Nokea
A normal person sees flashes of light while falling asleep. These are examples of
- A. Hypnopompic hallucinations
- B. Eidetic imagery
- C. Visual hallucinations
- D. Complex hallucinations
Correct Answer: C
Rationale: Flashes of light while falling asleep are hypnagogic visual hallucinations, a normal phenomenon, though 'visual hallucinations' is the closest match here.
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A nurse observes a patient who is sitting alone in a room put hands over both ears and vigorously shake her head as though saying, 'No.' Later the patient cries and mutters, 'You don't know what you're talking about! Leave me alone.' What assessment should the nurse attempt to validate?
- A. The patient is seeking the attention of staff.
- B. The patient is inappropriately expressing emotion.
- C. The patient is experiencing auditory hallucinations.
- D. The patient is displaying negative symptoms of schizophrenia.
Correct Answer: C
Rationale: The correct answer is C because the patient's behavior indicates a possible experience of auditory hallucinations. The patient covering both ears and shaking her head could be an attempt to block out voices or sounds she is hearing. The subsequent crying and muttering could be a response to these hallucinations.
Choice A is incorrect because the patient's behavior does not necessarily indicate a desire for attention. Choice B is incorrect because the patient's emotional expression is not the primary focus of the behavior. Choice D is incorrect because negative symptoms of schizophrenia typically involve a decrease in emotional expression or motivation, which is not evident in this scenario.
A homeless individual diagnosed with serious mental illness, anosognosia, and a history of persistent treatment nonadherence is persuaded to come to the day program at a community mental health center. Which intervention should be the teams initial focus?
- A. Teach appropriate health maintenance and prevention practices.
- B. Educate the patient about the importance of treatment adherence.
- C. Help the patient obtain employment in a local sheltered workshop.
- D. Interact regularly and supportively without trying to change the patient.
Correct Answer: D
Rationale: Building trust through regular, supportive interaction (D) is the initial focus to address nonadherence and anosognosia, forming a foundation for later interventions (A, B, C).
Which theme is most likely during family therapy with parents, siblings, and a teen patient with anorexia nervosa who engages in provocative behavior?
- A. Stable coalitions between family members
- B. Interpreting negative messages as positive
- C. Competition between the patient and father
- D. Lack of trust in the patient by family members
Correct Answer: C
Rationale: The correct answer is C: Competition between the patient and father. In family therapy with a teen patient with anorexia nervosa, the theme of competition between the patient and a parental figure, often the father, can be prominent. The rationale is that the father's influence and expectations can contribute to the teen's feelings of inadequacy and drive for control through anorexic behaviors. This dynamic can be explored and addressed in therapy to improve family relationships and support the patient's recovery.
A: Stable coalitions between family members - This is less likely as anorexia nervosa often disrupts family dynamics.
B: Interpreting negative messages as positive - While this can be a relevant theme, it is not as central to the specific scenario described.
D: Lack of trust in the patient by family members - While trust issues may exist, the theme of competition is more relevant in this context.
The wife of a client diagnosed with paranoid schizophrenia asks, 'I've been told that my husband's illness is probably related to imbalanced brain chemicals. Can you be more specific?' The response based on the dopamine hypothesis is:
- A. An increase in the brain chemical dopamine explains the presence of delusions and hallucinations.'
- B. An increase in the brain chemical dopamine explains the presence of lack of motivation and disordered affect.'
- C. Decreased amounts of the brain chemical dopamine explain the presence of delusions and hallucinations.'
- D. Breakdown of dopamine produces LSD, which in large amounts produces psychosis.'
Correct Answer: A
Rationale: Step-By-Step Rationale:
1. The dopamine hypothesis states that an increase in dopamine is linked to delusions and hallucinations in schizophrenia.
2. Delusions and hallucinations are common positive symptoms of schizophrenia.
3. Therefore, choice A is correct as it directly aligns with the dopamine hypothesis and the symptoms observed in paranoid schizophrenia.
Summary of Incorrect Choices:
B. Incorrect because an increase in dopamine is not typically associated with lack of motivation and disordered affect in schizophrenia.
C. Incorrect because decreased amounts of dopamine are not linked to delusions and hallucinations in schizophrenia.
D. Incorrect because the breakdown of dopamine producing LSD and causing psychosis is not supported by the dopamine hypothesis in schizophrenia.
A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self. Select the best outcome related to this diagnosis. Within 2 weeks, the patient will:
- A. appropriately express angry feelings.
- B. verbalize two positive things about self.
- C. verbalize the importance of eating a balanced diet.
- D. identify two alternative methods of coping with loneliness and isolation.
Correct Answer: D
Rationale: The correct answer is D because it directly addresses the nursing diagnosis of ineffective coping related to feelings of loneliness and isolation. By identifying two alternative methods of coping, the patient can develop healthier strategies to manage these emotions instead of resorting to overeating and vomiting. This outcome promotes long-term behavioral change and helps the patient build resilience.
Choice A is incorrect because expressing angry feelings may not necessarily address the underlying issues of loneliness and isolation. Choice B is incorrect as verbalizing positive things about oneself may be beneficial but does not directly address coping mechanisms for loneliness and isolation. Choice C is also incorrect because understanding the importance of a balanced diet does not directly address coping strategies for managing emotions like loneliness and isolation.