Nokea
A severely depressed patient with psychomotor retardation has begun activities therapy. His schedule is: 9 AM, ceramics; 10 AM, exercise group; 11 AM to noon, open; noon, lunch. The nurse creating the patient's schedule should opt to fill the hour block from 11 AM to noon with:
- A. Group therapy.
- B. A rest period.
- C. Reminiscence group.
- D. Individual counseling.
Correct Answer: B
Rationale: The correct answer is B: A rest period. Providing a rest period during the hour block from 11 AM to noon is crucial for a severely depressed patient with psychomotor retardation. This patient may experience fatigue and decreased energy levels due to their condition. Allowing for a rest period can help prevent overstimulation and promote relaxation, which is essential for mental well-being. Group therapy (choice A) may be too overwhelming for the patient at this time. Reminiscence group (choice C) may not be as beneficial for immediate symptom management. Individual counseling (choice D) may be helpful but may not align with the patient's immediate need for rest and relaxation.
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The wife of a patient with schizophrenia is worried about her 17-year-old daughter and asks the nurse what symptoms mark the prodromal stage of schizophrenia. The nurse should respond by listing behaviors such as:
- A. withdrawal, poor concentration, phobic or obsessive behavior, oddities of speech.
- B. auditory hallucinations, ideas of reference, thought insertion, and broadcasting.
- C. stereotyped behavior, echopraxia, echolalia, waxy flexibility, thought-blocking.
- D. looseness of associations, concrete thinking, echolalia, paranoid delusions.
Correct Answer: A
Rationale: The correct answer is A because the symptoms listed: withdrawal, poor concentration, phobic or obsessive behavior, and oddities of speech are characteristic of the prodromal stage of schizophrenia. During this phase, individuals may start to exhibit subtle changes in behavior and thinking, which may signal the onset of the disorder.
Choice B includes symptoms of active psychosis, such as auditory hallucinations and delusions, which are not typically seen in the prodromal stage. Choice C describes symptoms of catatonia, which are not specific to the prodromal phase. Choice D includes symptoms of acute psychosis, such as paranoid delusions, which are not typically present during the prodromal stage.
In summary, the correct answer is A because it accurately reflects the early, subtle symptoms that may precede the full onset of schizophrenia, while the other choices describe symptoms that are more indicative of later stages of the disorder.
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.
The subjective internal feeling of being either male of female is called
- A. Gender identity
- B. Sexuality
- C. Gender identity disorder
- D. Sexual orientation
Correct Answer: A
Rationale: Gender identity refers to one's internal sense of being male, female, or another gender, distinct from sexual orientation or physical traits.
Explain four (4) the behavioral features of Anorexia Nervosa
- A. Restricting food intake
- B. Excessive exercise
- C. Body image distortion
- D. Fear of weight gain
Correct Answer: A
Rationale: These behaviors reflect the core features of anorexia: restriction, overactivity, distorted perception, and weight obsession.
After assessing a patient with anorexia nervosa, a nurse writes the following nursing diagnosis: imbalanced nutrition, less than body requirements related to refusal to eat as evidenced by being 25% below body weight for height. The expected outcome should be listed as:
- A. Patient will identify cognitive distortions about food, weight, and body shape.'
- B. Patient will exhibit fewer signs of malnutrition within 2 weeks of hospitalization.'
- C. Patient will be able to describe both the physical and emotional complications of the eating disorder.'
- D. Patient will restore healthy eating patterns and normalize physiological parameters related to weight and nutrition.'
Correct Answer: D
Rationale: The correct answer is D because the expected outcome for a patient with imbalanced nutrition due to anorexia nervosa should focus on restoring healthy eating patterns and normalizing physiological parameters related to weight and nutrition. This outcome directly addresses the underlying issue of inadequate nutrition intake and helps the patient achieve a healthier state.
A: While identifying cognitive distortions is important for addressing the psychological aspects of anorexia nervosa, it does not directly address the patient's nutritional needs.
B: Exhibiting fewer signs of malnutrition is a vague outcome and does not specify how the patient will achieve this improvement.
C: Describing physical and emotional complications is informative but does not address the primary goal of improving nutrition intake and weight restoration.