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After 5 years in a state hospital, an adult diagnosed with schizophrenia was discharged to the community. This patient now requires persistent direction to accomplish activities of daily living and expects others to provide meals and do laundry. The nurse assesses this behavior as the probable result of:
- A. side effects of antipsychotic medications.
- B. dependency caused by institutionalization.
- C. cognitive deterioration from schizophrenia.
- D. stress associated with acclimation to the community.
Correct Answer: B
Rationale: Institutions impede independent functioning, fostering dependency (B) over time as daily activities are directed by staff. Antipsychotic side effects (A) and cognitive issues (C) may contribute, but the scenario suggests institutional adaptation. Stress (D) is less likely the primary cause.
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You are a nurse meeting for the first time with a stage 3 Alzheimer's patient who is newly referred to your home health agency. Which assessment data about the patient and caregiver(s) would be most important to acquire during your first visit to the family's home?
- A. Is the house design such that patient access to exits and stairways can be restricted?
- B. Does the family understand that the disease is likely to prove fatal within 3 to 5 years?
- C. What resources is the patient's family able to access in their particular community?
- D. None of the above.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Ensuring patient safety is a top priority, especially for a stage 3 Alzheimer's patient.
2. Restricting access to exits and stairways can prevent wandering and potential accidents.
3. This assessment is crucial for creating a safe environment for the patient.
4. Understanding the house design is essential for implementing appropriate safety measures.
Summary of other choices:
B. Understanding the prognosis is important but not as immediately critical as ensuring patient safety.
C. Knowing community resources is valuable but not as urgent as addressing safety concerns.
D. This choice is incorrect as assessing the house design for safety is crucial in this scenario.
People with disabilities (PWD):
- A. Have higher mortality rate due to their underlying bodily impairments
- B. Have a thinner margin of health compared to general population
- C. In the UK had lower infection and mortality rate during the Covid pandemic
- D. Have lesser secondary functional loss when they fall sick
Correct Answer: B
Rationale: PWD have a thinner margin of health, meaning they are more vulnerable to health declines, per global health data.
A pediatric nurse at the clinic interviews a 14-year-old client who is dressed in baggy clothes and two sweaters on a warm day. The client admits to not having had her period for 4 months. The nurse notes fine downy hair along the client's cheeks. Vital signs are T, 36.6; P, 64; and BP, 84/50. Which additional objective sign would best support the nurse's assessment that the client has anorexia nervosa?
- A. Weight 15% below normal for her height.
- B. Eroded dental enamel.
- C. Parotid gland enlargement.
- D. Dehydration.
Correct Answer: A
Rationale: The correct answer is A: Weight 15% below normal for her height. In anorexia nervosa, individuals have a fear of gaining weight leading to severe weight loss. A weight 15% below normal for her height indicates significant weight loss, a hallmark feature of anorexia nervosa. This is supported by the client's baggy clothes, two sweaters on a warm day, and absence of menstrual periods, which are common signs of anorexia nervosa.
Choice B: Eroded dental enamel is a sign of bulimia nervosa, not anorexia nervosa. Choice C: Parotid gland enlargement is seen in bulimia nervosa due to frequent vomiting, not anorexia nervosa. Choice D: Dehydration is a general sign and not specific to anorexia nervosa.
To evaluate whether patient teaching for coping skills has been effective, the psychiatric-mental health nurse asks an adolescent patient to:
- A. consider the outcomes objectively
- B. keep a written journal
- C. perform a return demonstration
- D. set measurable goals
Correct Answer: C
Rationale: A return demonstration shows the patient can apply coping skills, providing tangible evidence of learning.
A client with paranoid schizophrenia has said she feels like throwing a chair. The nurse in the dayroom hears this and wishes to encourage verbalization as a desecalation technique. Which response by the nurse would fulfill this plan?
- A. Tell me what's going on.'
- B. If you throw something, you will be restrained.'
- C. Why are you so upset?'
- D. It's time for group therapy. You can talk there.'
Correct Answer: A
Rationale: The correct answer is A because it encourages the client to express their feelings verbally, promoting communication and potentially preventing escalation of behavior. By saying "Tell me what's going on," the nurse acknowledges the client's emotions and creates a safe space for them to talk. Option B threatens restraint, likely increasing tension. Option C may come off as confrontational. Option D distracts from the immediate need for the client to process their feelings.