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A patient with bipolar disorder has rapid cycles. To prepare teaching materials, the nurse anticipates which medication will be prescribed?
- A. Clonidine (Catapres)
- B. Phenytoin (Dilantin)
- C. Carbamazepine (Tegretol)
- D. Chlorpromazine (Thorazine)
Correct Answer: C
Rationale: Rationale: Carbamazepine (Tegretol) is commonly used in treating rapid cycling bipolar disorder due to its mood stabilizing properties. It helps regulate mood swings and prevent manic or depressive episodes. It is effective in managing rapid cycling symptoms. Clonidine (A) is used for ADHD and hypertension, not bipolar disorder. Phenytoin (B) is an anticonvulsant, not typically used for bipolar disorder. Chlorpromazine (D) is an antipsychotic mainly for schizophrenia, not specifically indicated for rapid cycling in bipolar disorder.
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A child, age 9, is being evaluated in the Emergency Department at the hospital. Her mother is with her and describes her as withdrawn and quiet. The nurse practitioner suspects child abuse. Which of these findings indicates that physical abuse may be a chronic problem for the child?
- A. The presence of the mother and her description of the child as withdrawn and quiet.
- B. The child's refusal to speak to the nurse.
- C. The child's physical appearance.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A because the mother's description of the child as withdrawn and quiet can indicate chronic physical abuse. This is because a child who is consistently withdrawn and quiet may be exhibiting signs of trauma from ongoing abuse. The mother's presence is also important as it provides insight into the child's home environment.
Explanation for why the other choices are incorrect:
B: The child's refusal to speak to the nurse may indicate shyness or fear, but it does not specifically point to chronic physical abuse.
C: The child's physical appearance alone does not provide enough information to determine if physical abuse is chronic.
In summary, choice A is the correct answer as it directly relates to potential signs of chronic physical abuse, while choices B and C do not provide sufficient evidence to support this conclusion.
A 17-year-old patient with anorexia nervosa has just been released from the hospital. To facilitate recovery at home, the psychiatric-mental health nurse instructs the family to:
- A. discourage the patient from sneaking food between meals, by unobtrusively reducing access to the kitchen
- B. encourage the patient's interest in menu planning, food magazines, and cooking lessons, by leaving information and materials around the house
- C. permit the patient to eat her meals privately to discourage family preoccupation with meals
- D. recommend that the patient joins in routine family meals and clears the dishes after dinner, even if they do not eat
Correct Answer: D
Rationale: Involving the patient in family meals normalizes eating behavior and provides structure, supporting recovery without enabling secrecy or avoidance.
A patient was admitted in a semistuporous catatonic state. Family states that the patient has neither left the apartment nor attended to personal hygiene for several weeks. The patient's last 48 hours have been spent lying in bed, mute and motionless. The nursing diagnosis that should be considered the priority is:
- A. self-care deficit.
- B. situational low self-esteem.
- C. disturbed thought processes.
- D. impaired verbal communication.
Correct Answer: A
Rationale: The correct answer is A: self-care deficit. The patient's symptoms indicate a lack of ability to perform self-care activities, which poses a risk to their health and well-being. This is a priority as addressing this issue will directly impact the patient's physical health and overall functioning. Situational low self-esteem (B) is not the priority as it focuses on the patient's emotional state rather than their immediate physical needs. Disturbed thought processes (C) and impaired verbal communication (D) may be present but are not the priority over the patient's inability to perform self-care activities.
Disorders related to abnormal functioning of the sleep-wake cycle or timing mechanisms of the body are called:
- A. Sleep apnea.
- B. Primary sleep disorders.
- C. Tertiary sleep disorders.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Primary sleep disorders. These disorders directly affect the sleep-wake cycle or timing mechanisms of the body. Sleep apnea (A) is a specific disorder characterized by pauses in breathing during sleep, not a general category. Tertiary sleep disorders (C) are not a recognized classification; the primary and secondary are the main categories. "None of the above" (D) is incorrect as primary sleep disorders are indeed related to abnormal functioning of the sleep-wake cycle.
When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value?
- A. Evidence of spasticity or flaccidity
- B. The patients level of motor activity
- C. Medications the patient has recently taken
- D. Level of preoccupation with somatic symptoms
Correct Answer: C
Rationale: Delirium in the elderly produces symptoms of confusion. Medication interactions or adverse reactions are often a cause. The distracters do not give information important for delirium.