Nokea
In Massachusetts, which year contained the highest level of days exceeding the 8-hour average ground-level ozone standard?
- A. 1983
- B. 1984
- C. 2007
- D. 1999
Correct Answer: A
Rationale: 1983 likely had higher ozone exceedances due to less stringent regulations and higher industrial emissions at that time.
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Which of the following statements is true about the differences in mental health problems between children and adults?
- A. Children are affected by the same stressors as adults, but to different degrees and with different manifestations
- B. Childrens mental health disorders are generally much less severe and resolve more quickly than do those of adults
- C. Childrens mental health problems are different from those of adults because their brains are wired differently
- D. Children have better means of working off stresses than do adults
Correct Answer: A
Rationale: Mental health disorders in children have many similarities and differences from the same disorders in adults. The other responses are not correct.
A widow, aged 72 years, lives alone and is visited weekly by her son. She takes digoxin, hydrochlorothiazide, and an antihypertensive drug. She also has a prescription for diazepam (Valium) as needed for moderate to severe anxiety. When the son visited today, he found his mother confused and disoriented, with an unsteady gait. The nurse assessed the patient as having several cognitive problems, including memory and attention deficits and fluctuating levels of orientation. The nurse confirms that the patient's symptoms developed:
- A. Over the past few days.
- B. Over the past few weeks.
- C. Over the past few months.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Over the past few days. The sudden onset of confusion, disorientation, and cognitive deficits in the elderly patient suggests an acute change in her condition. This acute change is more indicative of a recent event or medication-related issue rather than a gradual decline over weeks or months. The sudden onset could be due to factors such as medication interactions, overdose, or underlying medical conditions. It is crucial to investigate recent changes in medications, lab results, or any other potential triggers that might have led to this acute cognitive decline. Choices B, C, and D are incorrect because they imply a gradual decline over weeks, months, or no specific timeframe, which does not align with the sudden onset observed in the patient.
When a patient with paranoid schizophrenia has a recurrence of positive symptoms after stopping his antipsychotic medication because of its postural hypotension (orthostasis) side effect, he is readmitted to the mental health unit. What measure should the nurse suggest to help the patient address this side effect?
- A. Ask the doctor to prescribe an anticholinergic drug like trihexyphenidyl (Artane).
- B. Chew sugarless gum or use sugarless hard candy to moisten your mouth.
- C. Increase the amount of sleep you get, and try to take frequent rest breaks.
- D. Wear elastic support hose, drink adequate fluids, and change position slowly.
Correct Answer: D
Rationale: The correct answer is D because wearing elastic support hose, drinking adequate fluids, and changing positions slowly can help prevent postural hypotension associated with antipsychotic medications. Elastic support hose can improve blood circulation and prevent blood pooling in the legs. Adequate fluid intake can help maintain blood volume and blood pressure. Changing positions slowly can prevent sudden drops in blood pressure upon standing.
Choice A (anticholinergic drug) is incorrect as it may worsen symptoms of schizophrenia. Choice B (sugarless gum or candy) is unrelated to postural hypotension. Choice C (increasing sleep and rest breaks) may help with fatigue but does not address postural hypotension directly.
A male patient diagnosed with paranoid schizophrenia typically relates effectively with female staff but angrily tells the male nurse, 'You act like a homosexual. None of the men trust you or want to be around you.' The nurse, who is heterosexual, is perplexed by the patient's statements and discusses the event with his mentor. Which explanation most likely underlies the patient's behavior?
- A. The patient was unleashing unconscious, hostile feelings toward the nurse.
- B. The patient feared the nurse would reject him, so he coped by rejecting the nurse first.
- C. It was the patient's way of distancing himself from potential emotional intimacy.
- D. The patient was coping with homosexual urges by projecting them onto the nurse.
Correct Answer: D
Rationale: The correct answer is D because the patient is exhibiting the defense mechanism of projection by attributing his own uncomfortable feelings (homosexual urges) to the nurse. This defense mechanism allows the patient to disown his feelings and project them onto others. This behavior is common in individuals struggling with their own conflicting desires or impulses.
Incorrect choices:
A: Unconscious hostile feelings are not necessarily the root cause in this scenario.
B: The patient's behavior is not about preemptively rejecting the nurse due to fear of rejection.
C: While emotional intimacy may play a role, the patient's behavior is more about projection of his own feelings onto the nurse rather than distancing himself.
Serious mental illness is characterized as:
- A. any mental illness of more than 2 weeks duration
- B. a major long-term mental illness marked by significant functional impairments
- C. a mental illness accompanied by physical impairment and severe social problems
- D. a major mental illness that cannot be treated to prevent deterioration of cognitive and social abilities
Correct Answer: B
Rationale: Serious mental illness has replaced the term chronic mental illness. Global impairments in function are evident particularly social. Physical impairments may be present. Serious mental illness can be treated, but remissions and exacerbations are part of the course of the illness.