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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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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.

Early manifestation of symptoms such as severe impairment in social interaction and in communication can be diagnosed as which of the following?

  • A. Infantile autism
  • B. Infantile amnesia
  • C. Cerebral palsy
  • D. Rett's syndrome
Correct Answer: A

Rationale: Infantile Autism: Early manifestations of Autistic Disorder symptoms, including impaired social interaction and communication.

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.

Suzanne is a 10-year-old girl who has been diagnosed as experiencing depression. What is likely to be the most effective way to help Suzanne express her feelings?

  • A. Have her participate in a group therapy session with other young children who are depressed
  • B. Ask her to draw some pictures about things that shes been thinking about
  • C. Arrange for individual psychotherapy sessions with a psychiatrist
  • D. Observe her actions but dont seek to draw her out into conversation
Correct Answer: B

Rationale: Younger children who may have more difficulty verbally expressing feelings may be able to draw them.

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.

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