Nokea
A patient reports an intense, overwhelming fear of driving a car. The fear has disrupted all elements of the patient's life. The patient does not go to the grocery store unless driven by someone else, has relinquished their job, and has few social contacts. The patient's treatment plan includes:
- A. assertiveness training
- B. biofeedback
- C. stress management assistance
- D. systematic desensitization
Correct Answer: D
Rationale: Systematic desensitization gradually exposes the patient to driving-related stimuli, reducing phobia through controlled steps.
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An acutely psychotic individual diagnosed with schizophreniaform disorder at admission is immediately placed on daily doses of risperidone. A hospitalization of 8 days' duration has been authorized by the HMO. By what hospital day would the nurse expect to note that client was demonstrating beginning trust in the nurse and reduction in hallucinations and delusions?
- A. Day of admission
- B. Day 3 of hospitalization
- C. Day 5 of hospitalization
- D. Day 7 of hospitalization
Correct Answer: B
Rationale: The correct answer is B: Day 3 of hospitalization. At this point, the risperidone medication would have had sufficient time to begin exerting its therapeutic effects on the individual's symptoms of hallucinations and delusions. It typically takes a few days for antipsychotic medications like risperidone to reach therapeutic levels in the body and start alleviating psychotic symptoms. By day 3, the individual may start to demonstrate improved trust in the nurse due to the reduction in distressing symptoms.
Incorrect options:
A: Day of admission - It is unlikely to see significant improvement in symptoms and trust on the same day of admission.
C: Day 5 of hospitalization - By this time, the medication would have likely already started showing some effects, and the individual would have had some time to build trust with the nurse.
D: Day 7 of hospitalization - Waiting until day 7 might be too late to note beginning trust and significant reduction in symptoms, as the
A patient with the diagnosis of schizophrenia, disorganized type, approaches the nurse and says, 'It's beat, it's eat. No room for doom.' The nurse can correctly assess this verbalization as:
- A. neologisms.
- B. clanging.
- C. ideas of reference.
- D. associative looseness.
Correct Answer: B
Rationale: The correct answer is B: clanging. Clanging refers to the pattern of speech characterized by the association of words based on sound rather than meaning. In this case, the patient's verbalization, "It's beat, it's eat. No room for doom," demonstrates a connection based on rhyming sounds rather than coherent meaning. This is a classic example of clanging commonly seen in individuals with disorganized schizophrenia. Neologisms (choice A) refer to new words created by the individual, ideas of reference (choice C) involve believing that external events have special significance for oneself, and associative looseness (choice D) pertains to a lack of logical connection between thoughts. These choices are incorrect as they do not accurately describe the patient's speech pattern in this scenario.
When a patient with anorexia nervosa is admitted for treatment, the milieu should provide: (Select all that apply.)
- A. Flexible mealtimes.
- B. Unscheduled weight checks.
- C. Adherence to a selected menu.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Flexible mealtimes. In the treatment of anorexia nervosa, providing flexible mealtimes allows patients to regain a sense of control over their eating habits, which is crucial in their recovery process. This approach helps to reduce anxiety around food and promotes a healthier relationship with eating.
Choice B: Unscheduled weight checks can be triggering and anxiety-provoking for patients with anorexia nervosa, as weight monitoring can be a significant source of distress for them.
Choice C: Adherence to a selected menu may reinforce rigid eating patterns and control issues related to food, which can be counterproductive in the treatment of anorexia nervosa.
Choice D: None of the above is incorrect because providing flexible mealtimes is essential in creating a supportive and therapeutic environment for patients with anorexia nervosa.
Children should undergo further evaluation when their weight is % above their height.
- A. 10
- B. 15
- C. 20
- D. 25
Correct Answer: C
Rationale: The correct answer is C (20%). This is because a weight that is 20% above a child's height can indicate potential health issues such as obesity. Excess weight can lead to various health problems in children. Choices A, B, and D are incorrect as they represent lower percentages, which may not be as concerning in terms of potential health risks. It is important to consider a higher percentage threshold for further evaluation to ensure early detection and intervention for any weight-related issues.
A patient remanded by the court after his wife had him jailed for battery told the judge how sorry he was and suggested he needed psychiatric help. His history reveals acting-out behaviors as an adolescent and several adult arrests. The nurse interviews him about his relationship with his wife. Which statement by the patient is most consistent with a diagnosis of antisocial personality disorder?
- A. I've done some stupid things in my life, but I've learned a lesson.'
- B. I'm feeling terrible about the way my behavior has hurt my family.'
- C. I have a quick temper, but I can usually keep it under control.'
- D. I hit her because she nags at me. She deserves it when I beat her up.'
Correct Answer: D
Rationale: The correct answer is D. This statement reflects a lack of remorse, empathy, and justification for violent behavior, which are key characteristics of antisocial personality disorder. The patient blames his wife for his violent actions and shows a sense of entitlement.
A: This statement shows acknowledgment of mistakes and a willingness to learn from them, which is not consistent with antisocial personality disorder.
B: Expressing feeling terrible about hurting family members demonstrates some level of empathy and remorse, which is not typical of individuals with antisocial personality disorder.
C: Acknowledging a quick temper but being able to control it does not align with the impulsivity and lack of control often seen in individuals with antisocial personality disorder.