The Client With a Somatoform Disorder

Somatoform Disorder. The client with an axis I diagnosis of Pain Disorder is angry and demanding and focus on the head pain she is experiencing. 1. At 11 am, the client demand that the nurse calls the physician for more pain medication because she is still pain after the 9 am analgesic. The best nursing action is a. call the physician as client request b. suggest the client lie down because she has to wait 4 hours for the next dose c. inform the client that the physician will be in later and to talk to her about it d. inform the client that the nurse can not give her additional medication at this time and invite the      client to participate a card game. (the correct answer is d, the nurse informs the client in the matter of fact manner that the nurse cannot give her additional pain medication at this time and invites the client to participate in a card game to decrease rumination about pain by directing the client's attention to a milieu activity. By telling the client
Post a Comment

The Client With an Obbsessive Compulsive Disorder

The Client arrive late for an appointment with the nurse in out patient clinic. During in interview,he fidgets restlessly,has trouble remembering what topic is being discussed, and says he thinks he is going crazy.


1.Which of the following statement by the nurse would best deal with the client's feeling about 'going crazy'
a.'I see that this concerns you,but what does 'crazy' mean to you?'
b.'Most people feel that way occasionally,you are no different from any one else'
c.'I don't know enough about you to judge,why don't you tell me more about yourself'
d.'You sound perfectly sane to me,may be your perception of word Crazy is different from mine'

(the correct answer is a, when the client says he thinks he is 'Going Crazy' it is best for the nurse to ask him what 'Crazy' means ti him, before moving toward consensual validation, the nurse must have a clear idea of what the client  means by his words and  actions)

 2.The client reveals that he was late for his appointment because of 'My Dumb Habit,I have to take off my sock and to put them back on 41 times! I can't stop until I do it just right'. The nurse judge correctly that the client's behavior most likely represent an effort to
a.relieve his anxiety
b.control his thoughts
c.gain attention from others
d.express hostility

(the correct answer is a, the client exhibiting obsessive convulsive behavior is attempting to control his anxiety, The convulsive component of the behavior is performed to relieve or bind anxiety. Obsessive convulsive disorder is an anxiety related disorder).

3.A decision is made not to hospitalize the client. Of the following abilities the client has demonstrated,the one that probably most influenced the decision not to hospitalize him is his ability to
a.hold a job
b.relate to his peers
c.perform activities of daily living
d.behave in an outwardly normal manner

(the correct answer is c, A client able to take care of his basic nutritional needs is probably not sufficiently  incapacitated by his illness to require hospitalization)

The Nurse works at a Psychiatric day-care facility


4.The client with obsessive convulsive disorder eat slowly and is always the last to finish lunch, which makes it difficult for the group to start a 1pm outing. Which of the following approaches would be the best plan of action for this problem.
a.change the time of outing to accommodate the client
b.arrange for the client to start eating earlier than the others
c.plan to go without the client so that he will have ample time for his lunch
d.inform the client that he will have to eat faster so that the group can leave on time.
 
 (the correct answer is b, letting the client eat earlier meet his need for more time and also the group need to depart for the outing on time, It also protect the client from being resented by others and lets him be included in the group activity. Changing the time of an activity to meet the need of one client is and may be undesirable and may be impractical as well)

5.The client want to take up a hobby and ask to the day-care nurse for some suggestions. From a therapeutic standpoint, which of the following activities will be the most desirable for the client
a.swimming
b.solo playing
c.drama club
d.photography

(the correct answer is c, drama clubs are good for their social and self expressive qualities. This client need outlets that are creative and oriented toward others. Swimming, solo playing and photography are hobbies with few social qualities )

A client tells the nurse that he checks all lights to be sure they are off 26 times before he can leave his home. he knows his behavior is senseless but he can't stop. He rarely sees his friend anymore because  they are fed up with his being let every time they plan to get to gather. Besides, he 'really too busy to see them' because of  'all the things going on at work'

6. Which of the following nursing diagnosis would be least appropriate for this client ?
a. Fear
b. Diversional activity
c. Social Isolation.
d. Powerlessness.

(the correct answer is a, Diversional Activity Deficit ,social isolation and powerlessness are appropriate for nursing diagnosis for this client. There are no data to support the problem of Fear for the client in this situation. Data supporting powerlessness include the statement, 'I know it is senseless,I can not stop". Being too busy at work to see friend and rarely seeing friends any more support Diversional Activity Deficit and Social Isolation)

7. In consideration the client's immediate needs, which of the following client outcomes is unrealistic at this time? the client will
 a. increase expression of feeling
b.  connect feeling with behavior
c. use two adaptive coping behaviors to deal with anxiety
d. make a decision about one of his problems

