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An elderly patient brings a bag of medications to the clinic. The nurse finds a bottle labeled Ativan and one labeled lorazepam, both of which are to be taken BID. There are also bottles labeled hydrochlorothiazide, Inderal, and rofecoxib, each to be taken once daily. Which conclusion is accurate?
- A. Rofecoxib should not be taken with Ativan.
- B. Lorazepam interferes with the action of Inderal.
- C. The patient should not self-administer medication.
- D. Lorazepam and Ativan are the same drug, so the dose is excessive.
Correct Answer: D
Rationale: Lorazepam and Ativan are generic and trade names for the same drug (D), creating an accidental misuse situation with an excessive dose. The patient needs medication education and help with proper labeling; there is no evidence they cannot self-administer (C). Options A and B are not factually supported.
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Which stage of Piaget's theory marks the onset of logical thinking?
- A. Sensorimotor
- B. Preoperational
- C. Concrete Operational
- D. Formal Operational
Correct Answer: C
Rationale: The Concrete Operational stage (C), around age 7-11, marks the onset of logical thinking about concrete events, per Piaget's theory. Earlier stages (A, B) lack this, and Formal Operational (D) involves abstract logic later.
What is the most important aspect of nursing care for patients with anorexia nervosa during refeeding?
- A. Refeed the patient with high-calorie foods quickly to gain weight.
- B. Start with small, manageable portions and gradually increase caloric intake.
- C. Restrict food choices to healthy foods only.
- D. Encourage the patient to take food supplements in addition to meals.
Correct Answer: B
Rationale: The correct answer is B: Start with small, manageable portions and gradually increase caloric intake. This approach is essential because refeeding syndrome can occur in patients with anorexia nervosa, where rapid refeeding can lead to severe electrolyte imbalances and potentially life-threatening complications. Starting with small portions helps to prevent this syndrome by allowing the body to gradually adjust to increased caloric intake. Additionally, it helps in preventing overwhelming the patient with large amounts of food, which can trigger anxiety and resistance to eating.
Incorrect choices:
A: Refeed the patient with high-calorie foods quickly to gain weight - This can lead to refeeding syndrome and is not a safe approach.
C: Restrict food choices to healthy foods only - Restricting food choices can exacerbate disordered eating behaviors and does not address the need for gradual refeeding.
D: Encourage the patient to take food supplements in addition to meals - While supplements can be helpful, they should not be a primary focus over balanced
A psychiatric technician mentions to the nurse, 'All these clients with Axis II problems! It makes me wonder how so many mothers could have been such poor parents and messed up their kids so badly!' The response by the nurse that helps put the development of personality disorders into perspective is:
- A. Parenting is the responsibility of fathers, too, so don't blame only mothers.'
- B. Personality disorder is often related to sexual abuse that occurs without parental knowledge.'
- C. There is some evidence to suggest a biologic component to personality disorders.'
- D. Peer interactions may be more important in child development than parental involvement.'
Correct Answer: C
Rationale: Step-by-step rationale for correct answer (C):
1. Personality disorders are complex and have multifactorial causes.
2. Research suggests a biological component to personality disorders, such as genetic predispositions.
3. This understanding helps to shift the blame away from solely poor parenting.
4. It aligns with the biopsychosocial model, which considers biological, psychological, and social factors.
5. This response promotes a holistic view of personality development.
Summary of why other choices are incorrect:
A: Shifts focus to gender roles, which is not directly relevant to the etiology of personality disorders.
B: Narrowly associates personality disorders with sexual abuse, ignoring other contributing factors.
D: Overemphasizes peer interactions over parental influence, which is not supported by extensive research on personality development.
Major concerns of the elderly living alone in their home are: (Name 1)
- A. Safety
- B. Quality of life
- C. Support system
- D. Access to medical care
Correct Answer: A
Rationale: Safety (A) is a major concern for the elderly living alone, as it impacts their ability to remain independent and healthy. Other concerns like quality of life (B), support system (C), and medical access (D) are also relevant but asked as a single choice here.
A child, age 5, was admitted to the children's unit, having been sexually abused by an acquaintance of her family. The child refuses to talk and participate in unit activities, choosing to stay in her room with her stuffed animals. Which therapeutic intervention will best help the child release pent-up feelings about the abuse?
- A. Individual communication with the nurse
- B. Play therapy
- C. Family therapy
- D. Role-play with other children on the unit
Correct Answer: B
Rationale: The correct answer is B: Play therapy. Play therapy is the most suitable therapeutic intervention for a child in this scenario because it allows the child to express their feelings and experiences through play, which is a natural form of communication for children. Through play therapy, the child can act out their experiences using toys and create a safe space to process their emotions without having to verbally communicate. It helps the child release pent-up feelings and trauma in a non-threatening environment.
Summary of other choices:
A: Individual communication with the nurse may not be as effective as play therapy in this case as the child is not yet comfortable verbalizing their feelings.
C: Family therapy may not be appropriate at this stage as the child is not ready to engage with family members about the abuse.
D: Role-play with other children on the unit may not be beneficial as it can potentially trigger more anxiety and discomfort for the abused child.