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A victim of partner abuse, parent of one child, describes the partner as someone who is easily frustrated and more likely to be abusive after experiencing an event in which the most recent episodes of violence were related to feeling 'upset' over a job loss. What type of therapy would provide the greatest help to the abuser?
- A. Voluntary individual or group therapy
- B. Court-ordered individual or group therapy
- C. Voluntary couples or family therapy
- D. None of the above
Correct Answer: A
Rationale: The correct answer is A: Voluntary individual or group therapy. This type of therapy would be most helpful as it focuses on addressing the abuser's personal issues and behaviors, such as managing frustration and anger. By participating voluntarily, the abuser is more likely to be open to introspection and change.
Summary of other choices:
B: Court-ordered therapy may not be as effective as voluntary therapy, as the abuser may feel forced and less motivated to engage in the process.
C: Couples or family therapy may not be appropriate initially as the abuser needs to work on personal issues first before addressing relationship dynamics.
D: None of the above is incorrect as voluntary individual or group therapy is the most suitable option for addressing the abuser's behavior.
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A nurse is planning care for a patient with anorexia nervosa. What is the priority intervention?
- A. Encourage the patient to verbalize concerns about body image.
- B. Monitor the patient's weight and nutritional intake closely.
- C. Provide education on healthy eating and exercise.
- D. Offer emotional support to the patient regarding self-esteem.
Correct Answer: B
Rationale: The correct answer is B. Monitoring the patient's weight and nutritional intake closely is the priority intervention for a patient with anorexia nervosa as it directly addresses the immediate health risks associated with the disorder, such as malnutrition and weight loss. By closely monitoring these parameters, healthcare providers can assess the patient's progress and make necessary adjustments to prevent further complications.
Choice A is incorrect because while addressing body image concerns is important in the long term, it is not the priority intervention when the patient's physical health is at risk.
Choice C is incorrect as providing education on healthy eating and exercise may not be effective if the patient is not yet in a stable physical condition to absorb and apply the information.
Choice D is incorrect as offering emotional support is valuable, but it is not the priority intervention in this case where the patient's physical health needs immediate attention.
The client has been taking lithium and fluoxetine (Prozac) for almost a week. During today's assessment, the nurse notes a temperature of 39°C, muscle rigidity, and confusion. The client's signs and symptoms suggest:
- A. Dystonic reactions
- B. Bradykinesic side effects
- C. Extrapyramidal side effects
- D. Neuroleptic malignant syndrome
Correct Answer: D
Rationale: The correct answer is D: Neuroleptic malignant syndrome (NMS). This is indicated by the client's elevated temperature, muscle rigidity, and confusion, which are classic symptoms of NMS. NMS is a serious, potentially life-threatening condition associated with the use of antipsychotic medications like lithium and fluoxetine. The onset of NMS is often rapid and can lead to severe complications if not treated promptly. Dystonic reactions (choice A) involve sudden and involuntary muscle contractions, which are not consistent with the client's symptoms. Bradykinesic side effects (choice B) refer to slowed movements, which are not present in this case. Extrapyramidal side effects (choice C) typically include symptoms like tremors, stiffness, and restlessness, but do not encompass the combination of symptoms seen in NMS.
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.
Police bring a 63-year-old woman to the emergency room, reporting that her behavior is disorganized and disruptive, that her speech makes little sense, and that she does not seem able to take care of herself. The woman has had elective surgeries at the hospital previously and was seen in the ER last week after a fall; records show no history of similar symptoms or mental illness. The ER physician speaks with the patient but does not examine her medically, diagnoses her with schizophrenia, and orders admission to the inpatient psychiatric unit. Which response by the nurse would be most appropriate?
- A. Ask another physician with more of an interest in psychiatry to also take a look at this patient, explaining that you just want to be as thorough as possible.
- B. Suggest that a psychiatric consult be requested before admitting the patient to a psychiatric unit, to validate the diagnosis and speed the initiation of medication.
- C. Remind the physician that schizophrenia usually develops earlier in life, that such presentations may be caused by medical problems, and suggest a medical work-up.
- D. Note that the patient's blood pressure and respirations were elevated when she arrived, and suggest that they be evaluated before admitting the patient to the psychiatric unit.
Correct Answer: C
Rationale: The correct answer is C because it promotes a thorough and systematic approach to the patient's care. First, it challenges the premature diagnosis of schizophrenia without a medical examination. Second, it highlights the importance of considering medical causes for the symptoms presented by the patient. This is crucial as the patient's age and lack of prior history of mental illness suggest that a medical work-up is necessary to rule out underlying medical conditions that could be causing her symptoms. This approach ensures a comprehensive evaluation and appropriate treatment tailored to the patient's specific needs.
Choices A, B, and D are incorrect because they do not address the fundamental issue of exploring potential medical causes for the patient's symptoms before jumping to a psychiatric diagnosis or treatment. A, B, and D focus on seeking additional psychiatric opinions, consulting for medication initiation, and evaluating vital signs, respectively, which do not address the need for a thorough medical evaluation in this case.
A woman tells the nurse, 'My partner is frustrated with me. I don't have any natural lubrication when we have sex.' What type of sexual disorder is evident?
- A. Genito-pelvic pain/penetration disorder
- B. Female sexual interest/arousal disorder
- C. Hypoactive sexual desire disorder
- D. Female orgasmic disorder
Correct Answer: B
Rationale: The correct answer is B: Female sexual interest/arousal disorder. The woman's complaint of lack of natural lubrication during sex indicates a difficulty in arousal, which falls under this disorder category. This is because arousal difficulties can lead to inadequate lubrication, impacting sexual satisfaction. Genito-pelvic pain/penetration disorder (A) involves pain during intercourse, not lack of lubrication. Hypoactive sexual desire disorder (C) refers to low libido, not lubrication issues. Female orgasmic disorder (D) pertains to difficulties reaching orgasm, not lubrication problems.