common side effect of buspirone. If a patient experiences this, it may be due to other factors such as dehydration, certain foods, or other medications.

Choice C rationale: Decreased appetite is not a common side effect of buspirone. While some medications can affect appetite, buspirone is not typically associated with significant changes in appetite.

Choice D rationale: Hallucinations are a serious side effect and should be reported to the provider immediately. Although rare, buspirone can cause severe side effects such as mental depression, confusion, and uncontrolled

movements of the body. If a patient experiences hallucinations while taking buspirone, it could indicate a serious adverse reaction that requires immediate medical attention.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a mental health clinic is assessing a client who was brought in by her adult daughter stating that her mother has not been able to leave her home for weeks because she is afraid to be outdoors alone.The nurse should anticipate planning care for managing which of the following phobias?

Correct Answer is A

Explanation

A nurse is caring for a client who has generalized anxiety disorder and is taking buspirone. Which of the following adverse effects should the nurse report to the provider?

Correct Answer is D

Explanation

A nurse is preparing to administer amantadine 150 mg PO every 12 hr. The available medication is amantadine 50 mg/5 mL syrup. How many mL should the nurse administer per dose?

A nurse in a mental health facility is planning care for a client who has obsessive-compulsive disorder (OCD) and is newly admitted to the unit. Which of the following actions should the mental health nurse plan to take regarding the client's compulsive behaviors?

During a family therapy session led by a nurse, which of the following statements should be recognized as an example of effective communication among a mother, father, and two adolescent siblings?

A nurse is admitting a client to an alcohol abuse program. The client states, "I'm here because of my boss.It was part of my job to go to parties and drink with clients." The client's statement is an example of which of the following defense mechanisms?

A nurse is caring for a client who has been diagnosed with end-stage liver cancer.Which of the following responses is an indication the client is in the denial phase of the grief process?

A nurse is assessing a client who has a new diagnosis of anorexia nervosa. Which of the following findings should the nurse expect?

A nurse is discussing the use of mechanical restraints with a newly licensed nurse.Which of the following situations should the nurse include as an indication for placing a client in mechanical restraints?

A school registered nurse is speaking to the father of a 15-year-old male adolescent. The father has concerns about his son.Which of the following statements by the mother should indicate to the nurse that the adolescent is at risk for suicide?