Nokea
A community mental health nurse receives a new client for his caseload. The diagnosis of the client is residual schizophrenia. Documentation states that the client has a number of negative symptoms. Which symptom would the nurse expect to assess in the client?
- A. Bizarre, somatic delusions
- B. Disorganized speech pattern
- C. Catatonic posturing
- D. Emotional blunting
Correct Answer: D
Rationale: The correct answer is D: Emotional blunting. In residual schizophrenia, negative symptoms are prominent, including emotional blunting which refers to a reduced ability to express emotions. This is commonly seen in clients with residual schizophrenia.
Explanation of why other choices are incorrect:
A: Bizarre, somatic delusions are characteristic of paranoid schizophrenia, not residual schizophrenia.
B: Disorganized speech pattern is a symptom of disorganized schizophrenia, not residual schizophrenia.
C: Catatonic posturing is associated with catatonic schizophrenia, not residual schizophrenia.
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A nurse is caring for a patient diagnosed with anorexia nervosa. What is the most important intervention during the refeeding phase?
- A. Monitor weight gain and provide a structured meal plan.
- B. Encourage the patient to eat independently without supervision.
- C. Focus on psychological therapy to address emotional issues.
- D. Offer the patient high-calorie, high-fat foods to increase intake.
Correct Answer: A
Rationale: The correct answer is A because during the refeeding phase of anorexia nervosa, monitoring weight gain and providing a structured meal plan are crucial to prevent refeeding syndrome and ensure a safe and gradual increase in caloric intake. This approach helps prevent complications such as electrolyte imbalances and organ dysfunction. Encouraging the patient to eat independently without supervision (B) can be harmful as they may not consume adequate or balanced nutrition. Psychological therapy (C) is important but not the most crucial during the refeeding phase. Offering high-calorie, high-fat foods (D) can lead to rapid weight gain and further complications.
Select the central concept around which a family education plan for preventing childhood eating problems is constructed:
- A. Promoting self-demand feeding for the child.
- B. Distinguishing between physical and psychological hunger.
- C. Scheduling meals because children do not recognize physical hunger.
- D. Parental expectations of ideal intake as determinants of healthy eating habits.
Correct Answer: A
Rationale: The correct answer is A: Promoting self-demand feeding for the child. This approach encourages the child to listen to their own hunger cues and regulate their food intake accordingly, promoting a healthy relationship with food. It empowers the child to develop autonomy and self-awareness around eating habits.
Explanation for why the other choices are incorrect:
B: While distinguishing between physical and psychological hunger is important, it is not the central concept for preventing childhood eating problems.
C: Scheduling meals may not align with the child's natural hunger cues and can potentially lead to disordered eating patterns.
D: Parental expectations can create pressure around eating, potentially leading to negative relationships with food.
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.
What is the rationale for establishing a contract with a patient with an eating disorder at the outset of treatment?
- A. The patient and nurse form a coalition that is difficult for the family to disrupt.
- B. A team approach to planning therapy ensures that physical and emotional needs will be met.
- C. Patient involvement in decision making increases the sense of control and promotes cooperation.
- D. Permission for refeeding is essential because this measure has the potential for negative effects.
Correct Answer: C
Rationale: Correct Answer: C - Patient involvement in decision making increases the sense of control and promotes cooperation.
Rationale:
1. Involving the patient in decision-making empowers them and enhances their autonomy.
2. Patients with eating disorders often feel a loss of control over their lives, so involving them in treatment decisions can help restore a sense of agency.
3. Increased sense of control can lead to improved cooperation and engagement in treatment.
Summary:
A: Incorrect. Establishing a contract with a patient is not about forming a coalition against the family but about empowering the patient.
B: Incorrect. While a team approach is important, the primary rationale for establishing a contract is to involve the patient in decision-making.
D: Incorrect. Refeeding is important in eating disorder treatment, but the rationale for establishing a contract is more about promoting patient cooperation through involvement in decision-making.
Which of the following is not a common type of water pollutant?
- A. Protists
- B. Bacteria
- C. Particulates
- D. Carbon Monoxide
Correct Answer: D
Rationale: Carbon Monoxide is an air pollutant, not a common water pollutant, unlike protists, bacteria, and particulates.