Mental Health NCLEX Mental and Emotional Responses to Medical Illness

A teenaged patient hospitalized with the diagnosis of HIV places a “No Visitors” sign on the door, refuses phone calls, and states to the nurse, “I know you don’t want to be around me.” Which of these nursing diagnoses is applicable to this situation?

a. Fear of dying related to medical diagnosis
b. Social isolation related to fear of rejection
c. Deficient knowledge related to cognitive limitations
d. Anger related to having to face death at such a young age

Which factor should be the primary consideration when assessing the advisability of prescribing psychotropic medications for a patient with AIDS?

a. Nutritional status of the patient
b. Tolerance for oral medications
c. Characteristics of emotional distress
d. Length of time since the diagnosis was made

A patient diagnosed with AIDS is observed attempting to hide an article on the subject of lethal injections. Which response by the nurse would be most appropriate?

a. “Please let me have the journal. An article like that will only upset you.”
b. “I noticed what you are reading. Why are you trying to hide it?”
c. “Tell me what you think of the article you were reading.”
d. “Isn’t that a pretty grim article?”

Which statement made by a patient with AIDS indicates that the patient is exhibiting symptoms associated with acute psychotic-type dementia?

a. “I move more slowly than I used to.”
b. “I don’t enjoy being with other people anymore.”
c. “I’d like to stop the voices I hear in my head.”
d. “I can’t always remember where I put things.”

A patient with HIV infection asks the nurse, “What do they mean by opportunistic infections?” The nurse’s best response would be, “They are:

a. Infections transmitted by sexual contact.”
b. Rare illnesses that occur only in homosexual men.”
c. Infectious diseases from tropical or subtropical countries.”
d. Infections that develop when the immune system is suppressed.”

The plan of care for a patient who is HIV-positive calls for the nurse to observe the patient for symptoms of AIDS dementia. Which symptoms support that diagnosis?

a. Fever, night sweats, and nausea
b. Elevated pulse, respirations, and blood pressure
c. Inability to concentrate, forgetfulness, and apathy
d. Increased appetite and specific food and drink cravings

A teen is concerned that she may have been exposed to the HIV virus by her sexual partner but has resisted being tested. The nurse can hypothesize that the primary reason she has not been tested is because she:

a. Distrusts the confidentiality of the health care system
b. Is concerned about possibly losing her current partner
c. Is waiting to see whether symptoms would develop
d. Fears she might test seropositive

A patient with AIDS is feeling threatened by his inability to work and take care of the yard and garden he loves. Which patient outcome is appropriate at this time? The patient will:

a. Explain his declining state of health to the family.
b. Realign goals to achieve a positive emotional state.
c. Enlist others to help him carry out his former tasks.
d. Accept the fact he will not be able to assume previous roles.

A patient has been hospitalized with problems related to AIDS and is experiencing profound dementia. Which intervention will be most helpful in assisting the family to adjust and plan for the patient’s future?

a. Provide information on available support groups.
b. Encourage placement of the patient in an adult care home.
c. Explain the importance of engaging in social activities with friends.
d. Advise the family to focus on present rather than possible future problems.

While being bathed, a patient with AIDS asks the nurse, “Aren’t you afraid of getting this disease from me?” Which response would be most therapeutic?

a. “You sound surprised that I want to spend time with you.”
b. “No; I always use universal precautions to manage the risk.”
c. “Statistics show that few nurses get AIDS from their patients.”
d. “I have always firmly believed that whatever will be, will be.”

The nurse manager is interviewing staff to work on the AIDS unit and asks the applicants this question: “How do you feel about working with patients who have AIDS?” The best candidate for the position would be the applicant who responds:

a. “I firmly believe there will soon be a cure for AIDS.”
b. “I believe that everyone is worthy of the best care I can provide.”
c. “I have done extensive research on AIDS and understand the disease.”
d. “I know I will have to be more careful, especially with injections and IVs.”

