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What is a key indicator of mental development in preschool children?
- A. Ability to count to 10
- B. Following multi-step instructions
- C. Recognizing colors
- D. Walking independently
Correct Answer: B
Rationale: Following multi-step instructions (B) reflects cognitive processing and memory, key mental development indicators in preschoolers. Counting (A) and colors (C) are simpler skills, while walking (D) is physical, not mental.
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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 5-year-old presents with a history of urgency of micturition, occasional enuresis, and a slight, non-offensive vaginal discharge for 3 months. She has had no vaginal bleeding. Examination reveals some reddening of the labia majora. Which one of the following is the most likely diagnosis?
- A. Trichomonal infection.
- B. Gonorrhoea.
- C. Cystitis.
- D. Non-specific vulvo-vaginitis.
Correct Answer: D
Rationale: Non-specific vulvo-vaginitis (E) is common in young girls due to hygiene or irritation, causing these symptoms. Trichomonas (A) and gonorrhoea (B) are rare without sexual history, cystitis (C) lacks vaginal signs, and foreign body (D) typically causes bleeding or foul discharge.
In Singapore, MSF-funded disability services for preschool children:
- A. Serve those with congenital, physical, sensory, developmental, and behavioural disorders
- B. Are all centre-based
- C. Provided by charity and public hospitals only
- D. Are overseen by the Early Childhood Developmental Agency (EDCA)
Correct Answer: A
Rationale: MSF-funded services cover a broad range of disabilities in preschoolers, aligning with Singapore's inclusive disability framework.
What is an appropriate goal for a nurse when working with a patient who has anorexia nervosa?
- A. The patient will achieve rapid weight gain and improve self-esteem.
- B. The patient will restore nutritional balance through safe weight gain.
- C. The patient will accept their body image without therapeutic intervention.
- D. The patient will maintain a healthy weight without any professional assistance.
Correct Answer: B
Rationale: The correct answer is B because restoring nutritional balance through safe weight gain is a realistic and appropriate goal for a nurse working with a patient with anorexia nervosa. This goal focuses on the patient's physical health and addresses the underlying issue of malnutrition. Rapid weight gain (A) may be dangerous and unsustainable. Accepting body image without intervention (C) ignores the severity of the disorder. Maintaining a healthy weight without professional assistance (D) is unlikely for someone with anorexia nervosa who requires specialized care.
Which patient is at greatest risk for physical abuse by a family member?
- A. An 8-year-old who is mentally challenged and living with a foster family
- B. A 15-year-old who lives with a single parent in an inner city apartment complex
- C. A 30-year-old adult who shares a home with a homosexual partner
- D. A 79-year-old with chronic depression who lives with a grandchild
Correct Answer: D
Rationale: The correct answer is D because the 79-year-old with chronic depression who lives with a grandchild is vulnerable due to age, health condition, and dependency on the grandchild. Older adults with mental health issues are at a higher risk of abuse, especially when living with family members. The other choices are less likely to be at greatest risk for physical abuse. A, B, and C do not have the same level of vulnerability due to age, health condition, or dependency as the 79-year-old with chronic depression living with a grandchild.