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A patient is admitted to the inpatient unit with a diagnosis of schizophrenia. The patient has had episodes of school absenteeism, withdrawal from friends, and bizarre behavior, including talking to his or her 'keeper.' The psychiatric-mental health nurse's most appropriate response is to:
- A. acknowledge that the patient's perceptions seem real to him or her, and refocus the patient's attention on a task or activity
- B. encourage the patient to express his or her thoughts, to determine the meaning they have for the patient
- C. ignore the patient's bizarre behavior, because it will diminish after he or she has been given the correct medication
- D. inform the patient that his or her perceptions of reality have become distorted because of the illness
Correct Answer: A
Rationale: Validating the patient's experience while redirecting to reality-based activity builds trust and reduces agitation without confrontation.
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In DSM-IV-TR intellectual disabilities are divided into a number of degrees of severity, depending primarily on the range of IQ score provided by the sufferer. One of these is Profound Mental Retardation, represented by an IQ score below:
- A. 20-25
- B. 25-30
- C. 15-20
- D. 15-Oct
Correct Answer: A
Rationale: Profound Mental Retardation: Defined by DSM-IV-TR as an IQ score below 20-25.
When people successfully adapt to their environment by using logical thought and socially appropriate ways, they are said to be functioning at the adaptive end of the _____ continuum.
- A. Emotional
- B. Self-protective
- C. Neurobiological
- D. Psychobiological
Correct Answer: C
Rationale: The correct answer is C: Neurobiological. This is because neurobiological factors refer to the brain's functioning and how it affects behavior and cognition. When individuals adapt to their environment using logical thought and socially appropriate ways, it indicates a high level of cognitive and behavioral functioning, which is closely tied to neurobiological processes.
A: Emotional is incorrect because emotional factors focus on feelings and affective responses, not necessarily on logical thought and social appropriateness.
B: Self-protective is incorrect as it pertains to behaviors aimed at ensuring one's safety and security, which may not necessarily involve logical thought and social appropriateness.
D: Psychobiological is incorrect as it encompasses the interaction between psychological and biological processes, which may not specifically relate to adaptive functioning in the given context.
The elderly spouse of a 74-year-old male client states that she has noticed that her husband 'doesn't remember as well as he used to.' She explains that he has been putting on his coat before his shirt, and that he can never get their checkbook to balance as it did in the past. The client is exhibiting signs and symptoms typical of:
- A. Vascular dementia
- B. Alzheimer's disease
- C. Acute delirium
- D. Aging
Correct Answer: B
Rationale: The correct answer is B: Alzheimer's disease. The client's symptoms of memory loss, confusion, and difficulty with daily tasks point towards Alzheimer's disease, a progressive neurodegenerative disorder affecting memory and cognitive function. Vascular dementia (A) typically presents with a history of stroke or cardiovascular disease, which is not indicated in the scenario. Acute delirium (C) is a sudden and fluctuating change in mental status often caused by medical conditions or medications, not a progressive decline like Alzheimer's. Aging (D) is a natural process and does not explain the specific symptoms described.
It has been discovered that all major anti-psychotic drugs
- A. block the action of dopamine
- B. facilitate the action of dopamine
- C. increase levels of dopamine
- D. decrease levels of dopamine
Correct Answer: A
Rationale: Antipsychotics reduce psychotic symptoms by blocking dopamine receptors in the brain.
A 19-year-old client is admitted for the second time in 9 months and is acutely psychotic with a diagnosis of undifferentiated schizophrenia. The client sits alone rubbing her arms and smiling. She tells the nurse her thoughts cause earthquakes and that the world is burning. The nurse assesses the primary deficit associated with the client's condition as:
- A. Altered mood states
- B. Disturbed thinking
- C. Social isolation
- D. Poor impulse control
Correct Answer: B
Rationale: The correct answer is B: Disturbed thinking. In this scenario, the client's belief that her thoughts cause earthquakes and the world is burning are examples of delusions, which are a key symptom of schizophrenia. This demonstrates a disturbance in the client's thought process, indicating a primary deficit in thinking. Altered mood states (A) may be present as well but are not the primary deficit in this case. Social isolation (C) is a consequence of the client's symptoms rather than the primary deficit. Poor impulse control (D) is not the primary issue presented in the scenario.