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 C

Explanation

The correct answer/s is C

Choice A rationale: Hyperkalemia, or high potassium levels in the blood, is not typically associated with anorexia nervosa. In fact, individuals with anorexia nervosa are more likely to experience hypokalemia, or low potassium levels, due to inadequate dietary intake and excessive loss of potassium through vomiting or use of diuretics1.

Choice B rationale: Metrorrhagia, or irregular menstrual bleeding between periods, can occur in females with anorexia nervosa due to hormonal imbalances caused by extreme weight loss and malnutrition. However, amenorrhea, or the absence of menstruation, is more commonly observed1.

Choice C rationale: Lanugo, which is fine, soft hair that grows on the face and body, is a common finding in individuals with anorexia nervosa. It is the body’s response to severe weight loss and starvation as an attempt to provide insulation and maintain body temperature1.

Choice D rationale: Tachycardia, or a rapid heart rate, is not typically associated with anorexia nervosa. Instead, individuals with anorexia nervosa often experience bradycardia, or a slower than normal heart rate, as the body’s response to starvation1.

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

Correct Answer is A

Explanation

The adverse effect the nurse should report to the provider is A. Sweating and fever.

This combination of symptoms is a key indicator of Serotonin Syndrome, a potentially life-threatening condition that, while rare with buspirone alone, can occur, particularly if the client is taking other medications that increase serotonin (like SSRIs or MAOIs).

The nurse should report these signs immediately because:

Sweating (Diaphoresis) and High Fever (Hyperthermia) are core components of the triad of symptoms for Serotonin Syndrome (autonomic instability).
Serotonin Syndrome also involves changes in mental status (e.g., confusion, hallucinations, which is option D) and neuromuscular hyperactivity (e.g., muscle rigidity, tremors).
This is a medical emergency that requires immediate intervention to prevent complications like rhabdomyolysis, metabolic acidosis, and renal failure.

In comparison:

C. Decreased appetite is a common, generally mild, and manageable side effect.
D. Hallucinations are a serious central nervous system side effect, but when presented alongside the life-threatening systemic signs of Serotonin Syndrome (A), option A represents the more urgent and dangerous adverse reaction.
B. Discolored urine is not a standard adverse effect and would need investigation, but is not as acutely critical as signs of Serotonin Syndrome.

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Naxlex Comprehensive Predictor Exams

A nurse is assessing an adolescent female client who has anorexia nervosa. Which of the following findings should the nurse expect?

Correct Answer is C

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 A

Explanation

A mental health nurse is reviewing the medical record of a client who self-harms. Which of the following pieces of information should the nurse identify as placing the client at risk for self-harm behaviors?

A nurse is assessing a client who has posttraumatic stress disorder (PTSD) following a sexual assault. Which of the following is an expected finding?

A nurse manager is discussing suicide with nursing staff.Which of the following should the manager identify as risk factors for suicide? (Select all that apply.)

A mental health nurse is assessing a client who has generalized anxiety disorder. Which of the following findings should the nurse expect?

A nurse is caring for a client following a suicide attempt.The client has a history of depression, substance abuse, and anorexia nervosa. Which of the following actions is the nurse's priority?

A nurse is reviewing the medical histories of four clients.Which of the following clients may develop extrapyramidal symptoms from medication therapy?

A nurse is caring for a client who requires a crisis intervention for acute anxiety. Which of the following actions should be the nurse's highest priority?