Nokea
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. None of the above.
Correct Answer: D
Rationale: Rationale:
1. Patient's diagnosis indicates coping issues, not anger expression or self-esteem.
2. Patient's coping mechanism involves overeating and vomiting, not diet.
3. Outcome should focus on coping skills improvement, not unrelated goals.
4. None of the choices address the root issue of coping with loneliness and isolation.
5. Thus, the correct answer is D, as none of the options directly address the patient's ineffective coping mechanism.
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Disability is:
- A. More common in low-income region of the world
- B. Found in 16% or 1.3 billion people worldwide
- C. More common in males
- D. Not inclusive of mental health conditions
Correct Answer: B
Rationale: WHO estimates disability affects 16% of the global population (1.3 billion), including mental health conditions.
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). The patient's symptoms align with NMS, a rare but serious side effect of antipsychotic medications like risperidone. The severe muscle stiffness, difficulty swallowing, altered mental status, diaphoresis, and elevated temperature, pulse, and blood pressure are all indicative of NMS. The nurse should suspect NMS and take immediate action by placing the patient in a cooling blanket to lower the temperature and transfer him to the ICU for close monitoring and further management.
Choice B is incorrect because anticholinergic toxicity typically presents with different symptoms such as dry mouth, dilated pupils, and confusion. Choice C is incorrect as there are no signs of a psychotic relapse, and administering more antipsychotic medication could worsen the NMS. Choice D is incorrect as agranulocytosis presents with symptoms like fever and sore throat, not the combination of symptoms seen in this case.
The severe feeling of restlessness produced by some psychotropic medications, which is often misinterpreted by patients as anxiety or a recurrence of psychiatric symptoms, is known as:
- A. akathisia
- B. akinesia
- C. bradykinesia
- D. dystonia
Correct Answer: A
Rationale: Akathisia is a common side effect of antipsychotics, characterized by restlessness often mistaken for worsening psychiatric symptoms.
The caregiver for a client with moderate to severe dementia tells the nurse, 'I'm exhausted. He wanders at night instead of sleeping, so I get no rest. I'm afraid to leave him during the day, so I have to take him to the grocery store and to the laundromat. When I'm busy there, he often wanders off. Still, I have to do it all.' The nurse recognizes the need to provide teaching for this caregiver. An appropriate outcome is that the caregiver will:
- A. Feel justified in putting the client in a nursing home
- B. Verbalize realistic self-expectations
- C. Cease abusive interactions with the client
- D. Feel comfortable leaving the client alone one morning a week
Correct Answer: B
Rationale: The correct answer is B: Verbalize realistic self-expectations. This is the most appropriate outcome to address the caregiver's situation. By verbalizing realistic self-expectations, the caregiver can understand the importance of self-care and setting boundaries. This outcome promotes the caregiver's well-being while still providing care for the client.
Choice A is incorrect because putting the client in a nursing home may not be the best solution without exploring other options first. Choice C is incorrect as there is no mention of abusive interactions in the scenario. Choice D is incorrect because feeling comfortable leaving the client alone without addressing the caregiver's exhaustion and concerns may not be the most appropriate approach.
A 45-year-old patient shows marked cognitive impairment that has developed progressively over several months. A family member reports that the patient's father also had early-onset dementia. What research-based information can be given to the family in response to their concerns about the patient developing early-onset dementia?
- A. The risk for developing the condition is about 50% only if both parents were affected.
- B. The greatest risk exists for relatives of individuals diagnosed with Alzheimer disease before age 55 years.
- C. Added risk is present only for people with Down syndrome, so relatives without Down syndrome are essentially "safe."Â
- D. Results of the research on genetic predisposition and its effect on the development of early-onset dementia are still unclear.
Correct Answer: B
Rationale: The correct answer is B because individuals with a family history of early-onset dementia, particularly Alzheimer's disease before age 55, are at a higher risk of developing the condition themselves. This is supported by research showing a strong genetic component in the development of early-onset dementia. Choice A is incorrect because the risk is not solely dependent on both parents being affected. Choice C is incorrect as early-onset dementia is not limited to individuals with Down syndrome. Choice D is incorrect because research has shown a clear link between genetic predisposition and early-onset dementia.