Nokea
A common nursing diagnosis for a patient with antisocial personality disorder is:
- A. chronic low self-esteem, related to poor self-image and excessive fear of failure
- B. disturbed thought processes, related to sensory-perceptual alterations
- C. impaired social interaction, related to manipulative behaviors
- D. social isolation, related to anxiety in social situations
Correct Answer: C
Rationale: Impaired social interaction due to manipulation reflects the interpersonal challenges of antisocial personality disorder.
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A patient has schizophrenia and is troubled by negative symptoms, muscle stiffness, and motor restlessness. His Advanced Practice Nurse (APN) is considering changing the patient's antipsychotic medication, haloperidol (Haldol, a typical or first generation antipsychotic drug). For planning purposes, which medication can the nurse assume that the APN will probably choose?
- A. Chlorpromazine (Thorazine)
- B. Clozapine (Clozaril)
- C. Olanzapine (Zyprexa)
- D. Fluoxetine (Prozac)
Correct Answer: C
Rationale: The correct answer is C: Olanzapine (Zyprexa). Olanzapine is an atypical or second-generation antipsychotic that is effective in treating both positive and negative symptoms of schizophrenia. It also has a lower risk of causing extrapyramidal symptoms like muscle stiffness and motor restlessness compared to typical antipsychotics like haloperidol. Chlorpromazine (A) is a typical antipsychotic with similar side effects as haloperidol. Clozapine (B) is an atypical antipsychotic that is effective for treatment-resistant schizophrenia but is usually considered as a last resort due to its potential for serious side effects. Fluoxetine (D) is an antidepressant and not typically used as a first-line treatment for schizophrenia.
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.
An elderly patient with dementia paces the hallway and often engages in wandering. The nurse documents that the patient is exhibiting which type of behavior that is characteristic of dementia?
- A. Passive behavior
- B. Functionally impaired behavior
- C. Involuntary psychomotor behavior
- D. Nonaggressive psychomotor behavior
Correct Answer: D
Rationale: The correct answer is D: Nonaggressive psychomotor behavior. In dementia, wandering and pacing are common behaviors due to cognitive impairment. Nonaggressive behavior refers to actions that do not involve harm or aggression towards others. The patient's behavior is voluntary and purposeless, indicating psychomotor involvement. Choices A, B, and C do not accurately describe the behavior exhibited by the patient with dementia. Passive behavior implies lack of engagement, functionally impaired behavior suggests difficulty performing activities of daily living, and involuntary psychomotor behavior implies actions beyond the patient's control, which are not the case in this scenario.
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.
What is an important aspect of managing refeeding syndrome in patients with anorexia nervosa?
- A. Refeeding the patient with high-calorie foods immediately.
- B. Monitoring electrolytes closely during the refeeding process.
- C. Allowing the patient to eat whatever they want without restrictions.
- D. Restricting fluid intake to avoid water retention.
Correct Answer: B
Rationale: The correct answer is B because monitoring electrolytes closely during refeeding is crucial to prevent life-threatening complications such as electrolyte imbalances. Refeeding syndrome can lead to shifts in electrolytes, particularly phosphorus, potassium, and magnesium, which may result in cardiac arrhythmias, respiratory failure, or even death. Close monitoring allows for timely interventions to maintain electrolyte balance.
Choice A is incorrect because refeeding a patient with high-calorie foods immediately can actually exacerbate refeeding syndrome by overwhelming the body's metabolic and electrolyte regulation processes. Choice C is incorrect because allowing the patient to eat whatever they want without restrictions can lead to rapid and uncontrolled weight gain, which may worsen medical complications. Choice D is incorrect because restricting fluid intake can also contribute to electrolyte imbalances and dehydration during refeeding.