Nokea
An Arab student new to an elementary school reports, 'I just don't want to go to gym class.' Which factor would be of primary concern for a school nurse?
- A. The student's family's cultural beliefs regarding females interacting with males in public
- B. Complaints from others of 'bullying' that occurs in gym class
- C. The student's problems adjusting to the new school environment
- D. A teacher's concern that the gym class is overcrowded
Correct Answer: B
Rationale: The correct answer is B because the primary concern for the school nurse would be addressing any potential bullying the Arab student is experiencing in gym class. This is important for the student's well-being and mental health. Choice A is not the primary concern as it does not directly address the student's reluctance to attend gym class. Choice C focuses on general adjustment issues, while choice D pertains to a logistical issue rather than the student's emotional or social well-being. Addressing bullying is crucial to creating a safe and inclusive environment for the student.
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The nurse notes that a male client, who is taking an antipsychotic medication, is constantly moving from chair to chair during a group activity, and he complains that he feels 'nervous and jittery inside.' The nurse is aware that this client most likely is experiencing:
- A. Akinesia
- B. Dystonia
- C. Dyskinesia
- D. Akathisia
Correct Answer: D
Rationale: The correct answer is D: Akathisia. Akathisia is a common side effect of antipsychotic medications characterized by restlessness, inability to sit still, and a feeling of inner restlessness or jitteriness. In this case, the client's constant movement and feeling of nervousness align with the symptoms of akathisia.
A: Akinesia is the opposite of what the client is experiencing, characterized by a lack of movement or muscle weakness.
B: Dystonia involves involuntary muscle contractions and abnormal postures, not constant movement.
C: Dyskinesia refers to abnormal, involuntary movements of the face, trunk, and limbs, which are not described in the scenario.
A 79-year-old white male tells a nurse, 'I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing.' The nurse should analyze this comment as:
- A. normal pessimism of the elderly
- B. evidence of risks for suicide
- C. a call for sympathy
- D. normal grieving
Correct Answer: B
Rationale: The patient describes loss of significant others, economic security, and health. He describes mood alteration and voices the thought that he has little to live for. Combined with his age, sex, and single status, each is a risk factor for suicide. Elderly white males have the highest risk for completed suicide.
Which of the following is an expected finding for a patient with anorexia nervosa?
- A. Increased appetite and food cravings.
- B. A body mass index (BMI) in the normal range.
- C. Bradycardia and hypotension.
- D. Elevated blood pressure and rapid pulse.
Correct Answer: C
Rationale: The correct answer is C. Patients with anorexia nervosa often have bradycardia and hypotension due to the physiological effects of severe malnutrition. Explanation: Severe restriction of food intake leads to decreased energy stores, causing the body to slow down its metabolic processes, including heart rate and blood pressure. Bradycardia and hypotension are common findings in individuals with anorexia nervosa.
Summary:
A: Increased appetite and food cravings are not expected findings in anorexia nervosa as patients typically have a decreased appetite.
B: A body mass index (BMI) in the normal range is not expected in anorexia nervosa, as patients often have a low BMI due to significant weight loss.
D: Elevated blood pressure and rapid pulse are not typical findings in anorexia nervosa; rather, patients may present with low blood pressure and bradycardia.
A patient diagnosed with dementia associated with excessive alcohol use tells a nurse, "Last week I had to take my baby to the hospital for major surgery. That's why I've been so nervous and needed to come here."Â The nurse is aware that the patient has never parented any children. The symptom described can be assessed as:
- A. akathisia.
- B. confabulation.
- C. intellectualization.
- D. magical thinking.
Correct Answer: B
Rationale: The correct answer is B: confabulation. Confabulation is the production of fabricated or distorted memories without the conscious intention to deceive. In this case, the patient is creating a false memory about having a baby and needing to take it to the hospital, which is not based on reality. Akathisia (A) is a movement disorder associated with restlessness, not memory distortion. Intellectualization (C) is a defense mechanism involving excessive focus on facts to avoid uncomfortable emotions, not memory fabrication. Magical thinking (D) involves believing that one's thoughts can influence events, not creating false memories.
In south and east Asia, a man may experience Koro, which is
- A. schizophrenia
- B. insanity
- C. anxiety about his penis receding into his body
- D. depression
Correct Answer: C
Rationale: Koro is a culture-bound syndrome involving intense anxiety that one's penis is retracting into the body.