Nokea
A person who is preoccupied with fears of having a serious disease suffers from
- A. a conversion reaction
- B. hypochondriasis
- C. a traumatic disorder
- D. an obsession
Correct Answer: B
Rationale: Hypochondriasis involves persistent fear of serious illness despite no evidence.
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A client with dementia was admitted to a dementia unit after she began persistently wandering away from home. The nursing staff should plan to:
- A. Provide unlimited freedom because the client has no place to go in the new neighborhood
- B. Provide one-to-one supervision when the client is ambulatory
- C. Place the client in a geriatric chair with a tray across the lap
- D. Provide the client with an electronic alarm that sounds when the client nears the exit door
Correct Answer: D
Rationale: The correct answer is D because providing the client with an electronic alarm that sounds when she nears the exit door is the best option to ensure her safety. This approach allows for monitoring without restricting her movement excessively. Choice A is incorrect as unlimited freedom poses risks. Choice B is not practical or feasible long-term. Choice C is not person-centered and may lead to discomfort and agitation. The electronic alarm in choice D is the most effective and least intrusive method to prevent wandering while respecting the client's autonomy.
The client tells the nurse, 'My husband left to go bowling with his buddies, so I had to cut myself.' The nurse using the SET method of communication will use as the initial response:
- A. Tell me what made you think of that action.'
- B. It concerns me to hear that you took that action.'
- C. You should have called your psychiatrist.'
- D. What can I do to help you now that you're here?'
Correct Answer: B
Rationale: The correct answer is B: "It concerns me to hear that you took that action." The rationale for this is that this response demonstrates empathy and concern for the client's well-being, which is essential in building a therapeutic relationship. It acknowledges the client's statement without judgment and opens the door for further exploration of the client's feelings and reasoning behind the self-harm.
Choice A: "Tell me what made you think of that action" may come across as too direct and could be perceived as insensitive or confrontational, potentially shutting down communication.
Choice C: "You should have called your psychiatrist" is dismissive and fails to address the client's emotional needs or offer support.
Choice D: "What can I do to help you now that you're here?" is forward-thinking and assumes the client is seeking help, which may not be the case. It also does not directly address the concerning behavior of self-harm.
When the family of a client who has been diagnosed with a dementia secondary to normal pressure hydrocephalus asks the nurse about prognosis, the nurse should reply:
- A. Unfortunately the prognosis is for a downhill course ending in death.'
- B. There will be good days and bad days for the rest of the client's life.'
- C. The symptoms usually remit after a shunt is inserted to drain fluid.'
- D. We'll try our very best, but only time will tell how successful we are.'
Correct Answer: C
Rationale: The correct answer is C because normal pressure hydrocephalus (NPH) symptoms typically improve after a shunt is inserted to drain the excess cerebrospinal fluid, leading to a better prognosis. This intervention can help alleviate symptoms such as gait disturbances, cognitive impairment, and urinary incontinence associated with NPH.
Choice A is incorrect as it inaccurately states that the prognosis is inevitably poor, which is not true for NPH with appropriate treatment. Choice B is incorrect because NPH symptoms can be effectively managed with treatment, so it is not accurate to say that there will always be good and bad days for the rest of the client's life. Choice D is incorrect as it does not provide specific information about the positive impact of shunt insertion on NPH symptoms and prognosis.
A patient has disorganized thinking associated with schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain?
- A. Hippocampus
- B. Frontal lobe
- C. Cerebellum
- D. Brainstem
Correct Answer: B
Rationale: The correct answer is B: Frontal lobe. Disorganized thinking in schizophrenia is often associated with executive function deficits, which are primarily controlled by the frontal lobe. This area is responsible for decision-making, problem-solving, and reasoning. Dysfunction here can lead to disorganized thoughts and behaviors. The other choices, such as the hippocampus (A), involved in memory, the cerebellum (C), involved in motor coordination, and the brainstem (D), involved in basic life functions, are less likely to be directly related to disorganized thinking in schizophrenia.
Which of the following is NOT a suitable place for a family doctor outside the polyclinic to refer an adolescent patient for psychotherapy/counselling?
- A. Local Social Service Office
- B. Nearby polyclinic
- C. Patients school
- D. A reputable restructured hospital
Correct Answer: B
Rationale: A nearby polyclinic is less suitable for psychotherapy referral as it focuses on primary care, unlike the other options with counseling services.