A type of delusion in which a patient claims that her genitals have disappeared without her knowledge is called
- A. Hypochondriacal
- B. Amorous
- C. Reference
- D. Nihilistic
Correct Answer: D
Rationale: Nihilistic delusions involve beliefs that parts of the body or the self have ceased to exist or are destroyed.
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A patient has not come out of her room for breakfast. The nurse finds the patient moving restlessly about her room in a disorganized manner. The patient is talking to herself, and her verbal responses to the nurse are nonsensical and suggest disorientation. The nurse notices that the patient's skin is hot and dry, and her pupils are somewhat dilated. All these symptoms are significant departures from the patient's recent presentation. The patient is likely experiencing ______, and the nurse should ______.
- A. anticholinergic toxicity"¦check vital signs and prepare to use a cooling blanket stat
- B. relapse of her psychosis"¦administer PRN antipsychotic drugs and notify her physician
- C. neuroleptic malignant syndrome"¦contact her physician for a transfer to intensive care
- D. agranulocytosis"¦hold her antipsychotic and draw blood for a complete blood count
Correct Answer: A
Rationale: The correct answer is A: anticholinergic toxicity. The patient's symptoms align with this diagnosis due to the disorganized behavior, nonsensical speech, disorientation, hot and dry skin, dilated pupils, and recent presentation changes. Anticholinergic toxicity can cause confusion, delirium, hyperthermia, and dilated pupils. Checking vital signs and preparing to use a cooling blanket are appropriate actions to manage the symptoms.
Choice B (relapse of psychosis) is incorrect because the symptoms are not typical of a psychotic relapse. Choice C (neuroleptic malignant syndrome) is incorrect as the symptoms do not completely align with this syndrome, which typically includes muscle rigidity and autonomic dysfunction. Choice D (agranulocytosis) is incorrect because it presents with low white blood cell count and not the symptoms described in the scenario.
Which of the following is an example of a Specific Learning Disability?
- A. Mental Retardation
- B. Dyslexia
- C. ADHD
- D. Autistic spectrum disorders
Correct Answer: B
Rationale: Dyslexia: A persistent, chronic condition in which reading ability lags behind that of non-impaired individuals for the course of most of their lifetime.
A client displays disorganized thinking, difficult-to-follow speech, and silly, inappropriate affect. The client isolates himself from other clients and staff, ignores unit activities, and often seems to be listening and responding to unseen stimuli. This client's behavior most closely conforms to the characteristic behavior of:
- A. Residual schizophrenia
- B. Schizoaffective disorder
- C. Paranoid schizophrenia
- D. Disorganized schizophrenia
Correct Answer: D
Rationale: The correct answer is D: Disorganized schizophrenia. The client's symptoms of disorganized thinking, difficult-to-follow speech, inappropriate affect, social withdrawal, and hallucinations (responding to unseen stimuli) align with the diagnostic criteria for Disorganized Schizophrenia. This subtype is characterized by disorganized behavior, speech, and affect, as well as social withdrawal and hallucinations.
A: Residual schizophrenia does not involve active psychotic symptoms like hallucinations or delusions, which are present in the client's behavior described.
B: Schizoaffective disorder combines symptoms of schizophrenia and mood disorders, and the client's symptoms do not strongly suggest a mood disorder component.
C: Paranoid schizophrenia typically involves prominent delusions and auditory hallucinations, which are not emphasized in the client's behavior described.
A man, aged 84 years, was stopped for going through a red light in a small town where he lives. He told the officer, 'It wasn't there yesterday.' He was unable to tell the officer his address and demonstrated labile mood, seeming pleasant one minute and angry the next. The officer took the man home to discuss his condition with the family and found that he has been wandering around the neighborhood, sometimes taking tools from people's garages, saying they belong to him. The family reluctantly agreed that he should go to the emergency department. What cardinal sign of Alzheimer's disease does this patient demonstrate?
- A. Agnosia.
- B. Apraxia.
- C. Aphasia.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Agnosia. Agnosia is the inability to recognize or interpret sensory information, such as objects, people, sounds, or shapes. In this case, the patient's inability to recognize the red light, his own address, and the ownership of tools indicates a problem with perception and recognition. This aligns with the symptoms of agnosia commonly seen in Alzheimer's disease.
Choices B and C are incorrect. Apraxia is the inability to perform purposeful movements, and aphasia is the loss of ability to understand or express speech. These symptoms are not the primary cardinal sign demonstrated by the patient in the scenario. Choice D, "None of the above," is also incorrect as the patient's symptoms align with the characteristics of agnosia.
Which of the following is a characteristic of bulimia nervosa?
- A. Severe caloric restriction and weight loss.
- B. Binge eating followed by compensatory behaviors like vomiting.
- C. Extreme preoccupation with body image and excessive exercise.
- D. Refusal to eat any food and self-imposed starvation.
Correct Answer: B
Rationale: The correct answer is B. Bulimia nervosa is characterized by recurrent episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, excessive exercise, or fasting. This behavior helps individuals to control their weight and manage guilt associated with binge eating. Choice A is incorrect as bulimia is not associated with severe caloric restriction and weight loss. Choice C is more characteristic of anorexia nervosa, not bulimia. Choice D describes anorexia nervosa, where individuals refuse to eat and engage in self-imposed starvation.
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