(the correct answer is d, Client with obsessive convulsive disorder are typically rigid and controlled in their thinking and behavior. They find it difficult to be introspective and to express or even recognize their feelings. Increasing identification and expression of feelings and connecting feeling with behavior may prove helpful. Learning and using adaptive coping behavior when anxious would be appropriate for the client. The primary gain  experienced by the client with obsessive convulsive disorder is relief of anxiety. Learning how to manage of anxiety decreases the need for obsessive and convulsions. Problem identification and decision making would be neither helpful to the client at this time nor realistic)

8. The client reports that before he leaves home to go any where, he count the money in his wallet as many as 12 times. The best explanation for the client motives when performing this particular ritual is that he is attempting to
a. channel excessive sexual energy into an appropriate habit
b. compensate for not having enough money to spend as a child
c. avoid the embarrassment of having a shortage of funds on hand
d. channel emotions unacceptable to him with an acceptable activity

(the correct answer is d, the dynamic of convulsive activity involve a defense against anxiety by persistently doing something to blind or reduce anxiety. This behaviors occurs each time threatening though occur. Judgement that the client count money repeatedly to compensate for not having enough money to spend as a child or to avoid the embarrassment of running short of money is based of insufficient data and represents an oversimplification of the client's problem)

9. Which of the following actions would be best for the nurse to take when the nurse observe the client in a ritualistic activity pattern behavior?
a. isolate the client so that he will not disturb others
b. observe the client closely to marked changes in behavior
c. remind the client that he can control his behavior if he wishes
d. enable the client to continue so that he will not become more agitated

(the correct answer is d

10. Which of the following qualities is most important for the nurse interacting with obsessive-convulsive client?
a. patience
b. compassion
c. friendliness
d. self-confidence

(the correct answer is a

11. The client has been taking clomipramine (anafranil) for his obsessive convulsive disorders. He tells the nurse, 'I am not really better and I've been taking the medication faithfully for the past week just like it says on this prescription bottle', which the following actions would the nurse do first ?
a. tell the client to stop taking the medication and call the physician
b. tell the client to continue taking the medication as prescribed because it takes 5 to 10 weeks for a
    full therapeutic effect
c. encourage the client to call his physician in one week and to continue taking his medication
d. ask the client if he has resumed smoking cigarettes

(the correct answer is b

12. which of the following methods for treatment would initially be best helpful to a client with obsessive convulsive disorder?
a. Relaxation exercise
b. Though stopping
c. Meditation
d. Exposure therapy

(the correct answer is c





Comments

Post a Comment

Popular posts from this blog

The Client With Bipolar Disorder, Manic Phase

A Client is admitted to the psychiatric unit accompanied by her husband. She brings six suitcases and three shopping bags. She orders the nurse to carry her bags. Her husband states she has been purchasing items that hey can not afford and has not slept for 4 nights 1. Which additional information would be priority for the nurse to seek from the client's husband?;    a. The client's fluid and food intake.    b. Their current financial status.    c. The client's usual sleeping pattern.    d. Whether the client becomes agitated easily.   (The correct answer is a, Assessing nutritional status is a priority in this situation. A client with bipolar disorder,maniac phase commonly does not have time to eat or drink because of their state of constant activity and easy destructibility. Altered nutritional status and constant physical activity can lead to malnutrition,weight loss and physical exhaustion.These state can lead to death appropriate attention is not institute
Read more

The Client With a Somatoform Disorder

Somatoform Disorder. The client with an axis I diagnosis of Pain Disorder is angry and demanding and focus on the head pain she is experiencing. 1. At 11 am, the client demand that the nurse calls the physician for more pain medication because she is still pain after the 9 am analgesic. The best nursing action is a. call the physician as client request b. suggest the client lie down because she has to wait 4 hours for the next dose c. inform the client that the physician will be in later and to talk to her about it d. inform the client that the nurse can not give her additional medication at this time and invite the      client to participate a card game. (the correct answer is d, the nurse informs the client in the matter of fact manner that the nurse cannot give her additional pain medication at this time and invites the client to participate in a card game to decrease rumination about pain by directing the client's attention to a milieu activity. By telling the client
Read more

The Client With Major Depression

A 62-years-old client comes to the neighborhood health center for his annual physical examination. 1. While interacting with the nurse,the client states that he feels tired all of the time, has trouble sleeping and has problem in thinking. The best nursing action is to;      a.Inform the client about the normal aging process.    b.Further assess the client's mental status and mental history.    c.Refer the client to a senior citizen'support group.    d.Advice the client to discontinue day time napping. (The correct answer is b, The client is exhibiting signs of possible depression. The nurse should explore his medical history and conduct a mental status examination to further assess and explore his possibility. He is not exhibiting sign and symptoms of the normal aging process. Referral to a senior citizen'support group may be will appropriate later,depending on the client's need and interest. Day time napping should be discouraged if it interrupt  night t
Read more