Nokea
A client on an antipsychotic medication develops a high fever, unstable blood pressure, and muscle rigidity. Her next dose of medication is due. The nurse should:
- A. Administer the medication and take the vital signs again
- B. Give a lower dose of the medication and take the blood pressure
- C. Prepare to give the pm anticholinergic, benztropine (Cogentin)
- D. Hold the medication and call the client's doctor immediately
Correct Answer: D
Rationale: The correct answer is D: Hold the medication and call the client's doctor immediately. This is the correct course of action because the client is exhibiting signs of neuroleptic malignant syndrome (NMS), a potentially life-threatening side effect of antipsychotic medications. Holding the medication is essential to prevent further complications. Calling the doctor is necessary to inform them of the situation and seek further instructions. Administering the medication (choice A) would exacerbate the symptoms, giving a lower dose (choice B) is not sufficient in this emergency situation, and administering an anticholinergic (choice C) is not the appropriate response for NMS.
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A patient with schizophrenia has been stabilized in the Crisis Center and is about to be discharged. He will be living with his family, but the family knows nothing about the patient's illness, its treatment, or the role they can play in his recovery. Which activity would be most beneficial for the family to attend?
- A. Psychoanalytic group
- B. Psychoeducational group
- C. Individual counseling
- D. Family therapy
Correct Answer: B
Rationale: The correct answer is B: Psychoeducational group. This option is most beneficial as it will provide the family with education about schizophrenia, its treatment, and the role they can play in the patient's recovery. This will help the family better understand the illness, how to support the patient, and how to communicate effectively.
Explanation:
1. Psychoanalytic group (A) focuses on exploring unconscious thoughts and emotions, which may not be as practical or helpful for educating the family about schizophrenia.
2. Individual counseling (C) may not involve the family as a whole and may not provide the necessary education and support for the family unit.
3. Family therapy (D) could be beneficial, but psychoeducational group specifically targets providing knowledge and skills needed to support the patient's recovery, making it the most appropriate choice in this scenario.
When an individual with multiple cognitive disabilities has extraordinary proficiency in one isolated skill, this is known as?
- A. Rainman syndrome
- B. Asperger ability
- C. Intellectual isolation
- D. Savant syndrome
Correct Answer: D
Rationale: Savant Syndrome: Extraordinary proficiency in one isolated skill in individuals with multiple cognitive disabilities, often linked to autism.
When undertaking care for a patient with an eating disorder, a nurse should first:
- A. perform a complete patient assessment.
- B. obtain a history from the patient's family.
- C. examine his or her own feelings about weight.
- D. question the patient as to when he or she last ate a meal.
Correct Answer: C
Rationale: The correct answer is C because examining the nurse's own feelings about weight is essential to ensure they have a neutral and non-judgmental attitude towards the patient. This self-awareness helps the nurse avoid projecting biases onto the patient and fosters a therapeutic relationship. Performing a complete patient assessment (A) is important but not the first step. Obtaining a history from the patient's family (B) may be helpful but is not the initial priority. Questioning the patient about their last meal (D) is important but does not address the nurse's own attitudes and biases that could impact care.
During morning care, the nursing assistant asks a patient with dementia, 'How was your night?' The patient replies, 'It was lovely. My husband and I went out to dinner and to a movie.' The nurse who overhears this should make the assessment that the patient is:
- A. Demonstrating a sense of humor.
- B. Using confabulation.
- C. Perseverating.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Using confabulation. Confabulation is when a person with dementia unknowingly creates fictitious memories to fill in gaps in their memory. In this scenario, the patient's response of going out to dinner and a movie with their husband is not based in reality, indicating confabulation. A: Demonstrating a sense of humor is incorrect because the patient is not intentionally being humorous. C: Perseverating is incorrect as it refers to repeating the same words or phrases, which is not evident in the patient's response. D: None of the above is incorrect as the patient's response aligns with confabulation.
What is a key consideration when treating a patient with anorexia nervosa?
- A. Addressing the patient's weight first and foremost.
- B. Focusing on nutrition and caloric intake without addressing underlying issues.
- C. Addressing the psychological and emotional factors that contribute to the disorder.
- D. Providing strict dietary restrictions to help the patient regain control over food.
Correct Answer: C
Rationale: The correct answer is C because addressing the psychological and emotional factors is crucial in treating anorexia nervosa. This disorder is not solely about weight or food intake; it often involves deeper psychological issues such as body image distortion, low self-esteem, and control issues. By focusing on the underlying psychological and emotional factors, therapists can help patients understand and cope with these issues, leading to more effective and sustainable recovery. Choices A, B, and D are incorrect because they overlook the complexity of anorexia nervosa and may even exacerbate the patient's condition by neglecting the root causes of the disorder.