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An appropriate short-term goal for a withdrawn, isolated patient diagnosed with schizophrenia is:
- A. The patient will participate in all therapeutic activities.'
- B. The patient will define major barriers to communication.'
- C. The patient will talk about feelings of withdrawal in group.'
- D. The patient will consistently interact with an assigned nurse.'
Correct Answer: D
Rationale: Step 1: Interacting with an assigned nurse helps build a therapeutic relationship, essential for engaging withdrawn patients.
Step 2: Consistent interaction promotes trust and communication, aiding in the patient's socialization.
Step 3: This goal is specific, measurable, achievable, relevant, and time-bound, aligning with the SMART criteria.
Summary:
A: Participation in all activities may overwhelm the patient.
B: Defining barriers to communication is too advanced for someone withdrawn.
C: Talking about feelings in a group setting may be too challenging for a withdrawn patient.
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A rape victim tells the emergency room nurse, 'I feel so dirty. Help me take a shower before anything else.' The nurse should:
- A. Arrange for the patient to shower.
- B. Explain that bathing would destroy evidence.
- C. Suggest the patient wait until after the examination.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Explain that bathing would destroy evidence. This is the best choice because preserving evidence is crucial in cases of sexual assault. Bathing could wash away vital evidence needed for investigation and prosecution. It is important to prioritize the victim's physical and emotional well-being, but preserving evidence for forensic examination takes precedence. Choices A, C, and D are incorrect because arranging for the patient to shower, suggesting waiting, or choosing none of the above would risk compromising the evidence needed for justice.
The dopamine-psychosis link is based on the observation that
- A. low dopamine levels of activity in the brain seem to produce psychotic symptoms
- B. there are high levels of dopamine activity in the brains of psychotic people
- C. there are high levels of amphetamine in the brains of schizophrenics
- D. dopamine interacts with serotonin creating psychosis
Correct Answer: B
Rationale: Elevated dopamine activity is associated with psychotic symptoms, especially in schizophrenia.
A client with anorexia nervosa has refused meal trays and supplemental feedings for 3 days following admission to the general hospital. The nurse can anticipate that intervention will include:
- A. IV infusions beginning immediately and continuing for 48 hours after client begins eating.
- B. Tube feedings until the client eats 90% of all meals for 1 day.
- C. Placing the client on suicide precautions and one-to-one observation.
- D. Limiting peer group visitors for 2 weeks.
Correct Answer: B
Rationale: The correct answer is B. Tube feedings until the client eats 90% of all meals for 1 day. This intervention is appropriate for a client with anorexia nervosa who is refusing to eat. Tube feedings ensure adequate nutrition while also encouraging the client to resume eating orally. It is a gradual approach that aims to transition the client back to regular eating habits.
Explanation for why other choices are incorrect:
A: IV infusions are not the first-line intervention for a client with anorexia nervosa refusing to eat. This choice does not address the underlying issue of the client's refusal to eat.
C: Placing the client on suicide precautions and one-to-one observation is not indicated solely based on refusal to eat. This choice does not address the nutritional needs of the client.
D: Limiting peer group visitors for 2 weeks does not address the client's refusal to eat and is not a relevant intervention in this situation.
An adult diagnosed with a serious mental illness says, I do not need help with money management. I have excellent ideas about investments. This patient usually does not have money to buy groceries by the middle of the month. The nurse assesses the patient as demonstrating:
- A. rationalization.
- B. identification.
- C. anosognosia.
- D. projection.
Correct Answer: C
Rationale: The patient shows anosognosia (C), an inability to recognize deficits due to illness, believing in their financial acumen despite evidence. This isn't rationalization (A), identification (B), or projection (D).
Which of the following should the nurse consider when planning care for a client with antisocial personality disorder? Clients with antisocial personality disorder:
- A. Demand constant attention
- B. Tolerate frustration well
- C. Have well-developed superegos
- D. Are initially often charming
Correct Answer: D
Rationale: The correct answer is D: Are initially often charming. This is because individuals with antisocial personality disorder often exhibit charm and charisma to manipulate others for personal gain. This behavior is known as "charm offensive" and can be used to deceive and exploit others. This initial charm can make it difficult for others to recognize their true motives and manipulative nature.
Incorrect options:
A: Demand constant attention - Individuals with antisocial personality disorder may appear self-centered and manipulative but not necessarily demand constant attention.
B: Tolerate frustration well - Clients with antisocial personality disorder often have difficulty managing frustration and may resort to aggressive or impulsive behavior.
C: Have well-developed superegos - Individuals with antisocial personality disorder typically lack empathy and have a weak or underdeveloped superego, leading to a disregard for social norms and the rights of others.