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A psychiatric technician asks the nurse to explain the difference between schizotypal personality disorder and schizophrenia. The information that should serve as the basis for the nurse's response is the fact that with schizotypal personality disorder:
- A. There is greater personality disorganization than in schizophrenia
- B. There may be misinterpretation of events but not psychosis
- C. The client will be sicker and require longer hospitalization
- D. The client will be more outgoing, actively seeking interactions with others
Correct Answer: B
Rationale: The correct answer is B: There may be misinterpretation of events but not psychosis. In schizotypal personality disorder, individuals may have odd beliefs, behaviors, and experiences, leading to misinterpretation of events, but they do not typically experience full-blown psychosis as seen in schizophrenia. This is a key distinction between the two disorders. Choice A is incorrect because schizophrenia is characterized by more severe disorganization of thoughts and behaviors. Choice C is incorrect as individuals with schizotypal personality disorder typically do not require long hospitalizations compared to those with schizophrenia. Choice D is incorrect as individuals with schizotypal personality disorder tend to be more socially isolated and have difficulty forming close relationships.
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Many clients with eating disorders have difficulty translating their pain into words. Which approach may be used to promote getting in touch with feelings and greater self-disclosure?
- A. Personality inventory testing.
- B. Dance and movement therapy.
- C. Letter writing.
- D. Cooking and meal-planning classes.
Correct Answer: B
Rationale: The correct answer is B: Dance and movement therapy. This approach can help clients with eating disorders express emotions non-verbally, promoting self-awareness and self-disclosure. Movement therapy encourages embodied expression of feelings, facilitating a deeper connection to internal experiences. It allows clients to explore and release emotions through physical movement, aiding in the processing of emotional pain. Personality inventory testing (A) may not directly address emotional expression. Letter writing (C) can help, but may not be as effective as movement in promoting non-verbal expression. Cooking and meal-planning classes (D) focus on practical skills rather than emotional expression.
A nurse is working with a family with an elderly family member who is in the predisgnostic phase of Alzheimer disease. The most important nursing intervention at this time would be to provide:
- A. family consultation to facilitate communication.
- B. information about support groups and counseling.
- C. options directed toward the reduction of caregiver stress.
- D. educational materials that help them understand their situation.
Correct Answer: D
Rationale: The correct answer is D because educating the family about Alzheimer's disease in the predisgnostic phase helps them understand what to expect and how to cope effectively. This empowers them to make informed decisions and provide appropriate care. Option A focuses on communication, which is important but not the most critical intervention at this stage. Option B is helpful but may not address the family's immediate needs. Option C addresses caregiver stress, which is important but may not be the priority in the predisgnostic phase. Therefore, providing educational materials is the most important intervention to support the family during this phase.
A client who was treated for anorexia nervosa is seen by the therapist for a follow-up visit 1 month after discharge from the hospital. Which statement indicates that the client has met the goal 'Demonstrate improvement in body image with more realistic view of body shape and size?'
- A. When I go shopping, I always select clothes that are several sizes too large for me.'
- B. My boyfriend says I really look good now that I'm out of the hospital.'
- C. I had my class picture taken, and I think it looks really good.'
- D. My mother bought me a whole new wardrobe since I've been home.'
Correct Answer: C
Rationale: The correct answer is C because the client's statement reflects a positive and self-affirming perception of themselves. By stating that they think their class picture looks really good, it shows an improvement in body image and a more realistic view of their body shape and size. This indicates progress towards the goal of developing a healthier self-perception.
Choice A is incorrect because selecting clothes that are several sizes too large may still indicate body image distortion and dissatisfaction. Choice B is incorrect because relying on external validation from a boyfriend does not necessarily reflect an internalized improvement in body image. Choice D is incorrect as the mother buying a new wardrobe does not directly address the client's perception of their body image or shape.
A 72-year-old patient has the medical diagnosis of delirium secondary to anticholinergic medication toxicity. Family members are very anxious and express their concerns about placing the patient in a nursing home. What information should serve as a basis for the nurse's reply?
- A. Delirium is reversible, and the patient will likely recover.
- B. The symptoms are related to depression, which can be treated.
- C. Delirium usually progresses to dementia, which is usually permanent.
- D. Home care should be attempted; a nursing home should be the last resort.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Delirium is an acute, reversible condition caused by underlying factors like medication toxicity.
2. By addressing the anticholinergic medication toxicity, the delirium can be resolved, leading to recovery.
3. The patient's age does not necessarily indicate a progression to dementia.
4. Placing the patient in a nursing home is not the immediate solution; resolving the toxicity should be the priority.
Summary:
Choice A is correct because delirium is reversible with appropriate treatment. Choices B, C, and D are incorrect because they do not address the underlying cause of delirium or provide accurate information about its progression or management.
A woman with Alzheimer's disease has significant apraxia and poor hygiene. Which intervention would be most appropriate for ensuring that the patient completes a shower?
- A. Remind her of the need for a shower and where the shower is, and repeat this every 30 minutes until the shower is completed.
- B. Discuss with her the importance of showers as part of daily self-care, and elicit and resolve any obstacles to the patient's showering.
- C. Walk her to the shower, and provide occasional reminders of what she should do next if she seems to be unsure or begins to repeat previous actions.
- D. Walk her to the shower, assist her to undress, start the water, supply the soap and washcloth, and instruct her to rub her face with the washcloth.
Correct Answer: D
Rationale: The correct answer is D because it provides the most direct and hands-on assistance to ensure completion of the shower. By walking her to the shower, assisting with undressing, starting the water, and providing necessary supplies and instructions, the patient is guided through each step of the showering process. This approach is essential for someone with significant apraxia and poor hygiene due to Alzheimer's disease.
Choice A is incorrect because simply reminding the patient every 30 minutes may not address the physical assistance needed for shower completion. Choice B is also incorrect as discussing the importance of showers may not be enough to overcome the challenges of apraxia and poor hygiene. Choice C is not as effective as choice D as occasional reminders may not provide the comprehensive assistance required for the patient to successfully complete the shower.