Nokea
A psychiatric clinical nurse specialist uses cognitive therapy with a patient with anorexia nervosa. Which statement by the nurse supports this type of therapy?
- A. What are your feelings about not eating foods you prepare?
- B. You seem to feel much better about yourself when you eat something.
- C. It must be difficult to talk about private matters to someone you just met.
- D. Being thin doesn't seem to solve problems. You're thin now but still unhappy.
Correct Answer: D
Rationale: The correct answer is D because it reflects a key principle of cognitive therapy, which is challenging distorted thoughts and beliefs. In this statement, the nurse is helping the patient recognize that being thin has not resolved their underlying unhappiness. This challenges the patient's belief that thinness equals happiness, promoting insight and cognitive restructuring.
A: This statement focuses on emotions related to food and preparation, not directly challenging distorted thoughts.
B: This statement focuses on self-esteem related to eating, not directly challenging distorted thoughts.
C: This statement addresses the difficulty of sharing personal information, not directly challenging distorted thoughts.
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The drug of choice for treating Tourette syndrome?
- A. Fluoxetine
- B. Fluvoxamine
- C. Haloperidol
- D. Paroxetine
Correct Answer: C
Rationale: Haloperidol is a typical antipsychotic commonly used to reduce tics in Tourette syndrome by modulating dopamine activity.
Mood disorders are those in which the person may
- A. experience severe depression and threaten suicide
- B. exhibit symptoms suggesting physical disease or injury but for which there is no identifiable cause
- C. exhibit behavior that is the result of an organic brain pathology
- D. experience delusions and hallucinations
Correct Answer: A
Rationale: Mood disorders, like depression, feature extreme emotional states, including suicidal ideation.
The nurse who sees a number of battered women each year decides to put together a set of guidelines for nurses. An appropriate guideline to include, with the victims' informed consent, would be to:
- A. Take at least two photographs of each trauma area
- B. Assess for sexually transmitted disease
- C. Follow rape protocol even when rape is not suspected
- D. Make protective services aware of the abuse
Correct Answer: A
Rationale: The correct answer is A because taking photographs of trauma areas can provide crucial evidence for legal and medical purposes. It can help document the extent of injuries and aid in the prosecution of the abuser. This step is essential in ensuring proper documentation and care for the victims.
Option B is incorrect because assessing for sexually transmitted diseases may not be the immediate priority in cases of domestic violence. Option C is incorrect as following rape protocol when rape is not suspected may not be necessary and could potentially retraumatize the victim. Option D is incorrect because making protective services aware of the abuse should only be done with the victim's consent to ensure their safety and autonomy.
Which outcome is realistic for a client with stage 1 Alzheimer's disease?
- A. Appropriate long-term placement will be arranged to maintain caregiver's health and well-being.
- B. The client will maintain the highest possible functional level within his or her capacity.
- C. All day-to-day decisions will be made by the caregiver to relieve client of stress.
- D. The client will remain fully functional physically, since Alzheimer's affects only the brain.
Correct Answer: B
Rationale: The correct answer is B because in stage 1 Alzheimer's, individuals can still maintain a relatively high level of functionality. This is because in the early stages, the cognitive decline is mild and individuals can still perform daily tasks independently. It is important to focus on maximizing the client's functional abilities through cognitive exercises and support services.
Choice A is incorrect because long-term placement may not be necessary in stage 1 and should only be considered if the caregiver's health is at risk. Choice C is incorrect because individuals with Alzheimer's should be encouraged to make decisions to maintain their sense of autonomy. Choice D is incorrect because Alzheimer's is a progressive disease that affects both cognitive and physical functions over time.
The wife of a client diagnosed with paranoid schizophrenia asks, 'I've been told that my husband's illness is probably related to imbalanced brain chemicals. Can you be more specific?' The response based on the dopamine hypothesis is:
- A. An increase in the brain chemical dopamine explains the presence of delusions and hallucinations.'
- B. An increase in the brain chemical dopamine explains the presence of lack of motivation and disordered affect.'
- C. Decreased amounts of the brain chemical dopamine explain the presence of delusions and hallucinations.'
- D. Breakdown of dopamine produces LSD, which in large amounts produces psychosis.'
Correct Answer: A
Rationale: Step-By-Step Rationale:
1. The dopamine hypothesis states that an increase in dopamine is linked to delusions and hallucinations in schizophrenia.
2. Delusions and hallucinations are common positive symptoms of schizophrenia.
3. Therefore, choice A is correct as it directly aligns with the dopamine hypothesis and the symptoms observed in paranoid schizophrenia.
Summary of Incorrect Choices:
B. Incorrect because an increase in dopamine is not typically associated with lack of motivation and disordered affect in schizophrenia.
C. Incorrect because decreased amounts of dopamine are not linked to delusions and hallucinations in schizophrenia.
D. Incorrect because the breakdown of dopamine producing LSD and causing psychosis is not supported by the dopamine hypothesis in schizophrenia.