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A nurses neighbor says, 'My sister has been diagnosed with bipolar disorder but will not take her medication. I have tried to help her for over 20 years, but it seems like everything I do fails. Do you have any suggestions?' Select the nurses best response.
- A. The National Alliance on Mental Illness offers a family education series that you might find helpful.'
- B. Since your sister is noncompliant, perhaps its time for ber to be changed to injectable medication.'
- C. You have done all you can. Now its time to put yourself first and move on with your life.'
- D. You cannot help her. Would it be better for you to discontinue your relationship?'
Correct Answer: A
Rationale: The National Alliance on Mental Illness (NAMI) offers a family education series that assists with the stress caregivers and other family members often experience. The nurse should not give advice about injectable medication or encourage the family member to give up on the patient.
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Which of the following is an example of a peri-natal cause of intellectual disability when there is a significant period without oxygen occurring during or immediately after delivery?
- A. Anoxia
- B. Pronoxia
- C. Anaphylaxia
- D. Dysnoxia
Correct Answer: A
Rationale: Anoxia: A peri-natal cause of intellectual disability due to a significant period without oxygen during or after delivery.
When a patient with paranoid schizophrenia has a recurrence of positive symptoms after stopping his antipsychotic medication because of its postural hypotension (orthostasis) side effect, he is readmitted to the mental health unit. What measure should the nurse suggest to help the patient address this side effect?
- A. Ask the doctor to prescribe an anticholinergic drug like trihexyphenidyl (Artane).
- B. Chew sugarless gum or use sugarless hard candy to moisten your mouth.
- C. Increase the amount of sleep you get, and try to take frequent rest breaks.
- D. Wear elastic support hose, drink adequate fluids, and change position slowly.
Correct Answer: D
Rationale: The correct answer is D because orthostatic hypotension is a common side effect of antipsychotic medications. Elastic support hose can help improve venous return, adequate fluids can prevent dehydration which worsens hypotension, and changing position slowly can prevent sudden drops in blood pressure. This measure directly addresses the side effect.
A: Anticholinergic drugs can worsen orthostatic hypotension.
B: Chewing gum or using candy does not address the physiological issue of orthostatic hypotension.
C: Increasing sleep and rest breaks may help overall well-being but does not directly address orthostatic hypotension.
A patient with catatonic schizophrenia exhibits little spontaneous movement and demonstrates waxy flexibility. Which nursing intervention should receive the highest priority?
- A. Conducting passive range-of-motion exercises
- B. Exposing the patient to auditory and visual stimuli
- C. Interacting with the patient as if he is responding
- D. Including the patient in a variety of milieu activities
Correct Answer: A
Rationale: The correct answer is A: Conducting passive range-of-motion exercises. This intervention is the highest priority because it addresses the physical needs of the patient by preventing complications such as muscle stiffness and contractures due to prolonged immobility. Passive range-of-motion exercises also promote circulation and prevent pressure ulcers. Choice B is incorrect because excessive stimuli can overwhelm the patient. Choice C is incorrect as it assumes the patient is responding when they may not be. Choice D is incorrect as the patient may not be ready or able to participate in activities due to their catatonic state.
When are the recommended ages for developmental screening to be done according to AAP guidelines?
- A. 6 months, 12 months, and 18 months
- B. 6 months, 18 months, and 36 months
- C. 18 months, 24 months, and 36 months
- D. 9 months, 18 months, and 30 months
Correct Answer: D
Rationale: The American Academy of Pediatrics (AAP) recommends developmental screening at 9, 18, and 30 months during well-child visits to identify developmental delays early.
A nurse would evaluate that a family education plan for preventing childhood eating problems has met the stated objectives if which outcome is evident?
- A. Parents serve three meals per day plus midmorning, midafternoon, and bedtime snacks.
- B. Parents indicate an interest in learning about healthier eating patterns for their children.
- C. Parents use food to reward their children for only especially good behavior or outstanding achievements.
- D. Parents keep a diary to record both physical and psychological signs of hunger.
Correct Answer: B
Rationale: The correct answer is B because it demonstrates that parents are actively engaged and interested in learning about healthier eating patterns for their children, aligning with the objective of preventing childhood eating problems. This outcome indicates a willingness to make positive changes in the family's approach to nutrition.
A: While providing structured meal times and snacks is important, this choice does not necessarily reflect an understanding of healthier eating patterns or prevention of eating problems.
C: Using food as a reward can actually contribute to unhealthy eating habits and does not align with the goal of preventing childhood eating problems.
D: Keeping a diary to record signs of hunger is useful, but it does not directly address the objective of learning about healthier eating patterns.