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A woman was bound, taken to a remote location, and raped at gunpoint. When found, she was examined and treated in the emergency department. Which aspect of this crisis produced the greatest amount of psychological trauma?
- A. The threat to her life
- B. Collection of evidence
- C. Physical pain experienced
- D. Being in a remote location
Correct Answer: A
Rationale: The correct answer is A: The threat to her life. This aspect produced the greatest psychological trauma as the fear of losing one's life triggers intense emotional distress and long-lasting psychological effects such as anxiety and PTSD. The threat of death during a traumatic event can lead to profound feelings of helplessness and vulnerability. In comparison, while the other aspects (B: Collection of evidence, C: Physical pain experienced, D: Being in a remote location) also contribute to the trauma experienced, they do not elicit the same level of fear and existential threat as the possibility of losing one's life.
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A patient with schizophrenia is admitted to the psychiatric unit in an acutely disturbed, violent state. He is given several doses of haloperidol (Haldol) and becomes calm and approachable. During rounds the nurse notices the patient has his head rotated to one side in a stiffly fixed position. His lower jaw is thrust forward and he appears severely anxious. The patient has ______, and the nurse should ______.
- A. a dystonic reaction"¦administer PRN IM benztropine (Cogentin)
- B. tardive dyskinesia"¦seek a change in the drug or its dosage
- C. waxy flexibility"¦continue treatment with antipsychotic drugs
- D. akathisia"¦administer PRN diphenhydramine (Benadryl) PO
Correct Answer: A
Rationale: The correct answer is A: a dystonic reaction"¦administer PRN IM benztropine (Cogentin).
1. Step: Identify the symptoms - The patient has head rotation, stiff fixed position, and lower jaw thrust forward, indicating dystonia.
2. Step: Understand dystonic reactions - Dystonia is an extrapyramidal side effect of antipsychotic medications like haloperidol.
3. Step: Choose appropriate treatment - Benztropine is an anticholinergic medication used to treat acute dystonic reactions.
4. Step: Administer the medication - IM benztropine is the correct route for acute treatment of dystonia.
Summary:
- Choice B (tardive dyskinesia) is incorrect because the symptoms described are acute and not consistent with the gradual onset of tardive dyskinesia.
- Choice C (waxy flexibility) is incorrect because it is a symptom of catatonia, not a side effect of ant
A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self. Select the best outcome related to this diagnosis. Within 2 weeks, the patient will:
- A. Appropriately express angry feelings.
- B. Verbalize two positive things about self.
- C. Verbalize the importance of eating a balanced diet.
- D. Identify two alternative methods of coping with loneliness and isolation.
Correct Answer: D
Rationale: The correct answer is D: Identify two alternative methods of coping with loneliness and isolation.
Rationale:
1. The nursing diagnosis is Ineffective coping related to feelings of loneliness and isolation, indicating the patient struggles with coping mechanisms.
2. The desired outcome is for the patient to identify alternative coping methods, which directly addresses the ineffective coping issue.
3. By identifying two alternative methods, the patient demonstrates an understanding of healthier coping strategies.
4. This outcome focuses on addressing the root cause of the behavior (loneliness and isolation) rather than just surface-level expressions or behaviors.
Summary:
A: Appropriately expressing angry feelings does not directly address coping mechanisms related to loneliness and isolation.
B: Verbalizing positive things about oneself is beneficial but does not address the core issue of ineffective coping.
C: Verbalizing the importance of a balanced diet is important but does not directly address coping with loneliness and isolation.
A nurse would assess for which feature in a patient diagnosed with anorexia nervosa without bingeing or purging?
- A. Extroverted personality traits
- B. Abuse of diuretics and laxatives
- C. Claims of sexual activity
- D. Denial of hunger at all times
Correct Answer: D
Rationale: The correct answer is D: Denial of hunger at all times. In anorexia nervosa without bingeing or purging, patients typically deny hunger despite severe weight loss. This is due to their distorted body image and fear of gaining weight. Assessing for denial of hunger helps in understanding their mindset and severity of the disorder.
Explanation of why other choices are incorrect:
A: Extroverted personality traits - Anorexia nervosa is often associated with introverted personality traits, not extroverted.
B: Abuse of diuretics and laxatives - This behavior is more characteristic of bulimia nervosa, not anorexia nervosa without bingeing or purging.
C: Claims of sexual activity - This choice is unrelated to the typical features of anorexia nervosa without bingeing or purging.
When people successfully adapt to their environment by using logical thought and socially appropriate ways, they are said to be functioning at the adaptive end of the _____ continuum.
- A. Emotional
- B. Self-protective
- C. Neurobiological
- D. Psychobiological
Correct Answer: C
Rationale: The correct answer is C: Neurobiological. This is because neurobiological factors refer to the brain's functioning and how it affects behavior and cognition. When individuals adapt to their environment using logical thought and socially appropriate ways, it indicates a high level of cognitive and behavioral functioning, which is closely tied to neurobiological processes.
A: Emotional is incorrect because emotional factors focus on feelings and affective responses, not necessarily on logical thought and social appropriateness.
B: Self-protective is incorrect as it pertains to behaviors aimed at ensuring one's safety and security, which may not necessarily involve logical thought and social appropriateness.
D: Psychobiological is incorrect as it encompasses the interaction between psychological and biological processes, which may not specifically relate to adaptive functioning in the given context.
In DSM-IV-TR intellectual disabilities are divided into a number of degrees of severity, depending primarily on the range of IQ score provided by the sufferer. One of these is Profound Mental Retardation, represented by an IQ score below:
- A. 20-25
- B. 25-30
- C. 15-20
- D. 15-Oct
Correct Answer: A
Rationale: Profound Mental Retardation: Defined by DSM-IV-TR as an IQ score below 20-25.