Nokea
A school-aged patient with attention-deficit hyperactivity disorder (ADHD) is displaying disruptive behaviors at home. The psychiatric-mental health nurse modifies the treatment plan for the social domain, by advising the patient's parents to:
- A. establish eye contact before giving directions
- B. initiate a point system, to reward the patient for appropriate behavior
- C. instruct the patient to work on one homework assignment at a time
- D. maintain a predictable environment in the home
Correct Answer: B
Rationale: A point system reinforces positive behavior, directly addressing social disruptiveness in ADHD.
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Which instruction has priority when teaching a patient taking clozapine (Clozaril)?
- A. Avoid unprotected sex.
- B. Report sore throat and fever immediately.
- C. Reduce foods high in polyunsaturated fats.
- D. Use over-the-counter preparations for rashes.
Correct Answer: B
Rationale: The correct answer is B: Report sore throat and fever immediately. This is because clozapine can cause a serious condition called agranulocytosis, which is characterized by a dangerously low white blood cell count. Sore throat and fever can be early signs of this condition, so it is crucial to report them immediately to prevent serious complications.
Avoiding unprotected sex (choice A) is important for overall health but is not directly related to clozapine use. Reducing foods high in polyunsaturated fats (choice C) is not a priority as it does not impact the safety or effectiveness of clozapine. Using over-the-counter preparations for rashes (choice D) is not advised as rashes can be a side effect of clozapine, and professional medical advice should be sought.
Therapeutic nutrition begins for a patient with anorexia nervosa who is 70% of ideal body weight. Which nursing intervention is most important to add to the plan of care?
- A. Communicate empathy for the patient's feelings.
- B. Observe for adverse effects associated with refeeding.
- C. Teach patient about psychological origins of the disorder.
- D. Direct the patient to balance energy expenditure and caloric intake.
Correct Answer: B
Rationale: The correct answer is B: Observe for adverse effects associated with refeeding. This is important because refeeding syndrome can occur when a severely malnourished individual is reintroduced to nutrition too quickly, leading to potentially life-threatening electrolyte imbalances. Monitoring for signs such as fluid retention, electrolyte abnormalities, and changes in vital signs is crucial in preventing these complications.
Choice A: Communicating empathy is important in building trust and rapport with the patient, but it is not the most critical intervention in this scenario.
Choice C: Teaching the patient about the psychological origins of the disorder is important for long-term treatment, but it is not the most immediate concern when starting therapeutic nutrition.
Choice D: Directing the patient to balance energy expenditure and caloric intake is important for overall health, but it is not the priority when the patient is severely malnourished and at risk for refeeding syndrome.
What is the primary nursing concern for a patient with anorexia nervosa during the early stages of treatment?
- A. Ensuring rapid weight gain to restore health.
- B. Addressing the patient's psychological issues related to body image.
- C. Maintaining nutritional intake to prevent further weight loss.
- D. Promoting self-esteem and body image satisfaction.
Correct Answer: C
Rationale: The primary nursing concern for a patient with anorexia nervosa in the early stages of treatment is maintaining nutritional intake to prevent further weight loss. This is crucial as malnutrition can lead to serious health complications. Ensuring adequate nutrition supports physical health and provides a foundation for addressing psychological issues in later stages of treatment. Rapid weight gain (A) can be harmful and lead to refeeding syndrome. Addressing psychological issues (B) and promoting self-esteem (D) are important but secondary concerns once nutritional stability is achieved.
Which statement would indicate the use and abuse of power in a violent family situation?
- A. I admit I was mad and yelling and swinging my fists in the air, but I wasn't trying to hit our child. I was letting off some steam. My spouse just overreacted.'
- B. When she found out I watched television instead of taking the kids to the park, she starting yelling about how I don't care about the kids. She has no right to get mad at me. I should have some time to myself.'
- C. I thought he would like this new recipe. I should have known better. I will not do that again. He was right. He works all day and should come home to a good meal that he can enjoy. It's not too much to ask of a wife.'
- D. All I did was tell him I need some money. I can't understand why he can't just give me what I need. I stay home and take care of his house and kids, and I have to almost beg before he gives me money to spend on myself.'
Correct Answer: C
Rationale: The correct answer is C because it reflects an imbalance of power within the family dynamic. The statement indicates an acceptance of blame and a submissive attitude, suggesting a power dynamic where one person feels the need to please and appease the other. This behavior can indicate an abuse of power by the dominant individual, leading to a controlling and potentially manipulative relationship.
In contrast, the other choices do not clearly demonstrate an abuse of power. Choice A shows anger management issues but does not necessarily indicate a power dynamic. Choice B focuses on a disagreement over parenting responsibilities rather than a power struggle. Choice D highlights financial disagreements but does not explicitly show an abuse of power.
Therefore, Choice C is the most indicative of power abuse in a family situation.
A man with hypospadias tells the nurse, 'Intercourse with my new bride is painful.' Which term applies to the patient's complaint?
- A. Dyspareunia
- B. Erectile dysfunction
- C. Premature ejaculation
- D. Genito-pelvic pain/penetration disorder
Correct Answer: D
Rationale: The correct answer is D: Genito-pelvic pain/penetration disorder. This term is applicable because it specifically refers to pain experienced during intercourse, which aligns with the patient's complaint. Hypospadias can lead to difficulties in penetration and subsequent pain during intercourse.
Choice A: Dyspareunia refers to persistent or recurrent pain during sexual intercourse, which is a broader term than what the patient is experiencing.
Choice B: Erectile dysfunction is the inability to achieve or maintain an erection, which is not directly related to the patient's complaint of pain during intercourse.
Choice C: Premature ejaculation is the early release of semen during sexual activity, which is unrelated to the pain experienced by the patient during intercourse.