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After taking an antidepressant for about a week, a patient reports constipation and blurred vision, with no improvement in mood. The psychiatric-mental health nurse informs the patient,:
- A. It takes approximately two to four weeks for depression to lessen, and side effects usually diminish over time'
- B. Stop the medication immediately and contact your primary care physician'
- C. You should contact your doctor. The doctor may need to change your medication'
- D. You should schedule an appointment with your ophthalmologist'
Correct Answer: A
Rationale: Antidepressants require 2-4 weeks for therapeutic effect, and early side effects often subside, making this the most reassuring response.
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A nurse is working with a family with an elderly family member who is in the predisgnostic phase of Alzheimer disease. The most important nursing intervention at this time would be to provide:
- A. family consultation to facilitate communication.
- B. information about support groups and counseling.
- C. options directed toward the reduction of caregiver stress.
- D. educational materials that help them understand their situation.
Correct Answer: D
Rationale: The correct answer is D because educating the family about Alzheimer's disease in the predisgnostic phase helps them understand what to expect and how to cope effectively. This empowers them to make informed decisions and provide appropriate care. Option A focuses on communication, which is important but not the most critical intervention at this stage. Option B is helpful but may not address the family's immediate needs. Option C addresses caregiver stress, which is important but may not be the priority in the predisgnostic phase. Therefore, providing educational materials is the most important intervention to support the family during this phase.
Which intervention would be most appropriate for a patient with bulimia nervosa who is at risk for electrolyte imbalance?
- A. Offer the patient water or an electrolyte replacement solution.
- B. Encourage the patient to engage in regular physical activity.
- C. Administer a diuretic as prescribed by the physician.
- D. Withhold food to reduce the risk of further weight gain.
Correct Answer: A
Rationale: The correct answer is A: Offering the patient water or an electrolyte replacement solution. This intervention is appropriate because patients with bulimia nervosa are at risk for electrolyte imbalances due to purging behaviors. Providing water or electrolyte replacement solution helps to replenish lost electrolytes and maintain proper balance.
Option B is incorrect as excessive physical activity can further deplete electrolytes. Option C is inappropriate as administering a diuretic can worsen electrolyte imbalances. Option D is also incorrect as withholding food can exacerbate the patient's condition and increase the risk of electrolyte imbalances.
The quality of life of people with intellectual disabilities can be improved significantly with the help of basic training procedures that will equip them with a range of skills depending on their level of disability. The application of learning theory to training in these areas is also known as:
- A. Applied cognitive approaches
- B. Applied treatment analysis
- C. Cognitive behavioural therapy
- D. Applied behaviour analysis
Correct Answer: D
Rationale: Applied Behaviour Analysis: Applying principles of learning theory, particularly operant conditioning, to improve skills in individuals with intellectual disabilities.
A patient is diagnosed with anorexia nervosa. A nurse who is assessing for co-morbid psychiatric disorders should begin by looking for signs of which common, concurrent diagnosis?
- A. Phobias.
- B. Depression.
- C. Schizophrenia.
- D. Personality disorder.
Correct Answer: B
Rationale: The correct answer is B: Depression. Anorexia nervosa commonly co-occurs with depression due to shared risk factors and biological mechanisms. Depression is often a primary trigger or consequence of anorexia nervosa, making it a crucial diagnosis to assess for. Phobias (choice A) may be present but are less commonly associated with anorexia nervosa. Schizophrenia (choice C) and personality disorders (choice D) are less likely to co-occur with anorexia nervosa compared to depression. Identifying and addressing depression in a patient with anorexia nervosa is essential for comprehensive treatment and improved outcomes.
A patient with many positive symptoms of schizophrenia, whose behavior is disorganized and who is highly anxious, tells the nurse in the psychiatric emergency department, 'You have got to help me. I do not know what is going on. I think someone is trying to wipe me out. I have to get a gun.' The patient, a college student, lives alone and has no family or support system in the immediate area. He has not left his room in 2 weeks, has not eaten in several days, and is unkempt. Of the available treatment settings, the nurse should recommend:
- A. admission to an unlocked residential crisis unit.
- B. inpatient hospitalization on a locked unit.
- C. attending a day treatment program for 4 weeks.
- D. admission to a partial hospital program.
Correct Answer: B
Rationale: The correct answer is B: inpatient hospitalization on a locked unit. This option is the most appropriate because the patient is presenting with severe symptoms of schizophrenia, including paranoia, disorganized behavior, and potential harm to self or others by mentioning getting a gun. In this case, the patient requires a higher level of care and safety, which can only be provided in an inpatient hospital setting on a locked unit. Admission to an unlocked residential crisis unit (Choice A) may not provide the necessary level of supervision and security. Attending a day treatment program for 4 weeks (Choice C) may not be intensive enough to address the patient's current crisis. Admission to a partial hospital program (Choice D) also may not provide the required level of supervision and structure for a patient with such acute symptoms.