Nokea
A 38-year-old woman, who had a subtotal thyroidectomy 8 years previously, is again thyrotoxic. Which one of the following is the most appropriate management?
- A. Perform total thyroidectomy after preparation with carbimazole.
- B. Radioactive iodine after preparation with oral iodine treatment.
- C. Prescribe immunosuppressive treatment with azathioprine.
- D. Control with cardimazole and then administration of radioactive iodine.
Correct Answer: D
Rationale: Recurrent thyrotoxicosis post-subtotal thyroidectomy is best managed with carbimazole to control symptoms, followed by radioactive iodine (D) for definitive treatment. Total thyroidectomy (A) is more invasive, iodine alone (B) is incorrect, immunosuppression (C) is irrelevant, and beta-blockers (E) are symptomatic only.
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The client has become unable to recognize formerly familiar objects and people in his environment. The client is experiencing:
- A. Affect "“ experienced feelings and emotions
- B. Agnosis "“ inability to recognize familiar objects or people
- C. Apraxia "“ difficulty carrying out purposeful, organized task that is somewhat complex (ex. dressing)
- D. Anhedonia "“ lack of pleasure
Correct Answer: B
Rationale: The correct answer is B: Agnosis - inability to recognize familiar objects or people. This is because the client's inability to recognize formerly familiar objects and people in his environment aligns with the definition of agnosis. Affect (choice A) refers to experienced feelings and emotions, which is not the issue described in the question. Apraxia (choice C) is difficulty carrying out purposeful tasks, not related to recognition of objects or people. Anhedonia (choice D) is a lack of pleasure, which is also not applicable to the client's situation. Therefore, the best fit for the client's experience is agnosis.
Which assessment findings would be expected for a patient diagnosed with bipolar I disorder?
- A. Rapid cycling
- B. Major depression and acute mania
- C. Major depression and/or hypomania
- D. Hypomania and/or minor depression
Correct Answer: B
Rationale: Step 1: Bipolar I disorder involves episodes of acute mania, which is characterized by elevated mood, increased energy, and impulsivity.
Step 2: Major depression can also occur in bipolar I, as patients may experience depressive episodes.
Step 3: Therefore, choice B (Major depression and acute mania) is the correct answer.
Summary: Choice A is incorrect because rapid cycling refers to frequent mood shifts, not specific to bipolar I. Choice C is incorrect as hypomania is characteristic of bipolar II, not bipolar I. Choice D is incorrect as minor depression is not a typical feature of bipolar I disorder.
Which remarks by a 72-year-old patient should prompt the nurse to assess for depression? Select one tha does not apply.
- A. Lately I have had a lot of aches and pains and just havent felt very well.
- B. People are in and out of my room all day and all night taking my things.
- C. Dont ask me to eat. I cant because my stomach is upset all the time.
- D. Im eating more than usual, and I am sleeping about 6 hours a night.
Correct Answer: D
Rationale: Somatic symptoms (A), delusions of persecution (B), and nihilistic delusions (C) are common in late-onset depression, warranting assessment. Increased appetite and contentment (D, E) do not suggest depression.
A frequent finding in clients with Paraphiliac sexual disorders is that they have:
- A. Other covert or overt emotional
- B. Gonadal and pituitary hormone deficiencies
- C. An inadequate physical development of the sex organs
- D. A poor adjustment due to association with society's fringe groups
Correct Answer: A
Rationale: Clients with paraphilic disorders often have coexisting emotional disorders, which may contribute to or result from their condition.
A delusion is defined as seeing something that is not real
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: A delusion is a fixed false belief, not a perception (hallucination involves seeing/hearing something not real).