One bed is available on the eating disorders unit. Which patient should be admitted? The patient whose assessment findings show the weight dropped from:
- A. 150 to 102 pounds over a 4-month period.
- B. 120 to 90 pounds over a 3-month period.
- C. 130 to 100 pounds over a 2-month period.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A because the patient has experienced a significant weight drop from 150 to 102 pounds over a 4-month period. This represents a loss of 48 pounds over a relatively longer period, indicating a more severe and prolonged issue with weight loss. The other choices show weight drops of 30 pounds over 3 months (B) and 30 pounds over 2 months (C), which are also concerning but not as severe or long-lasting as the situation described in choice A. Choice D is incorrect as at least one patient should be admitted based on the information provided.
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A patient with many positive symptoms of schizophrenia, whose behavior is disorganized and who is highly anxious, tells the nurse in the psychiatric emergency department, 'You have got to help me. I do not know what is going on. I think someone is trying to wipe me out. I have to get a gun.' The patient, a college student, lives alone and has no family or support system in the immediate area. He has not left his room in 2 weeks, has not eaten in several days, and is unkempt. Of the available treatment settings, the nurse should recommend:
- A. admission to an unlocked residential crisis unit.
- B. inpatient hospitalization on a locked unit.
- C. attending a day treatment program for 4 weeks.
- D. admission to a partial hospital program.
Correct Answer: B
Rationale: The correct answer is B: inpatient hospitalization on a locked unit. This option is the most appropriate because the patient is presenting with severe symptoms of schizophrenia, including paranoia, disorganized behavior, and potential harm to self or others by mentioning getting a gun. In this case, the patient requires a higher level of care and safety, which can only be provided in an inpatient hospital setting on a locked unit. Admission to an unlocked residential crisis unit (Choice A) may not provide the necessary level of supervision and security. Attending a day treatment program for 4 weeks (Choice C) may not be intensive enough to address the patient's current crisis. Admission to a partial hospital program (Choice D) also may not provide the required level of supervision and structure for a patient with such acute symptoms.
Prior to discharge, the nurse plans to teach the client and family about relapse. Which items will the nurse include in the teaching?
- A. Recognition of warning signs of relapse
- B. Notify the nurse of warning signs present for more than one month
- C. Lower medication dosage to manage emerging side effects
- D. Use street drugs judiciously and only in small amounts
Correct Answer: A
Rationale: The correct answer is A because recognizing warning signs of relapse is crucial for early intervention. By identifying these signs, the client and family can seek help promptly, preventing a full relapse. Choice B is incorrect as waiting for signs to persist for more than one month delays intervention. Choice C is incorrect as altering medication dosage without medical advice can be dangerous. Choice D is incorrect as using street drugs is never a safe or appropriate way to manage relapse.
A patient asks, 'What advantage does a durable power of attorney for health care have over a living will?' The nurse should reply, 'A durable power of attorney for health care:
- A. gives your agent authority to make decisions during any illness if you are incapacitated
- B. can be given only to a relative, usually the next of kin, who has your best interests at heart
- C. can be used only if you have a terminal illness and become incapacitated
- D. cannot be implemented until 30 days after the documents are signed
Correct Answer: A
Rationale: A durable power of attorney for health care is an instrument that appoints a person other than a health care provider to act as an individuals agent in the event that he or she is unable to make medical decisions. No waiting period is required for it to become effective, and the individual does not have to be terminally ill or incompetent for the person appointed to act on the individuals behalf.
Which of the following should be considered in the assessment of oppositional behaviours in children?
- A. Peer relationships
- B. Child s developmental stage
- C. Behaviours exhibited at home
- D. All of the above
Correct Answer: D
Rationale: All factorsâ€â€peer relationships, developmental stage, home behavior, and family historyâ€â€are critical in assessing oppositional behaviors comprehensively.
After taking an antidepressant for about a week, a patient reports constipation and blurred vision, with no improvement in mood. The psychiatric-mental health nurse informs the patient,:
- A. It takes approximately two to four weeks for depression to lessen, and side effects usually diminish over time'
- B. Stop the medication immediately and contact your primary care physician'
- C. You should contact your doctor. The doctor may need to change your medication'
- D. You should schedule an appointment with your ophthalmologist'
Correct Answer: A
Rationale: Antidepressants require 2-4 weeks for therapeutic effect, and early side effects often subside, making this the most reassuring response.