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A patient diagnosed with schizophrenia has difficulty completing tasks and seems forgetful and disinterested in unit activities. A nurse can best select successful strategies by understanding that these behaviors are due to:
- A. a lack of self-esteem.
- B. manipulative tendencies.
- C. shyness and embarrassment.
- D. problems in cognitive functioning.
Correct Answer: D
Rationale: The correct answer is D: problems in cognitive functioning. In schizophrenia, cognitive deficits are common, leading to difficulties in completing tasks, forgetfulness, and lack of interest. Understanding this helps the nurse select appropriate strategies, such as breaking tasks into smaller steps. Choice A (lack of self-esteem) is incorrect as cognitive deficits in schizophrenia are not solely related to self-esteem. Choice B (manipulative tendencies) is incorrect as these behaviors are not indicative of manipulation. Choice C (shyness and embarrassment) is incorrect as cognitive deficits in schizophrenia go beyond social anxiety.
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Which nursing intervention should be included in the care plan for a patient with anorexia nervosa who is at risk for refeeding syndrome?
- A. Refeed with high-calorie foods initially.
- B. Monitor serum electrolytes closely after refeeding begins.
- C. Increase fluid intake gradually over several days.
- D. Encourage early ambulation to prevent complications.
Correct Answer: B
Rationale: The correct answer is B: Monitor serum electrolytes closely after refeeding begins. Refeeding syndrome can occur in patients with anorexia nervosa when there is a rapid shift in electrolytes and fluid levels. Monitoring serum electrolytes closely after refeeding begins allows for early detection of any imbalances and prompt intervention. This helps prevent serious complications such as cardiac arrhythmias or neurological issues.
Choice A is incorrect because refeeding with high-calorie foods initially can exacerbate the risk of refeeding syndrome due to rapid changes in electrolyte levels. Choice C is incorrect as increasing fluid intake gradually may not directly address electrolyte imbalances. Choice D is incorrect as encouraging early ambulation is not directly related to preventing refeeding syndrome.
A patient with schizophrenia has been stabilized in the Crisis Center and is about to be discharged. He will be living with his family, but the family knows nothing about the patient's illness, its treatment, or the role they can play in his recovery. Which activity would be most beneficial for the family to attend?
- A. Psychoanalytic group
- B. Psychoeducational group
- C. Individual counseling
- D. Family therapy
Correct Answer: B
Rationale: The correct answer is B: Psychoeducational group. This option is most beneficial as it provides education and information to the family about the patient's illness, treatment options, and ways they can support his recovery. It helps them understand the challenges the patient faces and equips them with practical strategies to assist in his recovery process.
A: Psychoanalytic group focuses on exploring unconscious patterns of behavior and may not provide the necessary education and tools for the family to support the patient effectively.
C: Individual counseling is focused on the patient and may not involve the family members in understanding the illness and their role in the patient's recovery.
D: Family therapy involves the whole family in therapy sessions, but may not specifically focus on educating them about schizophrenia and its treatment, which is crucial for their support.
A normal person sees flashes of light while falling asleep. These are examples of
- A. Hypnopompic hallucinations
- B. Eidetic imagery
- C. Visual hallucinations
- D. Complex hallucinations
Correct Answer: C
Rationale: Flashes of light while falling asleep are hypnagogic visual hallucinations, a normal phenomenon, though 'visual hallucinations' is the closest match here.
A patient with schizophrenia repeatedly asks for directions and the time of day. The nurse should:
- A. repeat the information in a kind, matter-of-fact manner.
- B. write out the information so the patient can easily refer to it.
- C. tell the patient that the habit of frequent questioning is annoying.
- D. provide the information once and then remind the patient that the question was already asked.
Correct Answer: A
Rationale: The correct answer is A because patients with schizophrenia may have cognitive impairments affecting memory and orientation, leading to repetitive questioning. By repeating information in a kind, matter-of-fact manner, the nurse can address the patient's needs without causing distress.
Choice B may be helpful, but verbal reinforcement is essential for immediate clarification. Choice C is incorrect as it may exacerbate the patient's distress and worsen the therapeutic relationship. Choice D does not address the underlying cognitive issue and may come across as dismissive.
What is the priority nursing intervention for a patient with bulimia nervosa who is engaging in purging behaviors?
- A. Monitor electrolyte levels and cardiac function.
- B. Encourage self-monitoring of food intake.
- C. Provide emotional support and promote body image acceptance.
- D. Focus on encouraging weight loss through diet control.
Correct Answer: A
Rationale: The correct answer is A. The priority nursing intervention for a patient with bulimia nervosa engaging in purging behaviors is to monitor electrolyte levels and cardiac function. This is crucial due to the potential electrolyte imbalances and cardiac complications resulting from purging behaviors. Monitoring these parameters helps prevent life-threatening conditions such as hypokalemia and arrhythmias.
Option B is incorrect as self-monitoring of food intake may not address the immediate health risks associated with purging behaviors. Option C is also incorrect as emotional support and body image acceptance are important but not the immediate priority in this case. Option D is incorrect as focusing on weight loss through diet control can exacerbate the patient's eating disorder behaviors and does not address the urgent medical concerns associated with purging.