Nokea
A patient asks, 'What advantage does a durable power of attorney for health care have over a living will?' The nurse should reply, 'A durable power of attorney for health care:
- A. gives your agent authority to make decisions during any illness if you are incapacitated
- B. can be given only to a relative, usually the next of kin, who has your best interests at heart
- C. can be used only if you have a terminal illness and become incapacitated
- D. cannot be implemented until 30 days after the documents are signed
Correct Answer: A
Rationale: A durable power of attorney for health care is an instrument that appoints a person other than a health care provider to act as an individuals agent in the event that he or she is unable to make medical decisions. No waiting period is required for it to become effective, and the individual does not have to be terminally ill or incompetent for the person appointed to act on the individuals behalf.
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When a patient diagnosed with paranoid schizophrenia was discharged from the unit 6 months ago, the plan was for him to take chlorpromazine (Thorazine), a conventional (first generation) antipsychotic medication, 300 mg po daily. He tells the nurse he stopped taking his pills after a few months because they made him feel like a 'zombie.' What other common side effects should the nurse determine if the patient experienced?
- A. Sweating, nausea, and weight gain
- B. Sedation, tremor, and muscle stiffness
- C. Headache, watery eyes, and runny nose
- D. Mild fever, sore throat, and skin rash
Correct Answer: B
Rationale: The correct answer is B: Sedation, tremor, and muscle stiffness. These side effects are commonly associated with conventional antipsychotic medications like chlorpromazine. Sedation is a common side effect that can make the patient feel drowsy or sluggish. Tremors are involuntary muscle movements that can affect the hands, arms, or legs. Muscle stiffness can cause rigidity and difficulty moving smoothly. These side effects are known to impact the quality of life and may contribute to the patient feeling like a 'zombie.'
Choices A, C, and D are incorrect because they do not align with the common side effects of conventional antipsychotic medications. Sweating, nausea, and weight gain (Choice A) are not typical side effects of chlorpromazine. Headache, watery eyes, and runny nose (Choice C) are more commonly associated with allergies or cold symptoms rather than antipsychotic medications. Mild fever, sore throat, and skin rash (Choice D)
False beliefs that are held even when the facts contradict them are called
- A. fantasies
- B. hallucinations
- C. illusions
- D. delusions
Correct Answer: D
Rationale: Delusions are fixed false beliefs resistant to contradictory evidence, unlike hallucinations (perceptions).
Which aspect of assessment has priority when a nurse interviews a rape victim?
- A. Coping mechanisms the patient is using
- B. The patient's previous sexual experiences
- C. Adequacy of the patient's interpersonal relationships
- D. Whether the patient has ever had a sexually transmitted disease
Correct Answer: A
Rationale: The correct answer is A: Coping mechanisms the patient is using. This aspect has priority because it helps the nurse assess the immediate emotional and psychological impact of the trauma on the victim. Understanding coping mechanisms can guide the nurse in providing appropriate support and interventions. Choice B is incorrect as past sexual experiences are not as pertinent during the immediate assessment of a rape victim. Choice C is incorrect as assessing interpersonal relationships may not be a priority during the initial interview. Choice D is incorrect as the presence of a sexually transmitted disease is not the primary concern when assessing a rape victim.
A nurse conducts group therapy on the eating disorders unit. Sessions are scheduled immediately after meals. What is the rationale?
- A. Provide a forum for journaling about foods eaten.
- B. Shift the patients' focus from food to psychotherapy.
- C. Promote processing of anxiety associated with eating.
- D. Focus on weight control mechanisms and food preparation.
Correct Answer: C
Rationale: The correct answer is C because scheduling group therapy sessions immediately after meals can help promote processing of anxiety associated with eating. This timing allows patients to address their feelings and thoughts about food in a supportive environment, leading to better understanding and management of their anxieties. Choice A is incorrect because journaling about foods eaten is not the primary purpose of group therapy sessions. Choice B is incorrect as the main focus is on addressing anxiety related to eating disorders, not shifting focus to psychotherapy. Choice D is incorrect as weight control mechanisms and food preparation are not the main objectives of group therapy for eating disorders.
The most severe psychological disorder is a(n)
- A. personality disorder
- B. psychosomatic illness
- C. anxiety disorder
- D. psychosis
Correct Answer: D
Rationale: Psychosis, involving severe reality distortion, is considered the most debilitating class of disorders.