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A patient diagnosed with schizophrenia approaches the nurse and says, 'Cats eat birds. East now. Job is new. You father.' This speech pattern can be assessed as:
- A. hyperverbosity.
- B. circumstantiality.
- C. loose associations.
- D. expressing delusions.
Correct Answer: C
Rationale: The correct answer is C: loose associations. This speech pattern is characteristic of loose associations seen in schizophrenia, where thoughts are disorganized and lack logical connections. The patient's statements lack coherence and jump from one topic to another without a clear link. Hyperverbosity (A) refers to excessive speech without a clear point, which is not evident in this scenario. Circumstantiality (B) involves excessive detail before reaching the main point, which is not present here. Expressing delusions (D) would involve holding false beliefs, which are not explicitly stated in the patient's speech.
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In planning aftercare for a client with schizophrenia and whose insurance benefits have been exhausted, the nurse who is concerned about overcoming negative symptoms will make provisions for the client to have stimulation, structure, socialization, and support. Which option would best incorporate these factors?
- A. Day hospitalization
- B. Attending a psychosocial club
- C. Living with his elderly mother
- D. Spending free time in the mall
Correct Answer: B
Rationale: The correct answer is B, attending a psychosocial club. This option best incorporates the factors of stimulation, structure, socialization, and support. Psychosocial clubs offer a structured environment with various activities to stimulate the client's mind and prevent social isolation. It provides opportunities for socialization and peer support, which are crucial for individuals with schizophrenia. Day hospitalization may offer structure but lacks the socialization aspect. Living with his elderly mother may provide support but not necessarily the stimulation and structure needed. Spending free time in the mall does not provide the structured environment, socialization, or support necessary for aftercare in schizophrenia.
The antisocial personality is one who
- A. is irresponsible and seems to lack remorse
- B. is frequently dangerous and out of contact with reality
- C. is always a delinquent or criminal
- D. benefits greatly from humanistic and psychoanalytic therapies
Correct Answer: A
Rationale: Antisocial personality features irresponsibility and lack of remorse, not necessarily overt danger.
An advance directive gives legally binding direction for health care interventions when a patient:
- A. has a new diagnosis of cancer
- B. is diagnosed with Parkinsons disease
- C. is unable to make decisions for self because of illness
- D. diagnosed with amyotrophic lateral sclerosis is unable to speak
Correct Answer: C
Rationale: Advance directives are invoked when patients are unable to make their own health care decisions. The correct response is the most global answer. A diagnosis of cancer or Parkinsons disease does not mean the patient is unable to make a decision. For a patient with amyotrophic lateral sclerosis, there are other ways to communicate beyond speaking.
Several children a day are seen in the emergency department for treatment of illnesses and injuries. The situation that would create a high index of suspicion of child abuse is a child who:
- A. Has repeated middle ear infections.
- B. Complains of abdominal cramps and upset stomach.
- C. Has perineal bruises and urinary tract infections.
- D. Displays reduced functioning at school.
Correct Answer: C
Rationale: The correct answer is C because perineal bruises and urinary tract infections are physical signs that are highly suspicious for child abuse, particularly sexual abuse. Perineal bruises are not commonly seen in children due to accidental injuries, and urinary tract infections in young children are rare and may indicate sexual abuse. Repeated middle ear infections (choice A) and complaints of abdominal cramps and upset stomach (choice B) are common childhood illnesses that do not necessarily indicate child abuse. Displaying reduced functioning at school (choice D) may suggest various issues such as learning disabilities or emotional distress, but is not specific to child abuse.
A nurse is working with a patient diagnosed with bulimia nervosa. Which of the following would indicate the need for further education?
- A. I know that purging is harmful to my health, but I continue to do it.
- B. I feel better after purging, but I realize it is not a long-term solution.
- C. I can control my eating and purging behaviors without help from others.
- D. I am working with my healthcare team to improve my eating habits and emotional health.
Correct Answer: C
Rationale: The correct answer is C because it indicates a lack of awareness about the severity of the disorder. Choice A acknowledges the harm of purging but struggles to stop, showing insight. Choice B recognizes the temporary relief of purging but understands the need for a better solution. Choice D demonstrates active engagement with healthcare professionals for support. In contrast, choice C suggests overconfidence in managing the disorder independently, which can hinder recovery progress. It is crucial for individuals with bulimia nervosa to acknowledge the need for professional help and support.