Difficulty: Medium
Average Score: 64%
Simulated
Passage / Scenario
Medication Administration RecordÔÇó Escitalopram 20 mg once daily
Medical History
Client is 19 years old, has severe anxiety, and was admitted to an inpatient mental health facility for observation and behavioral therapy 2 weeks ago. The clientÔÇÖs weight at the time of admission was 54.4 kg (120 lb). The client reported sleeping 3 to 4 hours per night due to recurrent nightmares as well as a decrease in appetite. The clientÔÇÖs family member stated that the client had separated themselves from friends, refused to leave their house, and picked their skin until it bled. The clientÔÇÖs family member stated that there is a family history of anxiety. The client reported previous participation in cognitive-behavioral therapy.
NursesÔÇÖ Notes
Client appears to be well-groomed. The clientÔÇÖs current weight is 54 kg (119 lb). The client states they are sleeping 5 to 6 hours per night but having an occasional nightmare. The client verbalizes decreased appetite and gastrointestinal discomfort. The client states, ÔÇ£I feel anxious about leaving my house. I feel like everyone is staring at me and judging me.ÔÇØ The client verbalizes that bullying experienced during high school has led to anxiety. The client engages in thought-stopping behavioral therapy and cognitive restructuring. The client reports taking escitalopram 20 mg daily 2 hours after breakfast.
A nurse working in an outpatient mental health facility is caring for a client who has anxiety and was discharged from an inpatient mental health facility 1 week ago.Exhibits: A nurse in an outpatient mental health facility is assessing a client who has anxiety. Click to highlight the findings in the NursesÔÇÖ Notes that indicate an improvement in the clientÔÇÖs condition. To deselect a finding, click on the finding again.
Correct answer
A,C,E,F
Rationale
The correct answer is A, C, E, F. A: Well-groomed appearance indicates self-care and improvement in mood. C: Verbalizing decreased appetite and gastrointestinal discomfort may indicate decreased anxiety symptoms. E: Engaging in thought-stopping therapy and cognitive restructuring shows active participation in treatment. F: Taking prescribed medication as directed indicates compliance with the treatment plan. These findings suggest the client's condition is improving. Choices B, D, and G do not indicate clear improvement in the client's condition. B: Occasional nightmares suggest ongoing sleep disturbances. D: Statement about anxiety leaving the house indicates ongoing anxiety symptoms. G: Past bullying experiences may contribute to the client's anxiety but do not directly indicate improvement in the current condition.