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The psychiatric-mental health nurse, who is teaching a patient's parents how to use positive reinforcement techniques with the patient, recommends:
- A. agreeing with the child's statements, whether negative or positive, and simply restating the child's statements without other comment
- B. controlling the child's behavior, so there is no chance of negative behavior
- C. removing adverse consequences to produce positive results
- D. rewarding positive behaviors to promote their recurrence
Correct Answer: D
Rationale: Positive reinforcement rewards desired behaviors, increasing their frequency, a core behavioral strategy.
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A patient who takes lithium phones the nurse at the clinic to say, "I've had diarrhea for 4 days. I feel weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?" Which instruction by the nurse is appropriate?
- A. Have someone bring you to the clinic immediately.
- B. Restrict food and fluids for 24 hours and stay in bed.
- C. Drink a large glass of water with 1 teaspoon of salt added.
- D. Take antidiarrheal medication hourly until the diarrhea subsides.
Correct Answer: A
Rationale: The correct answer is A: Have someone bring you to the clinic immediately. The patient is experiencing symptoms of lithium toxicity, including diarrhea, weakness, unsteadiness, and worsening hand tremor. These symptoms indicate a potential lithium overdose, which can be life-threatening. Bringing the patient to the clinic immediately is crucial for assessment, monitoring, and intervention.
Choice B is incorrect because restricting food and fluids can worsen dehydration and electrolyte imbalances. Choice C is incorrect as adding salt to water can exacerbate electrolyte abnormalities in lithium toxicity. Choice D is incorrect as taking antidiarrheal medication can further worsen the symptoms and delay appropriate medical treatment.
A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. The client occasionally curses or calls another client a 'jerk' without provocation. The nurse asks the client how he is feeling, and he responds, 'Everybody picks on me. They frobitz me.' The best response for the nurse to make would be:
- A. That's really too bad.'
- B. Who do you mean when you say 'everybody'?'
- C. What difference does frobitzing make?'
- D. Why do they frobitz?'
Correct Answer: B
Rationale: The correct answer is B: "Who do you mean when you say 'everybody'?"
Rationale:
1. Clarifying the client's statement helps to understand his perception.
2. Asking specifically about 'everybody' encourages the client to express his feelings and thoughts.
3. It promotes therapeutic communication by showing empathy and active listening.
Incorrect choices:
A: "That's really too bad." - This response does not address the client's specific concerns or promote further exploration.
C: "What difference does frobitzing make?" - This response is dismissive and lacks empathy or understanding of the client's experience.
D: "Why do they frobitz?" - This response is confrontational and may come across as accusatory, potentially shutting down communication.
A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. He occasionally curses or calls another client a 'jerk' without provocation. The nurse asks the client how he is feeling, and he responds, 'Everybody picks on me. They frobitz me.' The nurse would assess 'frobitz' as:
- A. Circumstantial speech
- B. Loose associations
- C. Evidence of delusional thinking
- D. A neologism
Correct Answer: D
Rationale: The correct answer is D: A neologism. A neologism is a newly coined word or expression that is not easily understood by others. In this case, the client's use of the word 'frobitz' is not a recognized word, indicating it may be a neologism. This is commonly seen in individuals with schizophrenia who create new words or distort existing ones.
A: Circumstantial speech involves excessive and unnecessary details before reaching the main point. The client's response is not characterized by this.
B: Loose associations involve a lack of logical connections between thoughts. The client's response is not demonstrating this.
C: Evidence of delusional thinking would involve fixed, false beliefs that are not based in reality. The client's use of 'frobitz' does not necessarily indicate a delusion.
In summary, the use of 'frobitz' by the client is indicative of a neologism, as it is a new and potentially meaningless
A patient with anorexia nervosa is resistant to weight gain. What is the rationale for establishing a contract with the patient to participate in measures to produce a specified weekly weight gain?
- A. Severe anxiety concerning eating is expected, so objective and subjective data are needed.
- B. Patient involvement in decision-making increases sense of control and promotes collaboration.
- C. The patient's family is not supportive of the treatment plan.
- D. None of the above.
Correct Answer: B
Rationale: Correct Answer: B - Patient involvement in decision-making increases sense of control and promotes collaboration.
Rationale:
1. Involving the patient in decision-making empowers them and increases their sense of control over their treatment.
2. Collaborating with the patient fosters a positive therapeutic relationship.
3. This approach is more likely to lead to better treatment adherence and outcomes.
Summary:
A: While objective and subjective data are important, this choice does not address the need for patient involvement in decision-making and collaboration.
C: The lack of family support is not directly related to the rationale for establishing a contract with the patient.
D: This choice is incorrect as patient involvement is crucial in promoting successful treatment outcomes.
A nurse has recently been assigned to a unit that specializes in the care of patients diagnosed with eating disorders. The nurse should consider which of the following actions as having priority when preparing for this new assignment?
- A. Becoming familiar with the unit's policies and procedures.
- B. Arranging to mentor with a nurse who has experience on the unit.
- C. Self-reflecting on personal feelings regarding body weight and size.
- D. Attending an educational seminar that focuses on maladaptive eating disorders.
Correct Answer: C
Rationale: The correct answer is C. Self-reflecting on personal feelings regarding body weight and size is crucial for the nurse to be aware of any biases or triggers that may affect patient care. Understanding personal attitudes towards body image can prevent unintentional harm or judgment towards patients.
A: Becoming familiar with the unit's policies and procedures is important but not the top priority when dealing with patients with eating disorders.
B: Arranging to mentor with a nurse who has experience on the unit can be helpful but does not address the nurse's personal biases.
D: Attending an educational seminar is valuable but may not address the nurse's own attitudes towards body image.