A 10-year-old boy is diagnosed with gender dysphoria. Which assessment finding would the nurse expect?
- A. Having tea parties with dolls
- B. A compromised sexual response cycle
- C. Identifying with boys who are athletic
- D. Intense urges to watch his parents have sex
Correct Answer: A
Rationale: The correct answer is A because a child with gender dysphoria may display behaviors that align with the gender they identify with, such as engaging in activities typically associated with that gender. Tea parties with dolls may indicate the child's preference for activities stereotypically linked to girls, indicating a mismatch between their assigned gender and gender identity. Choices B, C, and D are incorrect as they do not align with typical assessment findings for gender dysphoria in children. B is more related to sexual dysfunction, C is a common behavior for all children, and D is inappropriate and unrelated to the diagnosis of gender dysphoria.
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A patient has not come out of her room for breakfast. The nurse finds the patient moving restlessly about her room in a disorganized manner. The patient is talking to herself, and her verbal responses to the nurse are nonsensical and suggest disorientation. The nurse notices that the patient's skin is hot and dry, and her pupils are somewhat dilated. All these symptoms are significant departures from the patient's recent presentation. The patient is likely experiencing ______, and the nurse should ______.
- A. anticholinergic toxicity"¦check vital signs and prepare to use a cooling blanket stat
- B. relapse of her psychosis"¦administer PRN antipsychotic drugs and notify her physician
- C. neuroleptic malignant syndrome"¦contact her physician for a transfer to intensive care
- D. agranulocytosis"¦hold her antipsychotic and draw blood for a complete blood count
Correct Answer: A
Rationale: The correct answer is A: anticholinergic toxicity. The patient's symptoms align with this diagnosis due to the disorganized behavior, nonsensical speech, disorientation, hot and dry skin, dilated pupils, and recent presentation changes. Anticholinergic toxicity can cause confusion, delirium, hyperthermia, and dilated pupils. Checking vital signs and preparing to use a cooling blanket are appropriate actions to manage the symptoms.
Choice B (relapse of psychosis) is incorrect because the symptoms are not typical of a psychotic relapse. Choice C (neuroleptic malignant syndrome) is incorrect as the symptoms do not completely align with this syndrome, which typically includes muscle rigidity and autonomic dysfunction. Choice D (agranulocytosis) is incorrect because it presents with low white blood cell count and not the symptoms described in the scenario.
Which of the following is a common emotional response for patients with anorexia nervosa?
- A. Fear of gaining weight and loss of control over eating.
- B. Lack of concern about food intake and weight.
- C. Excessive joy and pride in achieving weight loss.
- D. Denial of the need for treatment and weight restoration.
Correct Answer: A
Rationale: The correct answer is A because fear of gaining weight and loss of control over eating are core features of anorexia nervosa. Patients with anorexia often have an intense fear of gaining weight, leading to restrictive eating behaviors. This fear is accompanied by a sense of loss of control over their eating habits.
Choice B is incorrect because lack of concern about food intake and weight is not a common emotional response in anorexia nervosa. Choice C is incorrect as excessive joy and pride in achieving weight loss are more characteristic of other eating disorders like bulimia nervosa or orthorexia. Choice D is incorrect because denial of the need for treatment and weight restoration may be present in some cases but is not a common emotional response in anorexia nervosa.
A victim of partner abuse, parent of one child, describes the partner as someone who is easily frustrated and more likely to be abusive after experiencing an event in which the most recent episodes of violence were related to feeling 'upset' over a job loss. What type of therapy would provide the greatest help to the abuser?
- A. Voluntary individual or group therapy
- B. Court-ordered individual or group therapy
- C. Voluntary couples or family therapy
- D. None of the above
Correct Answer: A
Rationale: The correct answer is A: Voluntary individual or group therapy. This type of therapy would be most helpful as it focuses on addressing the abuser's personal issues and behaviors, such as managing frustration and anger. By participating voluntarily, the abuser is more likely to be open to introspection and change.
Summary of other choices:
B: Court-ordered therapy may not be as effective as voluntary therapy, as the abuser may feel forced and less motivated to engage in the process.
C: Couples or family therapy may not be appropriate initially as the abuser needs to work on personal issues first before addressing relationship dynamics.
D: None of the above is incorrect as voluntary individual or group therapy is the most suitable option for addressing the abuser's behavior.
An infant develops jaundice 6 hours after birth. Which one of the following is the most likely diagnosis?
- A. Haemolytic disease of the newborn.
- B. Umbilical sepsis.
- C. Physiological jaundice.
- D. Atresia of the bile ducts.
Correct Answer: A
Rationale: Jaundice within 24 hours of birth is pathological, often due to haemolytic disease of the newborn (A), such as Rh incompatibility causing rapid red cell breakdown. Physiological jaundice (C) typically appears after 24 hours, while umbilical sepsis (B), bile duct atresia (D), and neonatal hepatitis (E) are less likely to cause such early onset.
Which theory of etiology of Alzheimer's disease, suggested by current research, might the nurse use to help a family understand that this disorder is not of psychosocial origin? Alzheimer's disease is associated with:
- A. @-amyloid protein deposits in the brain
- B. Abnormal serotonin reuptake
- C. Excessive acetylcholine in the frontal cortex
- D. Prion infection of gray matter
Correct Answer: A
Rationale: The correct answer is A: @-amyloid protein deposits in the brain. This theory of Alzheimer's etiology is supported by current research, indicating that the accumulation of @-amyloid protein plaques in the brain is a key characteristic of the disease. These plaques lead to neuronal damage and cognitive decline. Option B, abnormal serotonin reuptake, is not associated with Alzheimer's. Option C, excessive acetylcholine in the frontal cortex, is incorrect as Alzheimer's is characterized by acetylcholine deficiency. Option D, prion infection of gray matter, is not linked to Alzheimer's disease. In summary, the presence of @-amyloid protein deposits in the brain is a key feature of Alzheimer's pathology, distinguishing it from psychosocial origins.
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