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NU 673 PSYCHIATRIC MENTAL HEALTH CARE REVIEW EXAM  WITH CORRECT Q & A UPDATED 2024

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NU 673 PSYCHIATRIC MENTAL HEALTH CARE REVIEW EXAM  WITH CORRECT Q & A UPDATED 2024 The nurse is admitting an adolescent reporting severe depression and  amenorrhea. What additional assessment findings by the nurse would  suggest the client may develop anorexia nervosa?  Select all that a...

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NU 673 PSYCHIATRIC MENTAL HEALTH CARE REVIEW EXAM WITH CORRECT Q & A UPDATED 2024 The nurse is admitting an adolescent reporting severe depression and amenorrhea. What additional assessment findings by the nurse would suggest the client may develop anorexia nervosa? Select all that apply 1. Tight fitting clothes 2. Oily, elastic skin 3. Brittle, dry nails 4. Gingival infections 5. Low blood pressure - 3. & 5. Correct: This client is reporting symptoms consistent with anorexia nervosa, a serious and potentially life -threatening eating disorder that develops secondary to the type of family or social stress experienced in adolescence. In addition to severe depr ession and amenorrhea, the nurse has identified brittle, dry nails, and a low blood pressure secondary to weight loss as additional indications of anorexia nervosa. 1. Incorrect: Despite the fact that anorexic clients experience severe weight loss, they c ontinue to view themselves as heavy and generally wear loose fitting clothing to hide what they perceive as an overweight body. 2. Incorrect: Because of skeletal muscle atrophy and poor nutritional intake, anorexic clients display sallow, dry skin with br ittle nails and hair. Oily, non -
elastic skin would not be noted in a client with anorexia nervosa. 4. Incorrect: Gingival infections and dental caries are typical of clients with bulimia, another eating disorder in which stomach acid from frequent vomitin g causes gum infections or dental caries. This is not common in anorexics. A teenage client asks the nurse, "Do you think I should tell my parents about my sexuality?" What is the nurse's best response? 1. "What do you think you should do?" 2. "Absolut ely, I think you should tell your parents." 3. "Don't you think your parents have the right to know about your sexuality?" 4. "I do not think now is the right time to tell your parents. Wait until you are 21." - 1. Correct: It is better to say "What do y ou think you should do?" This helps the client reflect on options and does not have the nurse tell the client what to do. It is much more therapeutic to help the client make the decision for themselves, instead of the nurse. This prevents any biases from i mpacting the outcome. 2. Incorrect: All of these responses give advice to the client. Telling the client what to do or how to behave which implies that the nurse knows what is best and that the client is not capable of making any decisions. 3. Incorr ect: All of these responses give advice to the client. Telling the client what to do or how to behave which implies that the nurse knows what is best and that the client is not capable of making any decisions. 4. Incorrect: All of these responses give a dvice to the client. Telling the client what to do or how to behave which implies that the nurse knows what is best and that the client is not capable of making any decisions. An adolescent client, diagnosed with anorexia nervosa, discloses an incestuous relationship to a nurse. What is the most therapeutic response by the nurse? 1. "It's okay. Let's talk about this." 2. "Have you discussed this with your primary healthcare provider?" 3. "Can you tell me how you feel about what happened?" 4. "Tell me more about what happened when you were younger." - 3. Correct: The nurse is using a therapeutic approach by encouraging the client to express feelings about the relationship using an open -ended question. 1. Incorrect: The nurse is providing false reassurance by saying, "It's okay." This is a statement not a question to see how the client feels about talking with the nurse . The nurse should use open -ended questions to determine whether or not the client wishes to discuss the incestuous relationship further at this time. 2. Incorrect: This is a non -therapeutic, closed ended question that only requires a yes or no answer. Th is is not a priority at this time. An open ended question will allow the nurse to see if the client is ready to share with the nurse. 4. Incorrect: The nurse should not probe for a factual account about a past event and should keep the focus of the discus sion on the client's feelings about the event. Again, this is a statement, not an open ended question. A client is seen in the clinic for recurrent, unexplained, vague stomach pain over the past 5 years. Esophagogastroduodenoscopy (EGD), colonoscopy, gallbladder ultrasound, and lab results have revealed no physical reason for the pain. The client tells the nurse, "the pain is so bad sometimes that I can't function!" What disorder is this client likely experiencing? 1. Conversion disorder 2. Pseudocyesis 3. Somatization disorder 4. Dysmorphic disorder - 3. Correct: Somatization disorder is a syndrome of multiple somatic symptoms that cannot be explained medically and are associated with psychosocial distress and long -term seeking of assistance from heal thcare professionals. Symptoms are vague, dramatized, or exaggerated in presentation. The disorder impairs social, occupational and other forms of functioning. 1. Incorrect: Conversion disorder is a loss of or change in body function resulting from a ps ychological conflict, the physical symptoms of which cannot be explained by any known medical disorder. This disorder affects voluntary motor or sensory functioning suggestive of a neurological disease. 2. Incorrect: Pseudocyesis is false pregnancy that may represent a strong desire to be pregnant. The client has nearly all the usual signs and symptoms of pregnancy such as enlarged abdomen, weight gain, cessation of menses and morning sickness..

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