Nokea
A nurse is educating a patient with anorexia nervosa about nutrition. What should the nurse focus on?
- A. Encouraging rapid weight gain through a high-calorie diet.
- B. Promoting gradual weight gain and nutritional rehabilitation.
- C. Providing a low-calorie diet to maintain a healthy weight.
- D. Focusing on weight maintenance without discussing food intake.
Correct Answer: B
Rationale: The correct answer is B because promoting gradual weight gain and nutritional rehabilitation is essential in treating anorexia nervosa. Rapid weight gain can lead to medical complications and mental distress. Providing a low-calorie diet (C) contradicts the goal of weight gain. Focusing on weight maintenance without discussing food intake (D) neglects the importance of nutrition in recovery.
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A patient receiving risperidone (Risperdal) reports severe muscle stiffness midmorning. During lunch he has difficulty swallowing food and speaking, and when vital signs are taken 30 minutes later, he is noted to be stuporous and diaphoretic, with a temperature of 38.8° C, pulse of 110 beats/min, and blood pressure of 150/90 mm Hg. The nurse should suspect _____ and should _____.
- A. neuroleptic malignant syndrome"¦place him in a cooling blanket and transfer to ICU
- B. anticholinergic toxicity"¦check vital signs and prepare to use a cooling blanket stat
- C. relapse of his psychosis"¦administer PRN antipsychotic drugs and notify his physician
- D. agranulocytosis"¦hold his antipsychotic and draw blood for a complete blood count
Correct Answer: A
Rationale: The correct answer is A: neuroleptic malignant syndrome (NMS). NMS is a rare but serious adverse reaction to antipsychotic medications like risperidone. The patient's symptoms of severe muscle stiffness, difficulty swallowing, altered mental status, diaphoresis, and elevated temperature, pulse, and blood pressure are all consistent with NMS. The nurse should suspect NMS due to the constellation of symptoms and vital sign changes. Placing the patient in a cooling blanket and transferring to the ICU is appropriate as NMS is a medical emergency requiring prompt intervention to lower the body temperature and provide supportive care.
Choices B, C, and D are incorrect:
B: Anticholinergic toxicity does not typically present with the specific symptoms described, such as muscle stiffness and stupor.
C: Relapse of psychosis would not explain the acute onset of symptoms and vital sign changes seen in the scenario.
D: Agranulocytosis is a rare side effect of some ant
A patient is hospitalized for severe depression. Of the medications listed below, the nurse can expect to provide the patient with teaching about:
- A. Chlordiazepoxide (Librium).
- B. Clozapine (Clozaril).
- C. Sertraline (Zoloft).
- D. Tacrine (Cognex).
Correct Answer: C
Rationale: Rationale:
1. Severe depression is typically treated with antidepressants like Sertraline (Zoloft).
2. Sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression.
3. The nurse should provide teaching on how to take the medication, potential side effects, and monitoring for effectiveness.
4. Other choices (A, B, D) are not typically used as first-line treatment for severe depression and may not be appropriate for this patient.
Which measure is advisable to take, considering that individuals with dramatic erratic personality disorders often have the ability to evade limits and manipulate others?
- A. Plan frequent client-centered staff meetings.
- B. Practice take-down and restraint procedures.
- C. Institute written or taped change-of-shift reports.
- D. Rotate staff assignments so no one is responsible for the client for a prolonged period of days.
Correct Answer: A
Rationale: The correct answer is A: Plan frequent client-centered staff meetings. This measure is advisable as it promotes open communication, collaboration, and consistency in care. By holding regular meetings, staff can discuss concerns, share observations, and develop strategies to effectively manage individuals with erratic personality disorders. This approach helps in setting clear boundaries, identifying manipulative behaviors, and ensuring a unified team response.
Summary:
- Choice B: Practice take-down and restraint procedures is incorrect as it focuses on physical control rather than preventive strategies.
- Choice C: Institute written or taped change-of-shift reports is incorrect as it lacks real-time communication and immediate response to potential issues.
- Choice D: Rotate staff assignments so no one is responsible for the client for a prolonged period of days is incorrect as it may disrupt continuity of care and hinder the establishment of trust and rapport.
The nurse is evaluating a patient with bulimia nervosa. The most appropriate action is to:
- A. Assign a strict dietary plan to prevent weight gain.
- B. Monitor the patient for physical symptoms of starvation.
- C. Encourage the patient to avoid purging after meals.
- D. Provide emotional support without focusing on food-related behaviors.
Correct Answer: C
Rationale: The correct answer is C: Encourage the patient to avoid purging after meals. This is the most appropriate action because it addresses the harmful purging behavior associated with bulimia nervosa. By encouraging the patient to avoid purging, the nurse can help prevent serious health consequences such as electrolyte imbalances and damage to the esophagus.
Option A is incorrect because assigning a strict dietary plan may exacerbate the patient's unhealthy relationship with food and contribute to feelings of guilt and shame. Option B is incorrect as monitoring for physical symptoms of starvation may not directly address the underlying issue of purging behavior. Option D is also incorrect as providing emotional support alone may not effectively address the harmful purging behavior.
Fragile X syndrome is associated with which of the following?
- A. Language impairment
- B. Behavioural problems
- C. Moderate levels of intellectual disability
- D. All of the above
Correct Answer: D
Rationale: Fragile X Syndrome: A chromosomal abnormality causing intellectual disability, language impairment, and behavioral issues.