Nokea
A patient with schizophrenia begins to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. The term 'volmers' most likely represents:
- A. a neologism.
- B. clanging.
- C. anhedonia.
- D. alogia.
Correct Answer: A
Rationale: The correct answer is A: a neologism. In schizophrenia, patients often create new words (neologisms) that have no meaning outside of their delusional context. The term 'volmers' is a made-up word by the patient, indicating a loss of touch with reality. Clanging (B) is a speech pattern characterized by rhyming or punning words, not creating new words. Anhedonia (C) refers to the inability to experience pleasure, unrelated to creating new words. Alogia (D) is a decrease in speech or thought productivity, not related to inventing new words. In this case, the patient's use of 'volmers' is indicative of a neologism associated with schizophrenia.
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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 Her mother is with her and describes her as withdrawn and quiet.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- A. The presence of the mother and her description of the child as withdrawn and quiet.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Rationale: The correct answer is A because the mother's description of the child as withdrawn and quiet can indicate chronic physical abuse. This is because a child who is consistently withdrawn and quiet may be exhibiting signs of trauma from ongoing abuse.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.
What should the nurse focus on when planning care for a patient with anorexia nervosa?
- A. Encourage the patient to restrict food intake and control weight.
- B. Provide a structured meal plan and monitor nutritional intake.
- C. Allow the patient to eat freely without any food restrictions.
- D. Encourage daily exercise to help manage weight.
Correct Answer: B
Rationale: The correct answer is B because providing a structured meal plan and monitoring nutritional intake is crucial in the care of a patient with anorexia nervosa to ensure they receive adequate nutrition. By following a structured plan, the patient can gradually restore a healthy relationship with food and gain weight safely. Encouraging the patient to eat freely (choice C) can lead to further disordered eating behaviors. Encouraging food restriction and weight control (choice A) can worsen the patient's condition. Encouraging daily exercise (choice D) may exacerbate the patient's excessive focus on weight and body image. In summary, choice B is the best option as it focuses on promoting healthy eating habits and addressing the nutritional needs of the patient with anorexia nervosa.
What is an appropriate goal for a nurse working with a patient with anorexia nervosa?
- A. The patient will gain weight rapidly to restore nutritional balance.
- B. The patient will express satisfaction with their body image by the end of treatment.
- C. The patient will eat three meals daily and demonstrate healthy eating behaviors.
- D. The patient will be able to resume normal physical activities without fatigue.
Correct Answer: C
Rationale: The correct answer is C because setting a goal for the patient to eat three meals daily and demonstrate healthy eating behaviors is a more realistic and achievable target for someone with anorexia nervosa. This goal focuses on establishing regular eating habits and promoting a healthy relationship with food, which are crucial in the treatment of anorexia nervosa. Choices A and D are incorrect as rapid weight gain and resuming normal physical activities may not be safe or sustainable goals for someone with anorexia nervosa. Choice B is also incorrect because body image satisfaction is a complex issue that may not be directly addressed solely through treatment for anorexia nervosa.
A client diagnosed with Alzheimer's disease has a catastrophic reaction during an activity involving simultaneous playing of music and working on a craft project. The client starts shouting 'no, no, no' and rushes out of the room. The nurse should:
- A. Isolate the client until she is calm, and then direct her back to the activity
- B. Follow the client, reassure her, and redirect her to a quieter activity
- C. Discontinue the activity program since it upsets the clients
- D. Give the client pm antianxiety medication and restrict her activity participation
Correct Answer: B
Rationale: The correct answer is B. The nurse should follow the client, reassure her, and redirect her to a quieter activity. This approach acknowledges the client's feelings and provides support to help her calm down. Isolating the client (Choice A) may escalate the situation and not address the underlying cause of the reaction. Discontinuing the activity program (Choice C) is not the best option as it may limit the client's engagement and therapeutic benefits. Giving medication and restricting activity (Choice D) should be a last resort and not the initial response to a behavioral reaction. In summary, Choice B focuses on comforting and redirecting the client, promoting a positive and supportive environment.
A 25-year-old individual was brought by ambulance to the emergency room. The patient's sensorium alternates between clouded and clear, and the patient becomes agitated both physically and verbally when approached. The patient's roommate states that the patient "was fine after getting up this morning but started talking crazy about 3 hours ago."Â The patient's cognitive impairment is most consistent with:
- A. delirium.
- B. dementia.
- C. sundown syndrome.
- D. early-onset Alzheimer disease.
Correct Answer: A
Rationale: The correct answer is A: delirium. Delirium is an acute change in mental status characterized by fluctuating levels of consciousness, inattention, disorganized thinking, and altered perception. In this case, the patient's clouded and clear sensorium, agitation, and recent onset of symptoms are indicative of delirium.
Choice B: dementia, is incorrect because dementia is a chronic, progressive decline in cognitive function that does not typically present with acute changes in mental status.
Choice C: sundown syndrome, is incorrect as it refers to a pattern of worsening confusion or agitation in the late afternoon or evening, not necessarily characterized by acute onset and fluctuating levels of consciousness.
Choice D: early-onset Alzheimer disease, is incorrect because Alzheimer's disease is a specific type of dementia that does not typically present with the acute and fluctuating symptoms described in the scenario.