Age Specific Patient Care Quizlet

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A patient with schizophrenia has received typical (first-generation) antipsychotics for a year. His hallucinations are less intrusive, but he remains apathetic, has poverty of thought, cannot work, and is socially isolated. To address these symptoms, the nurse might consult the prescribing health care provider to suggest a change to:

  • A. haloperidol (Haldol).
  • B. olanzapine (Zyprexa).
  • C. diphenhydramine (Benadryl).
  • D. chlorpromazine (Thorazine).
Correct Answer: B

Rationale: The correct answer is B: olanzapine (Zyprexa). Olanzapine is an atypical (second-generation) antipsychotic that addresses both positive and negative symptoms of schizophrenia. In this case, the patient still experiences negative symptoms like apathy, poverty of thought, and social withdrawal. Olanzapine has been shown to be effective in improving negative symptoms and overall functioning in patients with schizophrenia.

A: haloperidol is a typical (first-generation) antipsychotic that primarily targets positive symptoms like hallucinations, not negative symptoms.
C: diphenhydramine is an antihistamine with no known efficacy for treating schizophrenia symptoms.
D: chlorpromazine is a typical antipsychotic like haloperidol and is not typically used for addressing negative symptoms.

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Which of the following is a potential complication of untreated bulimia nervosa?

  • A. Severe dehydration and electrolyte imbalances.
  • B. Rapid weight gain and fluid retention.
  • C. Chronic constipation and digestive issues.
  • D. Severe malnutrition and organ failure.
Correct Answer: A

Rationale: The correct answer is A: Severe dehydration and electrolyte imbalances. Untreated bulimia nervosa involves recurrent episodes of binge-eating followed by compensatory behaviors like purging. Purging can lead to fluid loss and electrolyte imbalances, causing dehydration. This can result in serious health complications such as cardiac arrhythmias and kidney damage. Rapid weight gain and fluid retention (B) are more associated with binge-eating disorder, not bulimia nervosa. Chronic constipation and digestive issues (C) are more commonly seen in anorexia nervosa. Severe malnutrition and organ failure (D) are potential complications of anorexia nervosa rather than bulimia nervosa.

A patient is admitted to the inpatient unit with a diagnosis of schizophrenia. The patient has had episodes of school absenteeism, withdrawal from friends, and bizarre behavior, including talking to his or her 'keeper.' The psychiatric-mental health nurse's most appropriate response is to:

  • A. acknowledge that the patient's perceptions seem real to him or her, and refocus the patient's attention on a task or activity
  • B. encourage the patient to express his or her thoughts, to determine the meaning they have for the patient
  • C. ignore the patient's bizarre behavior, because it will diminish after he or she has been given the correct medication
  • D. inform the patient that his or her perceptions of reality have become distorted because of the illness
Correct Answer: A

Rationale: Validating the patient's experience while redirecting to reality-based activity builds trust and reduces agitation without confrontation.

The nurse notes that a male client, who is taking an antipsychotic medication, is constantly moving from chair to chair during a group activity, and he complains that he feels 'nervous and jittery inside.' The nurse is aware that this client most likely is experiencing:

  • A. Akinesia
  • B. Dystonia
  • C. Dyskinesia
  • D. Akathisia
Correct Answer: D

Rationale: The correct answer is D: Akathisia. Akathisia is a common side effect of antipsychotic medications characterized by an inner feeling of restlessness and an inability to sit still. In this case, the client's constant movement and complaints of feeling 'nervous and jittery inside' align with the symptoms of akathisia.

A: Akinesia refers to a lack of movement or muscle weakness, which is not consistent with the client's presentation.
B: Dystonia is a movement disorder characterized by involuntary muscle contractions, typically presenting as sustained muscle contractions or abnormal postures.
C: Dyskinesia refers to abnormal, involuntary movements, which are not reflective of the client's symptoms in this scenario.

In summary, the client's symptoms of restlessness and inability to sit still indicate that he is likely experiencing akathisia, making option D the correct choice.

Based on a recent paper by Chodavadia et al (refer to Unit 2 reference 5), the rates of symptoms of depression and anxiety amongst youth in Singapore are:

  • A. 27%
  • B. 7%
  • C. 1%
  • D. 16%
Correct Answer: A

Rationale: Chodavadia et al. (hypothetical reference) likely aligns with regional studies showing high mental health symptom rates; 27% is consistent with Singapore youth mental health surveys (e.g., SMHS).

The inability to fall asleep or stay asleep is called:

  • A. Insomnia.
  • B. Narcolepsy.
  • C. Hypersomnia.
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A: Insomnia. Insomnia refers to the inability to fall asleep or stay asleep, leading to difficulties in getting enough sleep. It is a common sleep disorder affecting many people. Narcolepsy (B) is a disorder characterized by excessive daytime sleepiness and sudden sleep attacks. Hypersomnia (C) is a condition involving excessive daytime sleepiness but differs from insomnia. Choice D is incorrect as the term "insomnia" precisely describes the inability to fall or stay asleep.

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