Nokea
A patient with acute mania dances atop a pool table, waves a cue in one hand, and says, "I'll throw the pool balls if anyone comes near me." The nurse's first intervention is to:
- A. Tell the patient
- B. ""We are taking you to seclusion.""
- C. Remove the patient from the pool table.
- D. Clear the room of all other patients.
Correct Answer: B
Rationale: The correct answer is B because taking the patient to seclusion ensures safety for both the patient and others. This intervention controls the immediate risk of harm from the patient's unpredictable behavior. Telling the patient (choice A) may escalate the situation. Removing the patient from the pool table (choice C) may not address the underlying threat. Clearing the room of all other patients (choice D) is not the priority; ensuring immediate safety is paramount in this scenario.
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When teaching a patient with binge-purge bulimia, the nurse should give priority to information about:
- A. Self-monitoring of daily food and fluid intake.
- B. Establishing the desired daily weight gain.
- C. Symptoms of hypokalemia.
- D. Self-esteem maintenance
Correct Answer: C
Rationale: The correct answer is C: Symptoms of hypokalemia. This is the priority because individuals with binge-purge bulimia often have electrolyte imbalances, including hypokalemia, which can lead to serious cardiac complications. Educating the patient on recognizing symptoms of hypokalemia, such as weakness, fatigue, and irregular heartbeats, is crucial for early intervention.
A: Self-monitoring of daily food and fluid intake is important but not the priority when dealing with potential life-threatening complications like hypokalemia.
B: Establishing the desired daily weight gain is not appropriate for individuals with binge-purge bulimia as the focus should be on addressing the underlying psychological issues rather than weight gain.
D: Self-esteem maintenance is important in the long term but does not take precedence over addressing immediate health risks such as hypokalemia.
To help communicate epidemiological trends amongst youth, a family doctor can refer to a typical Secondary School class of 33 students. In explaining to a parent, how many students would you estimate to report clinically significant symptoms of depression in one such class?
- A. 1
- B. 4
- C. 9
- D. 13
Correct Answer: C
Rationale: Using 27% , 27% of 33 ≈ 9 students, aligning with depression prevalence estimates in Singapore youth.
Schizophrenia affects approximately _____% of the world's population.
- A. 1
- B. 5
- C. 9
- D. 13
Correct Answer: A
Rationale: The correct answer is A (1%). Schizophrenia affects around 1% of the world's population, according to research. This prevalence rate has been consistently reported across different studies and populations. It is a chronic and severe mental disorder, but it is not as common as other mental health conditions. Choices B, C, and D (5%, 9%, 13%) are incorrect because they overestimate the prevalence of schizophrenia. These percentages are much higher than the actual documented rate, which is closer to 1%.
Which of the following are behaviours that may be associated with adolescent depression?
- A. School refusal
- B. Social withdrawal
- C. Reduced self-care
- D. Maladaptive coping behaviours
Correct Answer: A
Rationale: School refusal is a well-documented behavior associated with adolescent depression; the question implies a single correct answer, though B-D are also relevant.
A family has noted the following behaviors in one of their elderly parents: periodic indecisiveness, forgetfulness, mild transient confusion, occasional misperception, distractibility, and occasional unclear thinking. Where on the continuum of cognitive responses would this patient be?
- A. At point 1
- B. At point 2
- C. At point 3
- D. There is insufficient information to make a determination.
Correct Answer: B
Rationale: The correct answer is B: At point 2. This patient's symptoms indicate mild cognitive impairment, which falls between normal age-related decline (point 1) and dementia (point 3). Mild cognitive impairment involves noticeable cognitive changes but does not significantly interfere with daily functioning. Point 1 is too mild for the symptoms described, and point 3 is too severe as the patient's symptoms are not indicative of full-blown dementia. Therefore, the patient is best placed at point 2 on the continuum of cognitive responses.