Nokea
The following condition is an indication for electroconvulsive therapy (ECT)
- A. Serene depression
- B. Schizophrenia
- C. Autistic disorders
- D. Tourettes syndrome
Correct Answer: A
Rationale: Severe (likely intended as 'serene') depression, especially when treatment-resistant, is a primary indication for ECT due to its rapid efficacy.
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The nurse reports to the interdisciplinary team that an antisocial patient lies to other patients, verbally abuses a patient with Alzheimer's disease, flatters his primary nurse, and is detached and superficial during counseling sessions. Which behavior should be the priority focus of limit setting?
- A. Lying to other patients
- B. Flattering the nursing staff
- C. Verbally abusing other patients
- D. Superficiality during counseling
Correct Answer: C
Rationale: The priority focus of limit setting should be on verbally abusing other patients (Choice C) because it directly harms others and creates a hostile environment. This behavior is not only detrimental to the well-being of other patients but also disrupts the therapeutic milieu. Limiting this behavior is crucial to ensure the safety and emotional health of all patients in the care setting. Lying to other patients (Choice A), flattering the nursing staff (Choice B), and being superficial during counseling sessions (Choice D) are concerning behaviors as well, but they do not pose an immediate risk to the safety and well-being of others in the same way that verbal abuse does. It is important to address all inappropriate behaviors, but the priority should be given to the behavior that has the most significant negative impact on the therapeutic environment.
A client has been diagnosed with a dementia secondary to cerebral disease. The family members note the client 'has not been as sharp as he once was' and that he has developed urinary incontinence and a gait disturbance. They attributed the first symptom to normal aging but were alarmed by the latter two symptoms. Based on this history, which of the following should come to mind?
- A. Normal pressure hydrocephalus
- B. Vitamin B12 deficiency
- C. Hepatic disease
- D. Tuberculosis
Correct Answer: A
Rationale: Step 1: The client presents with urinary incontinence and a gait disturbance, suggestive of normal pressure hydrocephalus (NPH) due to cerebral disease.
Step 2: NPH is characterized by the triad of cognitive decline, gait disturbances, and urinary incontinence.
Step 3: Symptoms of NPH can mimic normal aging but are distinct from other conditions.
Step 4: Vitamin B12 deficiency (B) primarily presents with anemia and neurological symptoms, not the triad seen in NPH.
Step 5: Hepatic disease (C) typically presents with symptoms related to liver dysfunction, not the triad of NPH.
Step 6: Tuberculosis (D) manifests with respiratory symptoms and constitutional symptoms, not the cognitive decline and gait issues seen in NPH.
Obsessions are thoughts that are unwanted and known to be incorrect
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Obsessions are intrusive, unwanted thoughts recognized by the individual as irrational or excessive.
A patient with acute mania dances atop a pool table, waves a cue in one hand, and says, "I'll throw the pool balls if anyone comes near me." The nurse's first intervention is to:
- A. Tell the patient
- B. ""We are taking you to seclusion.""
- C. Remove the patient from the pool table.
- D. Clear the room of all other patients.
Correct Answer: B
Rationale: The correct answer is B because taking the patient to seclusion ensures safety for both the patient and others. This intervention controls the immediate risk of harm from the patient's unpredictable behavior. Telling the patient (choice A) may escalate the situation. Removing the patient from the pool table (choice C) may not address the underlying threat. Clearing the room of all other patients (choice D) is not the priority; ensuring immediate safety is paramount in this scenario.
A client with borderline personality disorder is having difficulty with memories of sexual abuse. She has a history of suicidal gestures, self-mutilation, sexual addiction, and substance addiction. She complains of vague pains, menstrual problems, and headaches. She entered the partial hospital program to prevent another suicide gesture or self-mutilation. The nurse recognizes that collaborative therapy may be helpful for this client and knows that the most useful collaboration in this case would be the client, the nurse, and the:
- A. Occupational therapist exploring ways to reduce stress
- B. Physical therapist exploring ways to reduce back pain
- C. Acupuncturist exploring ways to reduce pain
- D. Sexologist exploring healthy sexuality and safe sex
Correct Answer: A
Rationale: The correct answer is A: Occupational therapist exploring ways to reduce stress. In the case of a client with borderline personality disorder experiencing trauma-related symptoms, such as memories of sexual abuse, the focus is on addressing underlying emotional issues and coping strategies. Collaborative therapy involving the client, nurse, and occupational therapist can be beneficial. The occupational therapist can help the client develop coping skills, manage stress, and improve daily functioning. This approach targets the root of the client's difficulties and provides holistic support.
Summary:
- Choice B (Physical therapist exploring ways to reduce back pain): This option does not directly address the client's primary concerns related to trauma and emotional distress.
- Choice C (Acupuncturist exploring ways to reduce pain): While pain management is important, it does not address the client's complex psychological needs and trauma history.
- Choice D (Sexologist exploring healthy sexuality and safe sex): While important in some cases, focusing solely on sexuality does not address the broader range of issues the client