Nokea
A woman consults the nurse practitioner because she has not achieved orgasm for 2 years, despite having been sexually active. This is an example of
- A. Paraphilic disorder.
- B. Female orgasmic disorder.
- C. Genito-pelvic pain/penetration disorder.
- D. Female sexual interest/arousal disorder.
Correct Answer: B
Rationale: The correct answer is B: Female orgasmic disorder. This woman's inability to achieve orgasm despite being sexually active aligns with the diagnostic criteria for Female Orgasmic Disorder in the DSM-5. This disorder is characterized by a marked delay, absence, or decreased intensity of orgasm, which causes distress or interpersonal difficulty. Other choices are incorrect because Paraphilic Disorder refers to atypical sexual interests, Genito-pelvic pain/penetration disorder involves pain during intercourse, and Female Sexual Interest/Arousal Disorder pertains to lack of interest in or arousal during sexual activity.
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Which symptom of Alzheimer's disease is associated with disorientation to time and place?
- A. Forgetting in what order to put clothes on
- B. Forgetting simple words
- C. Forgetting where he or she lives
- D. Becoming suspicious of others
Correct Answer: C
Rationale: The correct answer is C: Forgetting where he or she lives. In Alzheimer's disease, disorientation to time and place is a common symptom due to memory loss and cognitive decline. Forgetting where one lives directly relates to disorientation, as the individual may not recognize their home or surroundings. Choice A is related to sequencing and executive function, not specific to time and place. Choice B is more associated with language and communication difficulties. Choice D relates to paranoia or mistrust, not specifically related to disorientation to time and place. In summary, the correct answer directly reflects the symptom of disorientation in Alzheimer's disease, while the other choices are related to different cognitive functions.
A client with schizophrenia is medication compliant and has well-controlled symptoms. He has, however, never been successful in holding a job because of poor social skills and lack of understanding of basic job skills. The nurse case manager should consider referring the client:
- A. To a day hospital program
- B. For psychosocial rehabilitation
- C. For cognitive therapy
- D. To assertiveness training
Correct Answer: B
Rationale: The correct answer is B: For psychosocial rehabilitation. This option is the most appropriate because the client is struggling with social skills and job-related skills. Psychosocial rehabilitation programs focus on improving social and vocational skills, which are essential for the client to succeed in holding a job. These programs also provide support and training tailored to the individual's needs. Referring the client to a day hospital program (A) may not address his specific vocational needs. Cognitive therapy (C) primarily focuses on addressing cognitive distortions and may not directly target social and vocational skills. Assertiveness training (D) may be helpful but may not fully address the client's broader vocational challenges.
Which factor least influences whether a country will have a higher life expectancy?
- A. The level of racial diversity
- B. Quality sanitation and sewage treatment facilities
- C. Access to food
- D. Access to medicine
Correct Answer: A
Rationale: Racial diversity has little direct impact on life expectancy compared to sanitation, food, and medical access, which are critical determinants.
At 11:00 AM, a patient with schizophrenia who exhibits concrete thinking asks the nurse for PRN acetaminophen (Tylenol). However, he last had it at 8:00 AM, and it is ordered only every 4 hours. Which nursing response would be most therapeutic?
- A. I'm sorry, it's not quite time yet; please come back again in 1 hour.'
- B. I'm sorry, it's not quite time yet; please come back again at 12 noon.'
- C. It's not time yet; please come back when both hands of the clock point straight up.'
- D. It's not time yet; I will let you know when it is time. Perhaps a nap would help?'
Correct Answer: C
Rationale: The correct answer is C because it provides a clear, concrete instruction that the patient can easily understand. By stating "come back when both hands of the clock point straight up," the nurse offers a specific and visual cue for the patient to know when it's time for the medication. This approach aligns with the patient's concrete thinking and helps him grasp the concept of time more effectively.
Choice A is incorrect because stating "in 1 hour" may be too abstract for a patient with concrete thinking. Choice B is also incorrect as it provides a general time frame without a visual reference, which may confuse the patient. Choice D is incorrect as suggesting a nap does not address the patient's request for medication and does not provide a clear time frame.
Consider these three drugs: divalproex (Depakote), carbamazepine (Tegretol), gabapentin (Neurontin). Which drug also belongs with this group?
- A. Clonazepam (Klonopin)
- B. Lamotrigine (Lamictal)
- C. Risperidone (Risperdal)
- D. Aripiprazole (Abilify)
Correct Answer: B
Rationale: The correct answer is B: Lamotrigine (Lamictal). All the drugs listed are commonly used in the treatment of epilepsy and mood disorders. Lamotrigine is often prescribed alongside divalproex, carbamazepine, and gabapentin as a mood stabilizer and antiepileptic medication. It works by stabilizing electrical activity in the brain and preventing seizures. Clonazepam (A) is a benzodiazepine used for anxiety and seizures, not in the same class as the other drugs. Risperidone (C) and Aripiprazole (D) are antipsychotics used for schizophrenia and bipolar disorder, not primarily for epilepsy.