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A patient diagnosed with schizophrenia tells the community mental health nurse, 'I threw away my pills because they interfere with Gods voice.' The nurse identifies the etiology of the patients ineffective management of the medication regime as:
- A. inadequate discharge planning
- B. poor therapeutic alliance with clinicians
- C. dislike of antipsychotic medication side effects
- D. impaired reasoning secondary to the schizophrenia
Correct Answer: D
Rationale: The patients ineffective management of the medication regime is most closely related to impaired reasoning. The patient believes in being an exalted personage who hears Gods voice, rather than an individual with a serious mental disorder who needs medication to control symptoms. Data do not suggest any of the other factors often related to medication nonadherence.
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A woman with Alzheimer's disease has significant apraxia and poor hygiene. Which intervention would be most appropriate for ensuring that the patient completes a shower?
- A. Remind her of the need for a shower and where the shower is, and repeat this every 30 minutes until the shower is completed.
- B. Discuss with her the importance of showers as part of daily self-care, and elicit and resolve any obstacles to the patient's showering.
- C. Walk her to the shower, and provide occasional reminders of what she should do next if she seems to be unsure or begins to repeat previous actions.
- D. Walk her to the shower, assist her to undress, start the water, supply the soap and washcloth, and instruct her to rub her face with the washcloth.
Correct Answer: D
Rationale: The correct answer is D because it provides the most direct and hands-on assistance to ensure completion of the shower. By walking her to the shower, assisting with undressing, starting the water, and providing necessary supplies and instructions, the patient is guided through each step of the showering process. This approach is essential for someone with significant apraxia and poor hygiene due to Alzheimer's disease.
Choice A is incorrect because simply reminding the patient every 30 minutes may not address the physical assistance needed for shower completion. Choice B is also incorrect as discussing the importance of showers may not be enough to overcome the challenges of apraxia and poor hygiene. Choice C is not as effective as choice D as occasional reminders may not provide the comprehensive assistance required for the patient to successfully complete the shower.
Which of the following is classified as a mood disorder?
- A. bipolar disorder
- B. multiple personality disorder
- C. delusional disorder
- D. dissociative disorder
Correct Answer: A
Rationale: Bipolar disorder, with its mood swings, is a classic mood disorder.
Explain four (4) the behavioral features of Anorexia Nervosa
- A. Restricting food intake
- B. Excessive exercise
- C. Body image distortion
- D. Fear of weight gain
Correct Answer: A
Rationale: These behaviors reflect the core features of anorexia: restriction, overactivity, distorted perception, and weight obsession.
Which of the following is a characteristic of anorexia nervosa?
- A. Binge eating followed by purging.
- B. Refusal to maintain a healthy weight and an intense fear of gaining weight.
- C. Frequent overeating episodes without purging behaviors.
- D. Extreme preoccupation with body image and excessive exercise.
Correct Answer: B
Rationale: The correct answer is B because anorexia nervosa involves a refusal to maintain a healthy weight, an intense fear of gaining weight, and a distorted body image. This disorder is characterized by restrictive eating habits leading to significant weight loss. Individuals with anorexia nervosa often perceive themselves as overweight despite being underweight. Choices A, C, and D are incorrect as they describe characteristics more closely associated with bulimia nervosa, binge eating disorder, and orthorexia, respectively. Binge eating followed by purging (A) is a behavior seen in bulimia nervosa, frequent overeating episodes without purging (C) is typical of binge eating disorder, and extreme preoccupation with body image and excessive exercise (D) may be seen in orthorexia or other eating disorders, but not specifically in anorexia nervosa.
The daughter of an 84-year-old client with dementia tearfully tells the nurse that she doesn't know what's wrong with her mother, who has begun accusing the family of stealing her lingerie and holding her prisoner. The nurse assesses the client's stage of Alzheimer's disease as stage:
- A. 1
- B. 2
- C. 3
- D. 4
Correct Answer: B
Rationale: The correct answer is B (stage 2) because the client is exhibiting symptoms of moderate Alzheimer's disease, such as paranoia and delusions. In stage 2, cognitive decline becomes more noticeable, leading to memory loss, confusion, and behavioral changes. The client's accusations and false beliefs indicate a decline in reality orientation, which is characteristic of stage 2. Choices A, C, and D are incorrect because stage 1 is characterized by mild cognitive decline, stage 3 by severe cognitive decline, and stage 4 by very severe cognitive decline.