At an educational session for patients with HIV infection and their support persons, the nurse is asked, “If the incidence of AIDS has declined, why is it that its prevalence has increased?” The nurse can explain this by responding:

a. “This is a statistical aberration; don’t let it confuse you.”
b. “More people are living longer with both HIV infection and AIDS.”
c. “Delays in diagnosis and treatment contribute to the increased death rate.”
d. “Transmission to vulnerable populations has affected AIDS surveillance data.”

When planning care for a patient newly diagnosed with AIDS, the nurse takes into consideration that the patient should be closely monitored for covert symptoms associated with:

a. Fluid and electrolyte imbalance
b. Imbalanced nutrition
c. Adjustment disorder
d. Schizophrenia

A patient with AIDS persistently uses denial with respect to the seriousness of the condition. The nurse will need to be alert for the presence of defining characteristics for the nursing diagnosis of:

a. Anxiety
b. Hopelessness
c. Noncompliance
d. Powerlessness

A patient who is HIV-seropositive continues to use heroin on a daily basis but has agreed that his behavior endangers others and promises not to share needles. What can the nurse give as a realistic estimate for success in attaining this outcome?

a. Low potential for achievement
b. High potential for achievement
c. Moderate potential for achievement
d. Ultra-high potential for achievement

A patient with AIDS tells the nurse, “My recent life has been a series of losses. I’ve lost my job and my income, as well as my identity as a prominent business leader. What’s next?” What can the nurse offer that will facilitate adaptive coping?

a. “I can see that you’re feeling discouraged and hopeless.”
b. “I will help you plan to live as normally as possible in the months ahead.”
c. “Perhaps it would be wise to restrict your contacts to those who know of your illness.”
d. “If you wish, I can help you investigate to see if you have been the victim of discrimination.”

Which remark by a patient would suggest that the treatment plan for a patient with AIDS has been successful in promoting decisional control?

a. “I recognize that what I’ve lost, I will never be able to regain.”
b. “I’ve learned enough about my disease to be able to make informed decisions.”
c. “I’ll be happy when my suffering comes to an end and I can join my partner.”
d. “I see no advantage in antiviral therapy. The side effects are worse than the symptoms of AIDS.”

The nurse is preparing to teach a patient who is newly diagnosed with diabetes about medications and blood testing. As the teaching occurs, the nurse knows that effective coping will depend to a great degree on the patient’s:

a. Perceived self-efficacy
b. External locus of control
c. Religious belief systems
d. Number of significant others

A patient newly diagnosed with diabetes has also been diagnosed with depression. The nurse knows to be alert for:

a. Increased low blood glucose results
b. Increased high blood glucose results
c. Failure to follow treatment plans consistently
d. Anger and potential of violence against significant others

A patient diagnosed with HIV has moved back to her small hometown to be close to family. The major impact on the health management of this patient will include:

a. Emotional toll on families
b. The lack of supportive services
c. Financial burden of care on families
d. Distance from emergency acute care facilities

Which intervention addresses a strategy identified by the federal government to achieve an HIV-free generation?

a. Nutritional programs that deliver meals
b. Free medications for the uninsured patient
c. Screening programs directed towards women
d. Home health personnel available to deliver care

A patient who received a diagnosis of HIV infection a week ago, reports to the clinic nurse symptoms that are seen in acute anxiety. Which behaviors are supportive of that diagnosis? Select all that apply.

a. Incapable of staying physically relaxed
b. Difficulty with focusing thoughts
c. Muscular tension
d. Bradycardia
e. Insomnia

A patient recently diagnosed with HIV infection reports symptoms that support a diagnosis of adjustment disorder. These symptoms include telling the nurse, “I feel so sad every time I think of my diagnosis. I cry a lot, and I don’t go out as much as I did before. It just doesn’t seem right to laugh. I don’t have a good appetite, but I force myself to eat something at every meal, so I haven’t lost weight.” From this description, the nurse would determine that the patient’s symptoms most closely correspond to those of (select all that apply)

a. Sadness
b. Anorexia
c. Aggression
d. Frequent crying
e. Delusional beliefs