Nokea
A patient experiencing delirium secondary to corticosteroid toxicity is manifesting paranoid thinking and noisy, assaultive behavior. The patient is currently pacing the hall and shouting. A nurse has placed a call to the physician and is anticipating the following order:
- A. the use of supervised restraints.
- B. a loading dose of phenytoin.
- C. a small dose of prednisone.
- D. an IV dose of thiamine.
Correct Answer: A
Rationale: The correct answer is A: the use of supervised restraints. In this situation, the patient is displaying agitated and assaultive behavior, posing a risk to themselves and others. Supervised restraints are necessary to ensure the safety of the patient and healthcare providers until the effects of corticosteroid toxicity subside. Restraints should only be used as a last resort when other interventions have failed.
Choice B: A loading dose of phenytoin is incorrect because phenytoin is not indicated for managing delirium secondary to corticosteroid toxicity.
Choice C: A small dose of prednisone is incorrect because adding more corticosteroids would exacerbate the toxicity and worsen the delirium.
Choice D: An IV dose of thiamine is incorrect as thiamine is used to treat thiamine deficiency, not corticosteroid toxicity-induced delirium.
You may also like to solve these questions
Which one of the following definitions is incorrect?
- A. Delusions – A fixed false belief not based in reality
- B. Mental illness – A condition affecting thinking, mood, or behavior
- C. Obsessive-compulsive disorder – A disorder with intrusive thoughts and repetitive behaviors
- D. Obsessive-compulsive disorder – A disorder with intrusive thoughts and repetitive behaviors
Correct Answer: C
Rationale: An illusion is actually a misinterpretation of a real stimulus, not the perception of something that does not exist. The incorrect definition given in option D confuses an illusion with a hallucination, which is a false sensory perception without an external stimulus.
What is the most effective strategy for preventing relapse in patients with anorexia nervosa?
- A. Providing a strict, rigid meal plan that the patient must follow.
- B. Offering frequent, supportive counseling to address underlying issues.
- C. Encouraging the patient to self-monitor their food intake only.
- D. Reassuring the patient that their weight will stabilize without further intervention.
Correct Answer: B
Rationale: The correct answer is B because offering frequent, supportive counseling to address underlying issues is the most effective strategy for preventing relapse in patients with anorexia nervosa. Counseling helps patients explore and work through the root causes of their disorder, such as body image issues, low self-esteem, or past trauma. It also provides ongoing support and guidance in developing healthy coping mechanisms and behaviors.
Choice A is incorrect because providing a strict, rigid meal plan can exacerbate feelings of control and restriction, which are common triggers for relapse in individuals with anorexia nervosa.
Choice C is incorrect as solely focusing on self-monitoring food intake may not address the psychological and emotional factors contributing to the disorder, which are crucial for long-term recovery.
Choice D is incorrect because reassuring the patient that their weight will stabilize without further intervention ignores the complexities of anorexia nervosa and does not address the underlying issues that need to be resolved for sustained recovery.
A client seen by the rape crisis nurse 1 month after the incident states, 'I'm confused and just not myself. I have mood swings during the day, and I have nightmares at night. Sometimes I think I'm going crazy.' Other times, she is just plain afraid to be alone. The nurse should assess the client for:
- A. Trauma syndrome.
- B. Post-traumatic stress disorder.
- C. Acute stress disorder.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Trauma syndrome. This choice is correct because the client's symptoms of confusion, mood swings, nightmares, feeling like they are going crazy, and fear of being alone align with the criteria for trauma syndrome. This syndrome encompasses a range of symptoms that occur after experiencing a traumatic event, such as rape.
Choice B: Post-traumatic stress disorder (PTSD) is not the best option in this case because the client's symptoms are more indicative of acute distress and confusion rather than the criteria for a formal diagnosis of PTSD, which typically requires the persistence of symptoms over time.
Choice C: Acute stress disorder is also not the most appropriate choice because while some symptoms may align, the duration and specific criteria for this disorder may not fully match the client's presentation.
Choice D: None of the above is incorrect as trauma syndrome best fits the client's symptoms based on the information provided.
A client with an eating disorder that has resulted in weight loss to a point 15% below normal weight tells the nurse, 'I don't need to be hospitalized. I can control myself.' The nurse continues to prepare the client for hospitalization because the vicious cycle of eating disorder behavior is fueled by:
- A. feelings of power and control resulting from weight loss.
- B. dysfunctional family dynamics.
- C. faulty use of the defense mechanism projection.
- D. lack of superego constraints on behavior.
Correct Answer: A
Rationale: The correct answer is A: feelings of power and control resulting from weight loss. In clients with eating disorders, the behavior is often driven by a sense of control and power gained through weight loss. This reinforces the cycle of the disorder as the individual feels empowered by their ability to restrict food intake. This false sense of control becomes a driving force in the continuation of the disorder.
Incorrect answers:
B: Dysfunctional family dynamics may contribute to the development of an eating disorder, but in this scenario, the client's refusal for hospitalization is more related to their own sense of control rather than family dynamics.
C: Faulty use of the defense mechanism projection is not the primary reason for the client's resistance to hospitalization in this case.
D: Lack of superego constraints on behavior is not the main factor driving the client's refusal for hospitalization.
The nurse is explaining to the family of a patient diagnosed with schizophrenia that the disorder is considered to have neurobiological origins. When the patient's mother asks, 'What part of the brain is dysfunctional?' the nurse should reply, 'Research has implicated the:
- A. medulla and cortex.
- B. cerebellum and cerebrum.
- C. hypothalamus and medulla.
- D. prefrontal and limbic cortices.'
Correct Answer: D
Rationale: The correct answer is D: prefrontal and limbic cortices. The prefrontal cortex is involved in decision-making, planning, and social behavior, functions commonly impaired in schizophrenia. The limbic cortex regulates emotions and memory, areas affected in schizophrenia. Medulla (A, C) controls basic functions like breathing, not implicated in schizophrenia. Cerebellum (B) coordinates movement, unrelated to schizophrenia. Hypothalamus (C) regulates hormones, not directly linked to schizophrenia. In summary, D is correct as prefrontal and limbic cortices are key brain regions affected in schizophrenia, while the other choices are not directly involved in the disorder.