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A nurse administers ordered preoperative glycopyrrolate (Robinul) 30 minutes prior to a client’s electroconvulsive therapy (ECT) procedure. What is the rationale for administering this medication?
- A. Robinul decreases anxiety during the ECT procedure.
- B. Robinul induces an unconscious state to prevent pain during the ECT procedure
- C. Robinul prevents severe muscle contractions during the ECT procedure.
- D. Robinul decreases secretions to prevent aspiration during the ECT procedure.
Correct Answer: D
Rationale: Glycopyrrolate is an anticholinergic that reduces salivation and other secretions, which helps to prevent aspiration during ECT, where muscle relaxants are used.
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A novice mental health nurse shares that, “I’ll never get used to playing cards or other games with patients. It seems like a poor use of scarce nursing time.” The best response for the nurse’s mentor would be:
- A. “Perhaps you’ll want to rethink your transfer to this unit if you’re really uncomfortable.”
- B. “Your comments make a point about scarce resources. I’ll ask the treatment team to review our position on activities.”
- C. “Activity co-leadership puts us in a position to help patients develop social skills and support them as they take small risks.”
- D. “Managed care has cost us activities therapists. Activities are
Correct Answer: C
Rationale: The best response for the nurse’s mentor would be to highlight the importance of activities in mental health nursing. Participating in activities such as playing cards or games with patients is not just about passing time, but it also serves a therapeutic purpose. Engaging in activities helps patients to develop social skills, build relationships, and take small risks in a safe environment. As mental health nurses, it is crucial to understand that these activities are not a waste of time but rather an essential part of the therapeutic process. By participating in activities with patients, nurses can actively support their mental well-being and contribute to their overall treatment and recovery.
The treatment team was engaged in planning how group therapy could be included as a part of the structured daily activities of the unit. A new team member asked, “Why is it so important to include group therapy for the patients?” The most accurate response would be based on the assumption that:
- A. Hidden agendas frequently surface in group sessions.
- B. Some persons do not relate well on an individual therapy
- C. Psychopathology has its source in disordered relationships.
- D. Group therapy is far more cost effective for the patients.
Correct Answer: D
Rationale: Group therapy is important because psychopathology often has its roots in disordered relationships. Many mental health issues are influenced by one's interactions with others, whether it be issues with communication, trust, boundaries, or other relational dynamics. Group therapy provides a structured environment where patients can explore and work through these relational difficulties with the support and feedback of peers. By addressing these relational patterns in a group setting, patients can gain insight into their behavior and develop healthier ways of relating to others. This can be a valuable component of their overall treatment plan and can help facilitate lasting change and growth.
Which complaint is representative of anxiety in a 6-year-old child?
- A. I worry that my dad will get hurt at work.
- B. I get a stomach ache when it's my weekend at my dad's house.
- C. I can't sleep when I stay at Grandma's because I worry about my mom.
- D. I'm not going to sports camp because I don't like being away from my friends.
Correct Answer: B
Rationale: Children often express anxiety through physical complaints like stomachaches, especially in situations that cause distress or discomfort, such as visiting a noncustodial parent.
Which older adult patient’s medical conditions support the hypothesis upon which the immunologic theory of aging is based?
- A. Has, at age 64, been diagnosed with type 2 diabete
- B. Has been treated for multiple sclerosis since age 30.
- C. Is managing a 36-year history of chronic Graves’ disease.
- D. Has begun to experience symptoms of rheumatoid arthritis.
Correct Answer: B, C
Rationale: he immunologic theory of aging suggests that aging is associated with increased autoimmunity. Conditions like multiple sclerosis, rheumatoid arthritis, and Graves’ disease reflect immune dysfunction.
Which person has the greatest potential for developing dysfunctional grief?
- A. A teen who has always been one of the ‘popular kids’
- B. A widow who regularly states, “I really loved my deceased wife”
- C. A woman whose husband died as a result of a sudden, traumatic injury
- D. An adult who has dealt with the loss of several family members over the
Correct Answer: D
Rationale: The person with the greatest potential for developing dysfunctional grief is an adult who has dealt with the loss of several family members over their lifetime. Losing multiple family members can create a cumulative effect, leading to unresolved grief and complicated bereavement reactions. These repeated losses can overwhelm an individual's coping mechanisms and increase the risk of developing dysfunctional grief patterns. The ongoing experience of loss and grief can make it challenging for the individual to process their emotions effectively and adjust to their new reality, potentially leading to prolonged and complicated mourning.