Nokea
A boy with a conduct disorder diagnosis would be most likely to have which symptom?
- A. Withdrawal
- B. Ritualistic behavior
- C. Class bully
- D. Class clown
Correct Answer: C
Rationale: A pattern of bullying is a common sign of conduct disorder. Responses A and B may reflect autism.
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A patient, aged 77 years, has Alzheimer's disease. She goes to day care during the week and is otherwise cared for by her daughter and grandchildren. The nurse at the day care center noticed multiple bruises on the patient's palms, elbows, and buttocks. When the daughter arrived to pick her up, the nurse discussed her observations. The daughter became defensive and said that her mother was very difficult to manage. She stated, "My mother is not my mother anymore. She is confused, and she wanders all night. We have to watch her constantly. Last night I fell asleep, and she fell down the stairs. Sometimes she cannot recognize me and accuses me of trying to poison her. I can't concentrate at work, and it's wrecking the family. Sometimes I just cannot bear it."Â Which nursing diagnosis would be most important to address for this family?
- A. Knowledge deficit pertaining to dementia
- B. Grieving related to mother's deterioration
- C. Risk for injury related to cognitive impairment
- D. Caregiver role strain related to increased care needs
Correct Answer: D
Rationale: The correct nursing diagnosis to address in this scenario is D: Caregiver role strain related to increased care needs. This is the most important as it focuses on the daughter's challenges and emotional burden due to her mother's condition. The daughter's statements reveal feelings of overwhelm, guilt, and exhaustion, which are key indicators of caregiver role strain. By addressing this nursing diagnosis, the healthcare team can provide support and resources to help the daughter cope with the demands of caring for her mother.
Choice A (Knowledge deficit pertaining to dementia) is not the most important in this situation as the daughter's issue is not lack of knowledge but rather emotional stress. Choice B (Grieving related to mother's deterioration) is not the priority as addressing the daughter's emotional strain is more urgent than addressing grief. Choice C (Risk for injury related to cognitive impairment) is also important but not as immediate as addressing the caregiver's emotional well-being.
The wife of a client newly diagnosed with paranoid schizophrenia asks the nurse, 'My husband was well adjusted until a month ago, and then, after a lot of work stress, he got sick. What can I expect? Will he be this sick for the rest of his life?' What information can the nurse provide about prognosis?
- A. This disorder responds well to treatment and, with follow-up, may not recur.'
- B. All types of schizophrenia are chronic relapsing disorders.'
- C. Outcomes are poor related to client prehospital disorganization.'
- D. The usual outcome is that only partial remission is achieved.'
Correct Answer: A
Rationale: The correct answer is A: "This disorder responds well to treatment and, with follow-up, may not recur."
Rationale:
1. Paranoid schizophrenia typically responds well to treatment, especially with early intervention.
2. With proper medication and therapy, individuals with paranoid schizophrenia can experience significant improvement and lead fulfilling lives.
3. Follow-up care and support are crucial in maintaining stability and preventing relapses.
Summary of why other choices are incorrect:
B: All types of schizophrenia are chronic relapsing disorders - This is not accurate as outcomes can vary depending on the subtype of schizophrenia.
C: Outcomes are poor related to client prehospital disorganization - This statement is too general and does not specifically address the prognosis of paranoid schizophrenia.
D: The usual outcome is that only partial remission is achieved - This is not always the case, as many individuals with paranoid schizophrenia can achieve full remission with appropriate treatment.
A homeless patient diagnosed with a serious mental illness became suspicious and delusional. Depot antipsychotic medication began, and housing was obtained in a local shelter. One month later, which statement by the patient indicates significant improvement?
- A. They will not let me drink. They have many rules in the shelter.'
- B. I feel comfortable here. Nobody bothers me.'
- C. Those shots make my arm very sore.'
- D. Those people watch me a lot.'
Correct Answer: B
Rationale: Evaluation of a patients progress is made based on patient satisfaction with the new health status and the health care teams estimation of improvement. For a formerly delusional patient to admit to feeling comfortable and free of being bothered by others denotes improvement in the patients condition. The other options suggest that the patient is in danger of relapse.
A patient has recently been under significant stress and worked long hours. At home, the patient watches television and eats until going to bed. The patient is too tired to exercise and has gained 25 pounds in 1 month. A desired outcome for the patient is to recognize anxiety that precedes binge eating and reduce it. Which intervention addresses the outcome?
- A. Teach stress-reduction techniques such as relaxation and imagery.
- B. Encourage the patient to design and implement an exercise program.
- C. Explore ways in which the patient may feel more in control of the environment.
- D. Encourage the patient to attend a support group such as Overeaters Anonymous.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Teaching stress-reduction techniques (relaxation, imagery) helps patient identify anxiety triggers leading to binge eating.
2. By recognizing anxiety, patient can interrupt pattern of mindless eating and address root cause.
3. Relaxation techniques empower patient to cope effectively without turning to food.
4. Encouraging exercise (choice B) may not directly address underlying anxiety and binge eating triggers.
5. Exploring control over the environment (choice C) does not necessarily address emotional aspects of binge eating.
6. Attending a support group (choice D) may provide peer support but doesn't focus on recognizing and reducing anxiety triggers.
The main focus of medical management for anorexia is to:
- A. Encourage rapid weight gain.
- B. Encourage the client to eat voluntarily.
- C. Teach more appropriate food choices.
- D. None of the above.
Correct Answer: D
Rationale: The correct answer is D because the main focus of medical management for anorexia is not to encourage rapid weight gain, as it can lead to serious health complications. Encouraging the client to eat voluntarily is also not the main focus, as anorexia involves psychological factors that go beyond simple lack of appetite. Teaching more appropriate food choices is not the main focus either, as anorexia requires comprehensive treatment that addresses underlying emotional issues. Overall, the main focus is on a multidisciplinary approach that includes therapy, nutritional counseling, and medical monitoring to address the physical and psychological aspects of the disorder.