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A nurse is providing education to a patient with anorexia nervosa. Which of the following statements indicates a need for further education?
- A. I understand that my body needs food to function properly.
- B. I am willing to work on gaining weight with the help of my care team.
- C. I believe that eating food will make me fat and out of control.
- D. I am ready to learn how to improve my relationship with food.
Correct Answer: C
Rationale: The correct answer is C because the statement reflects a common misconception associated with anorexia nervosa, indicating a need for further education. Here's the rationale:
1. Anorexia nervosa involves a distorted body image and fear of gaining weight.
2. Believing that eating food will make one fat and out of control aligns with these distorted beliefs.
3. This statement demonstrates a lack of understanding and acceptance of the importance of proper nutrition for health.
4. Choices A, B, and D show positive attitudes towards recovery and willingness to address the disorder, highlighting a better understanding of the condition.
In summary, choice C shows a need for further education due to the presence of distorted beliefs, while the other options reflect a more positive and informed mindset towards recovery.
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A 25-year-old individual was brought by ambulance to the emergency room. The patient's sensorium alternates between clouded and clear, and the patient becomes agitated both physically and verbally when approached. The patient's roommate states that the patient "was fine after getting up this morning but started talking crazy about 3 hours ago."Â The patient's cognitive impairment is most consistent with:
- A. delirium.
- B. dementia.
- C. sundown syndrome.
- D. early-onset Alzheimer disease.
Correct Answer: A
Rationale: The correct answer is A: delirium. Delirium is an acute change in mental status characterized by fluctuating levels of consciousness, inattention, disorganized thinking, and altered perception. In this case, the patient's clouded and clear sensorium, agitation, and recent onset of symptoms are indicative of delirium.
Choice B: dementia, is incorrect because dementia is a chronic, progressive decline in cognitive function that does not typically present with acute changes in mental status.
Choice C: sundown syndrome, is incorrect as it refers to a pattern of worsening confusion or agitation in the late afternoon or evening, not necessarily characterized by acute onset and fluctuating levels of consciousness.
Choice D: early-onset Alzheimer disease, is incorrect because Alzheimer's disease is a specific type of dementia that does not typically present with the acute and fluctuating symptoms described in the scenario.
The physician prescribes haloperidol (Haldol), a first-generation antipsychotic drug, for a patient with schizophrenia who displays delusions, hallucinations, apathy, and social isolation. Which symptoms should most be monitored to evaluate the expected improvement from this medication?
- A. Talking to himself, belief that others will harm him
- B. Flat affect, avoidance of social activities, poor hygiene
- C. Loss of interest in recreational activities, alogia
- D. Impaired eye contact, needs help to complete tasks
Correct Answer: A
Rationale: The correct answer is A because haloperidol is primarily used to target positive symptoms of schizophrenia such as delusions and hallucinations. Monitoring improvements in symptoms like talking to himself and belief that others will harm him will indicate the effectiveness of the medication. Choices B, C, and D are incorrect because they focus on negative symptoms or general social withdrawal, which are less likely to show significant improvement with haloperidol, a first-generation antipsychotic drug that is more effective for positive symptoms. Monitoring these symptoms may not directly reflect the medication's effectiveness in treating the primary symptoms of schizophrenia in this case.
A rape victim tells the emergency room nurse, "I feel so dirty. Help me take a shower before the doctor examines me."Â The nurse should:
- A. Arrange for the patient to shower.
- B. Explain that bathing would destroy evidence.
- C. Give the patient a basin of water and towels.
- D. Explain that bathing facilities are not available in the emergency department.
Correct Answer: B
Rationale: The correct answer is B: Explain that bathing would destroy evidence. This is the correct choice because bathing can potentially wash away crucial forensic evidence that can be collected during a sexual assault examination. Preserving evidence is essential for legal proceedings and ensuring justice for the victim.
Choice A is incorrect because arranging for the patient to shower would destroy evidence. Choice C is incorrect as giving the patient a basin of water and towels would still risk destroying evidence. Choice D is also incorrect as it does not address the importance of preserving evidence in cases of sexual assault.
A patient with bipolar disorder has rapid cycles. To prepare teaching materials, the nurse anticipates which medication will be prescribed?
- A. Clonidine (Catapres)
- B. Phenytoin (Dilantin)
- C. Carbamazepine (Tegretol)
- D. Chlorpromazine (Thorazine)
Correct Answer: C
Rationale: Rationale: Carbamazepine (Tegretol) is commonly used in treating rapid cycling bipolar disorder due to its mood stabilizing properties. It helps regulate mood swings and prevent manic or depressive episodes. It is effective in managing rapid cycling symptoms. Clonidine (A) is used for ADHD and hypertension, not bipolar disorder. Phenytoin (B) is an anticonvulsant, not typically used for bipolar disorder. Chlorpromazine (D) is an antipsychotic mainly for schizophrenia, not specifically indicated for rapid cycling in bipolar disorder.
A women who is 16 weeks pregnant presents with symptoms suggestive of a urinary tract infection. Which one of the following is correct?
- A. She should be assured that urinary tract infections are common in pregnancy and require no treatment.
- B. A midstream urine should be collected and the bacteriology report awaited.
- C. A midstream urine should be collected and a wide spectrum antibiotic prescribed.
- D. A self-retaining catheter should be introduced to promote free drainage of urine.
Correct Answer: C
Rationale: In pregnancy, UTIs require prompt treatment due to risks like pyelonephritis. Collecting a midstream urine and starting a broad-spectrum antibiotic (C) is standard, pending culture results. Ignoring treatment (A), waiting without antibiotics (B), or invasive measures (D, E) are inappropriate.