Population Specific Care

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A male patient diagnosed with paranoid schizophrenia typically relates effectively with female staff but angrily tells the male nurse, 'You act like a homosexual. None of the men trust you or want to be around you.' The nurse, who is heterosexual, is perplexed by the patient's statements and discusses the event with his mentor. Which explanation most likely underlies the patient's behavior?

  • A. The patient was unleashing unconscious, hostile feelings toward the nurse.
  • B. The patient feared the nurse would reject him, so he coped by rejecting the nurse first.
  • C. It was the patient's way of distancing himself from potential emotional intimacy.
  • D. The patient was coping with homosexual urges by projecting them onto the nurse.
Correct Answer: D

Rationale: The correct answer is D because the patient is exhibiting the defense mechanism of projection by attributing his own uncomfortable feelings (homosexual urges) to the nurse. This defense mechanism allows the patient to disown his feelings and project them onto others. This behavior is common in individuals struggling with their own conflicting desires or impulses.

Incorrect choices:
A: Unconscious hostile feelings are not necessarily the root cause in this scenario.
B: The patient's behavior is not about preemptively rejecting the nurse due to fear of rejection.
C: While emotional intimacy may play a role, the patient's behavior is more about projection of his own feelings onto the nurse rather than distancing himself.

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The management of nausea as a side effect of lithium carbonate (Eskalith) includes instructing the patient to take the medication:

  • A. after meals
  • B. between meals
  • C. with a carbonated beverage
  • D. with a large glass of water
Correct Answer: A

Rationale: Taking lithium after meals reduces gastrointestinal irritation, including nausea, by buffering its absorption.

A client is admitted to a day hospital following an episode in which he purchased a gun to use while standing guard over his property to prevent a neighbor from erecting a boundary fence. His wife describes him as distrustful of the motives of others and often interpreting others' motives as threats. She mentions that one time he accused her of having an affair with a neighbor with whom she chatted occasionally. The care plan will list the priority outcome as 'Client will:

  • A. admit his action was excessive based on the circumstance.
  • B. write the neighbor a letter of apology.
  • C. demonstrate trust in the nurse.
  • D. identify positive role models.'
Correct Answer: C

Rationale: The correct answer is C: demonstrate trust in the nurse. This is the priority outcome because the client's lack of trust and tendency to perceive threats need to be addressed first. By demonstrating trust in the nurse, the client can begin to develop a therapeutic relationship, which is essential for addressing his distrustful behavior and interpreting threats. This outcome focuses on building rapport and establishing a foundation for therapeutic interventions.

Choice A is incorrect because admitting his action was excessive may not address the underlying issues of distrust and misinterpretation of motives. Choice B is incorrect as it does not address the client's core issues and may not be appropriate in this context. Choice D is also incorrect as identifying positive role models is not a priority when the client's trust and perception issues need immediate attention.

Male erectile disorder is always the result of psychological factors

  • A. TRUE
  • B. FALSE
Correct Answer: B

Rationale: Erectile disorder can stem from both psychological (e.g., anxiety) and physical (e.g., vascular) causes.

Which finding for a patient with an eating disorder most clearly indicates the need for hospitalization?

  • A. Weight 15% below ideal weight
  • B. Urine output less than 30 mL/hr
  • C. Serum potassium 3.4 mEq/L
  • D. Pulse rate 54 beats/min
Correct Answer: B

Rationale: The correct answer is B because urine output less than 30 mL/hr indicates severe dehydration and compromised kidney function, which can lead to organ failure. Hospitalization is necessary for immediate fluid resuscitation and monitoring. Option A is indicative of malnutrition but does not directly signify acute medical complications. Option C suggests hypokalemia, which can be managed on an outpatient basis. Option D, a low pulse rate, may be a sign of bradycardia but typically does not require immediate hospitalization unless accompanied by other severe symptoms.

A history reveals that a patient virtually stopped eating 5 months ago and lost 25% of body weight. The nurse says, "Describe what you think about your present weight and how you look." Which response would be most consistent with anorexia nervosa?

  • A. "I'm fat and ugly."
  • B. "What I think about myself is my business."
  • C. "I'm grossly underweight, but I cover it well."
  • D. "I'm a few pounds overweight, but I can live with it."
Correct Answer: A

Rationale: The correct answer is A because the response indicates a distorted body image, a common characteristic of anorexia nervosa. Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted perception of body image, leading individuals to see themselves as overweight despite being underweight. In this case, the patient's response of "I'm fat and ugly" demonstrates a negative perception of their weight and appearance, which aligns with the distorted body image seen in anorexia nervosa.

Choices B, C, and D are incorrect:
B: "What I think about myself is my business" - This response does not indicate a distorted body image or negative perception of weight and appearance, which are key features of anorexia nervosa.
C: "I'm grossly underweight, but I cover it well" - While this response acknowledges being underweight, it does not reflect the distorted body image commonly seen in anorexia nervosa.
D: "I'm a

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