Nokea
A female client with a psychotic disorder is experiencing olfactory hallucinations. Most likely, she would be complaining of:
- A. A vision that is disturbing to her
- B. A sound that is disturbing to her
- C. A smell that is disturbing to her
- D. A sense of touch that is disturbing to her
Correct Answer: C
Rationale: The correct answer is C because olfactory hallucinations involve perceiving smells that are not actually present. In a psychotic disorder, such hallucinations are common and can be disturbing to the individual. This is due to the sensory perception of smells that others cannot detect. Choices A, B, and D do not align with the experience of olfactory hallucinations. Vision (A) and sound (B) are not related to olfactory hallucinations, and a sense of touch (D) is not typically associated with this type of sensory distortion in psychotic disorders.
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Which therapy is shown through evidence to be the most effective for a patient with an eating disorder?
- A. Supportive therapy.
- B. Behavioral therapy.
- C. Cognitive behavioral therapy.
- D. Psychoanalytical group therapy.
Correct Answer: C
Rationale: The correct answer is C: Cognitive behavioral therapy (CBT). CBT is the most effective therapy for eating disorders based on research evidence. It helps patients identify and change negative thoughts and behaviors related to food and body image. CBT also teaches coping skills and strategies to manage triggers. Supportive therapy (choice A) offers emotional support but may not target the underlying issues. Behavioral therapy (choice B) focuses on changing specific behaviors but may not address cognitive patterns. Psychoanalytical group therapy (choice D) delves into past experiences but is not as effective as CBT in treating eating disorders.
To plan effective interventions, the nurse should understand that the underlying reason a patient with paranoid personality disorder is so critical of others probably lies in the patient's:
- A. need to control all aspects of the world around him.
- B. use of intellectualization to protect against anxiety.
- C. inflexible view of the environment and the people in it.
- D. projection of blame for his own shortcomings onto others.
Correct Answer: D
Rationale: The correct answer is D because paranoid personality disorder is characterized by distrust and suspicion of others, leading individuals to project their own negative traits onto others (projection). This defense mechanism helps them avoid accepting their own shortcomings. Option A is incorrect because the focus is on control, not blame. Option B is incorrect as intellectualization is a defense mechanism that involves avoiding emotions by focusing on rational aspects. Option C is incorrect as it refers to rigidity and not projection of blame. In summary, projection of blame onto others is the underlying reason for the critical behavior in paranoid personality disorder.
A 10-year-old boy presents with a history of central abdominal pain of a few hours' duration. On examination he has minimal tenderness in the right iliac fossa and no abnormal findings on rectal examination. Which of the following alternatives should be carried out?
- A. Arrange a barium meal follow through.
- B. Arrange to see the patient later on in the day for review.
- C. Send the patient away with instructions to return if the pain becomes worse.
- D. Tell the patient to come back in a week.
Correct Answer: B
Rationale: Early appendicitis can present subtly. Minimal right iliac fossa tenderness warrants observation, so reviewing later (B) is appropriate. Imaging (A), dismissal (C, D), or immediate surgery (E) without further assessment are not justified yet.
A patient moving from chair to chair in the day room and pacing in the hallway repeatedly, rapidly, and for extended periods is likely demonstrating ______, and the nurse should ______.
- A. a dystonic reaction"¦administer PRN IM benztropine (Cogentin)
- B. anxiety"¦ teach and guide the patient to use relaxation exercises
- C. akathisia"¦administer PRN diphenhydramine (Benadryl) PO
- D. tardive dyskinesia"¦recommend a change in medication
Correct Answer: C
Rationale: The correct answer is C: akathisia"¦administer PRN diphenhydramine (Benadryl) PO. Akathisia is characterized by restlessness and an inability to sit still. Administering diphenhydramine can help alleviate these symptoms. A is incorrect because dystonic reactions present with muscle spasms and abnormal postures, not restlessness. B is incorrect as anxiety does not typically manifest as physical restlessness. D is incorrect as tardive dyskinesia involves involuntary movements of the face and body, not restlessness.
A consumer at a rehabilitative psychosocial program says to the nurse, 'People are not cleaning up behind themselves in the bathrooms. The building is dirty and cluttered.' How should the nurse respond?
- A. Encourage the consumer to discuss it at a meeting with everyone
- B. Hire a professional cleaning service to clean the restrooms
- C. Address the complaint at the next staff meeting
- D. Tell the consumer, 'Thats not my problem'
Correct Answer: A
Rationale: Consumer-run programs range from informal clubhouses, which offer socialization and recreation, to competitive businesses, such as snack bars or janitorial services, which provide needed services and consumer employment while encouraging independence and building vocational skills. Consumers engage in problem solving under the leadership of staff.