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The sibling of a patient who was diagnosed with a serious mental illness asks why a case manager has been assigned. The nurses reply should cite the major advantage of the use of case management as:
- A. The case manager can modify traditional psychotherapy for homeless patients so that it is more flexible.
- B. Case managers coordinate services and help with accessing them, making sure the patients needs are met.
- C. The case manager can focus on social skills training and esteem building in the real world where the patient lives.
- D. Having a case manager has been shown to reduce hospitalizations, which prevents disruption and saves money.
Correct Answer: B
Rationale: Case managers coordinate services and access (B), overcoming obstacles for the mentally ill, making it the primary advantage. Other options (A, C, D) are less central to their role.
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A nurse is providing education to a patient with anorexia nervosa. Which of the following statements indicates a need for further education?
- A. I understand that my body needs food to function properly.
- B. I am willing to work on gaining weight with the help of my care team.
- C. I believe that eating food will make me fat and out of control.
- D. I am ready to learn how to improve my relationship with food.
Correct Answer: C
Rationale: The correct answer is C because the statement reflects a common misconception associated with anorexia nervosa, indicating a need for further education. Here's the rationale:
1. Anorexia nervosa involves a distorted body image and fear of gaining weight.
2. Believing that eating food will make one fat and out of control aligns with these distorted beliefs.
3. This statement demonstrates a lack of understanding and acceptance of the importance of proper nutrition for health.
4. Choices A, B, and D show positive attitudes towards recovery and willingness to address the disorder, highlighting a better understanding of the condition.
In summary, choice C shows a need for further education due to the presence of distorted beliefs, while the other options reflect a more positive and informed mindset towards recovery.
A patient was admitted in a semistuporous catatonic state. Family states that the patient has neither left the apartment nor attended to personal hygiene for several weeks. The patient's last 48 hours have been spent lying in bed, mute and motionless. The nursing diagnosis that should be considered the priority is:
- A. self-care deficit.
- B. situational low self-esteem.
- C. disturbed thought processes.
- D. impaired verbal communication.
Correct Answer: A
Rationale: The correct answer is A: self-care deficit. The patient's symptoms indicate a lack of ability to perform self-care activities, which poses a risk to their health and well-being. This is a priority as addressing this issue will directly impact the patient's physical health and overall functioning. Situational low self-esteem (B) is not the priority as it focuses on the patient's emotional state rather than their immediate physical needs. Disturbed thought processes (C) and impaired verbal communication (D) may be present but are not the priority over the patient's inability to perform self-care activities.
The physician prescribes haloperidol (Haldol), a first-generation antipsychotic drug, for a patient with schizophrenia who displays delusions, hallucinations, apathy, and social isolation. Which symptoms should most be monitored to evaluate the expected improvement from this medication?
- A. Talking to himself, belief that others will harm him
- B. Flat affect, avoidance of social activities, poor hygiene
- C. Loss of interest in recreational activities, alogia
- D. Impaired eye contact, needs help to complete tasks
Correct Answer: A
Rationale: The correct answer is A because haloperidol is primarily used to target positive symptoms of schizophrenia such as delusions and hallucinations. Monitoring improvements in symptoms like talking to himself and belief that others will harm him will indicate the effectiveness of the medication. Choices B, C, and D are incorrect because they focus on negative symptoms or general social withdrawal, which are less likely to show significant improvement with haloperidol, a first-generation antipsychotic drug that is more effective for positive symptoms. Monitoring these symptoms may not directly reflect the medication's effectiveness in treating the primary symptoms of schizophrenia in this case.
A nurse caring for a patient with Alzheimer disease can anticipate that the family will most likely need information about:
- A. antimetabolites.
- B. benzodiazepines.
- C. immunosuppressants.
- D. acetylcholinesterase inhibitors.
Correct Answer: D
Rationale: The correct answer is D: acetylcholinesterase inhibitors. Patients with Alzheimer's disease often benefit from this type of medication to help improve cognitive function. The family would need information on this to understand the treatment plan. Antimetabolites (A), benzodiazepines (B), and immunosuppressants (C) are not typically used in the treatment of Alzheimer's disease and would not be relevant for the family to know about in this context.
An acutely psychotic individual diagnosed with schizophreniaform disorder at admission is immediately placed on daily doses of risperidone. A hospitalization of 8 days' duration has been authorized by the HMO. By what hospital day would the nurse expect to note that client was demonstrating beginning trust in the nurse and reduction in hallucinations and delusions?
- A. Day of admission
- B. Day 3 of hospitalization
- C. Day 5 of hospitalization
- D. Day 7 of hospitalization
Correct Answer: B
Rationale: The correct answer is B: Day 3 of hospitalization. Typically, antipsychotic medications like risperidone take a few days to start showing noticeable effects in reducing hallucinations and delusions. By day 3, the medication would have had enough time to begin its therapeutic effect. Building trust with a psychotic patient also takes time, so by day 3, the patient may start showing signs of trust in the nurse. Day of admission (Choice A) is too early for the medication to take effect. Day 5 (Choice C) and Day 7 (Choice D) are too late as the medication usually shows noticeable improvement within the first few days.