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A disorder that interrupts normal sleep patterns and is characterized by repeated, brief jerks of the arms and legs that occur every 20 to 60 seconds during the beginning of sleep is called:
- A. Insomnia.
- B. Narcolepsy.
- C. Hypersomnia.
- D. None of the above.
Correct Answer: D
Rationale: The correct answer is D: None of the above. The disorder described in the question is Periodic Limb Movement Disorder (PLMD), not any of the options provided. PLMD involves involuntary movements during sleep, which are different from the symptoms of insomnia, narcolepsy, or hypersomnia. Insomnia is difficulty falling or staying asleep, narcolepsy is a neurological disorder characterized by excessive daytime sleepiness, and hypersomnia is excessive daytime sleepiness despite getting enough sleep. Therefore, the correct answer is D as none of the provided options accurately describe the specific disorder mentioned in the question.
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A patient reports, 'My brain is tapped. The government has implanted a device in my head.' What outcome would the nurse identify as being appropriate for the patient to achieve within 1 week of admission?
- A. Taking antipsychotic medication as prescribed without objection
- B. Giving coherent data to support beliefs that the brain is 'tapped'
- C. Interpreting reality correctly by stating no 'brain tap' has been implanted
- D. Reporting feeling less anxious about having the government listening to interior thoughts
Correct Answer: C
Rationale: The correct answer is C because it reflects the goal of promoting reality testing and challenging the patient's delusional beliefs. By helping the patient interpret reality correctly and recognize that the implanted device is not real, the nurse can support the patient in overcoming their delusions and improving their mental health.
Choice A is incorrect as simply taking medication does not address the underlying delusional belief. Choice B is incorrect as it validates and reinforces the patient's delusion, which is not therapeutic. Choice D is incorrect as it does not address the core issue of the patient's delusional belief and may not lead to long-term improvement in mental health.
During a manic episode, a patient is hyperactive, restless, and disorganized. The patient goes to the dining room and begins to throw food and dishes. Verbal intervention is ineffective. The patient's behavior poses a substantial risk of harm to others. Staff escorts the patient to the patient's room to dine alone. What is the rationale for this action?
- A. Prevent other patients from observing the behavior.
- B. Reduce environmental stimuli that negatively affect the patient.
- C. Protect the patient's biological integrity until medication takes effect.
- D. Reinforce limit setting
Correct Answer: B
Rationale: The correct answer is B: Reduce environmental stimuli that negatively affect the patient. This action helps reduce stimulation that may be exacerbating the manic episode, promoting a calmer environment for the patient. Removing the patient from the dining room minimizes triggers for further disruptive behavior. This approach prioritizes the patient's well-being by managing the environmental factors contributing to the escalation of symptoms.
A: Preventing other patients from observing the behavior does not directly address the patient's needs during the manic episode and does not actively help in managing the situation.
C: Protecting the patient's biological integrity until medication takes effect may be important, but in this scenario, the immediate focus is on addressing the environmental factors contributing to the behavior.
D: Reinforcing limit setting is important in managing behavior, but in this specific situation, reducing environmental stimuli is a more immediate and effective intervention.
Which measure is critical to achieving desired outcomes in the nurse-client relationship? The nurse:
- A. develops trust in the client.
- B. uses autodiagnosis.
- C. relies on the client liking the nurse rather than limit-setting to achieve structure.
- D. analyzes the relationships among biologic, familial, and sociocultural factors that contributed to the client's disorder.
Correct Answer: B
Rationale: The correct answer is B: uses autodiagnosis. Autodiagnosis is critical in the nurse-client relationship as it involves self-awareness and reflection by the nurse to understand their own biases, emotions, and reactions. This self-awareness allows the nurse to effectively manage their responses, maintain professionalism, and provide quality care to the client. By being aware of their own thoughts and feelings, nurses can better empathize with the client, build trust, and communicate effectively. This approach helps prevent potential conflicts and misunderstandings, leading to better outcomes in the nurse-client relationship.
Summary:
A: Developing trust in the client is important but not the most critical measure.
C: Relying on the client liking the nurse is not professional and may compromise boundaries.
D: Analyzing biologic, familial, and sociocultural factors is important but not as critical as self-awareness through autodiagnosis.
A woman, abducted and raped at gunpoint by an unknown assailant, was found confused and disoriented. The nurse makes these observations about the patient: talking rapidly in disjointed phrases, unable to concentrate, indecisive when asked to make simple decisions. What is the patient's level of anxiety?
- A. Weak
- B. Mild
- C. Moderate
- D. Severe
Correct Answer: D
Rationale: The correct answer is D: Severe. The patient's symptoms of talking rapidly, inability to concentrate, and indecisiveness are indicative of severe anxiety. Rapid speech and disjointed phrases suggest heightened arousal, while the inability to concentrate and make decisions point to severe impairment in cognitive functioning. These symptoms align with the DSM-5 criteria for severe anxiety, which includes extreme levels of distress and impairment in daily functioning. Weak (A), mild (B), and moderate (C) levels of anxiety would not typically manifest in such severe cognitive and behavioral symptoms.
The affective losses of Alzheimer's disease refer to losses noticed in the individual's:
- A. Personality
- B. Thought processes
- C. Ability to make and carry out plans
- D. Self-care
Correct Answer: A
Rationale: The affective losses of Alzheimer's disease refer to changes in emotions and mood, impacting personality traits. This is because the disease affects areas of the brain responsible for regulating emotions. Personality changes are commonly observed in individuals with Alzheimer's. Thought processes (choice B) are more related to cognitive decline, while ability to make and carry out plans (choice C) and self-care (choice D) are more associated with functional decline. Therefore, choice A is correct as it specifically addresses the affective aspect of the disease.