Nokea
A much-feared outcome of Alzheimer's disease is
- A. functional psychosis
- B. paranoia
- C. general paresis
- D. senile dementia
Correct Answer: D
Rationale: Senile dementia is a progressive cognitive decline feared in Alzheimer's, impairing memory and daily functioning.
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Police bring a 63-year-old woman to the emergency room, reporting that her behavior is disorganized and disruptive, that her speech makes little sense, and that she does not seem able to take care of herself. The woman has had elective surgeries at the hospital previously and was seen in the ER last week after a fall; records show no history of similar symptoms or mental illness. The ER physician speaks with the patient but does not examine her medically, diagnoses her with schizophrenia, and orders admission to the inpatient psychiatric unit. Which response by the nurse would be most appropriate?
- A. Ask another physician with more of an interest in psychiatry to also take a look at this patient, explaining that you just want to be as thorough as possible.
- B. Suggest that a psychiatric consult be requested before admitting the patient to a psychiatric unit, to validate the diagnosis and speed the initiation of medication.
- C. Remind the physician that schizophrenia usually develops earlier in life, that such presentations may be caused by medical problems, and suggest a medical work-up.
- D. Note that the patient's blood pressure and respirations were elevated when she arrived, and suggest that they be evaluated before admitting the patient to the psychiatric unit.
Correct Answer: C
Rationale: The correct answer is C because it demonstrates critical thinking and patient advocacy. By reminding the physician that schizophrenia typically develops earlier in life and suggesting a medical work-up, the nurse is advocating for a comprehensive approach to ruling out potential medical causes for the patient's symptoms before jumping to a psychiatric diagnosis. This approach aligns with best practices in patient care and ensures that all possible underlying causes are considered and addressed appropriately.
Choice A is incorrect because it does not address the need for a medical work-up to rule out physical causes of the symptoms. Choice B is incorrect as it focuses on validating the diagnosis and initiating medication rather than investigating potential medical issues. Choice D is incorrect as it only addresses the patient's vital signs, overlooking the need for a thorough medical evaluation.
A patient with fluctuating levels of awareness, confusion, and disorientation shouts, 'The bugs, they are crawling on my legs! Get them off me!' The nurse's inspections show that no bugs are present. The nurse can best assess this presentation as:
- A. Perseveration.
- B. Hypermetamorphosis.
- C. Tactile hallucinations.
- D. None of the above.
Correct Answer: C
Rationale: The correct answer is C: Tactile hallucinations. Tactile hallucinations involve the perception of physical sensations such as bugs crawling on the skin when no external stimuli are present. In this scenario, the patient's complaint of bugs crawling on their legs despite the nurse's inspection confirming the absence of bugs indicates a sensory hallucination, specifically a tactile one. This is different from perseveration (repetition of a particular response or activity) and hypermetamorphosis (excessive attention to environmental details). Choosing "None of the above" would not address the specific symptom of tactile hallucinations described in the patient's presentation.
A nurse is caring for a patient with bulimia nervosa. The nurse should monitor for which of the following complications?
- A. Nutritional deficiency and dehydration.
- B. Respiratory failure and aspiration pneumonia.
- C. Peripheral edema and hyperkalemia.
- D. Mental confusion and decreased blood pressure.
Correct Answer: A
Rationale: The correct answer is A: Nutritional deficiency and dehydration. In bulimia nervosa, recurrent episodes of binge eating followed by purging can lead to electrolyte imbalances, dehydration, and malnutrition. Monitoring for nutritional deficiencies and dehydration is crucial in managing patients with bulimia nervosa.
Explanation for why other choices are incorrect:
B: Respiratory failure and aspiration pneumonia - Although purging behaviors can increase the risk of aspiration pneumonia, it is not as common as nutritional deficiencies and dehydration in patients with bulimia nervosa.
C: Peripheral edema and hyperkalemia - These complications are not typically associated with bulimia nervosa.
D: Mental confusion and decreased blood pressure - While electrolyte imbalances can lead to mental confusion, these specific complications are not as common as nutritional deficiencies and dehydration in patients with bulimia nervosa.
Which service would be expected to provide resources 24 hours a day, 7 days a week if needed for persons with serious mental illness?
- A. Clubhouse model
- B. Cognitive Behavioral Therapy (CBT)
- C. Assertive Community Treatment (ACT)
- D. Cognitive Enhancement Therapy (CET)
Correct Answer: C
Rationale: Assertive Community Treatment (ACT) (C) offers 24/7 multidisciplinary support in the patient's environment, unlike the Clubhouse model (A), CBT (B), or CET (D), which lack such availability.
Psychological dependence on mood- or behavior-altering drugs is known as
- A. drug psychosis
- B. a substance related disorder
- C. an orthopsychosis
- D. a psychotropic disorder
Correct Answer: B
Rationale: Substance-related disorders encompass psychological dependence on drugs altering mood or behavior.