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An outpatient diagnosed with schizophrenia tells the nurse, I am here to save the world. I threw away the pills because they make God go away. The nurse identifies the patients reason for medication nonadherence as:
- A. poor alliance with clinicians.
- B. inadequate discharge planning.
- C. dislike of medication side effects.
- D. lack of insight associated with the illness.
Correct Answer: D
Rationale: The patient's belief in an exalted role and rejection of medication due to hallucinations (God's voice) reflect lack of insight (D) into their illness, the primary reason for nonadherence here.
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A 72-year-old patient has the medical diagnosis of delirium secondary to anticholinergic medication toxicity. Family members are very anxious and express their concerns about placing the patient in a nursing home. What information should serve as a basis for the nurse's reply?
- A. Delirium is reversible, and the patient will likely recover.
- B. The symptoms are related to depression, which can be treated.
- C. Delirium usually progresses to dementia, which is usually permanent.
- D. Home care should be attempted; a nursing home should be the last resort.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Delirium is an acute, reversible condition caused by underlying factors like medication toxicity.
2. By addressing the anticholinergic medication toxicity, the delirium can be resolved, leading to recovery.
3. The patient's age does not necessarily indicate a progression to dementia.
4. Placing the patient in a nursing home is not the immediate solution; resolving the toxicity should be the priority.
Summary:
Choice A is correct because delirium is reversible with appropriate treatment. Choices B, C, and D are incorrect because they do not address the underlying cause of delirium or provide accurate information about its progression or management.
Multiple personality or dissociative identity disorder often begins
- A. as a result of combat exhaustion
- B. in adulthood as a response to unremitting phobias
- C. as a consequence of post-traumatic stress disorders
- D. in childhood as a result of unbearable experiences
Correct Answer: D
Rationale: Dissociative identity disorder typically originates in childhood from severe trauma, such as abuse, leading to identity fragmentation.
The wife of a patient with schizophrenia is worried about her 17-year-old daughter and asks the nurse what symptoms mark the prodromal stage of schizophrenia. The nurse should respond by listing behaviors such as:
- A. withdrawal, poor concentration, phobic or obsessive behavior, oddities of speech.
- B. auditory hallucinations, ideas of reference, thought insertion, and broadcasting.
- C. stereotyped behavior, echopraxia, echolalia, waxy flexibility, thought-blocking.
- D. looseness of associations, concrete thinking, echolalia, paranoid delusions.
Correct Answer: A
Rationale: The correct answer is A because the symptoms listed: withdrawal, poor concentration, phobic or obsessive behavior, and oddities of speech are characteristic of the prodromal stage of schizophrenia. During this phase, individuals may start to exhibit subtle changes in behavior and thinking, which may signal the onset of the disorder.
Choice B includes symptoms of active psychosis, such as auditory hallucinations and delusions, which are not typically seen in the prodromal stage. Choice C describes symptoms of catatonia, which are not specific to the prodromal phase. Choice D includes symptoms of acute psychosis, such as paranoid delusions, which are not typically present during the prodromal stage.
In summary, the correct answer is A because it accurately reflects the early, subtle symptoms that may precede the full onset of schizophrenia, while the other choices describe symptoms that are more indicative of later stages of the disorder.
Which of the following is a common physical sign of anorexia nervosa?
- A. Hypoglycemia and tachycardia.
- B. Severe weight loss and dry skin.
- C. Increased appetite and excessive weight gain.
- D. High blood pressure and rapid heart rate.
Correct Answer: B
Rationale: The correct answer is B: Severe weight loss and dry skin. In anorexia nervosa, individuals typically experience significant weight loss due to severe restriction of food intake. This leads to a low body weight, which is a key physical sign of the disorder. Dry skin is also common in anorexia nervosa due to malnutrition.
Rationale:
A: Hypoglycemia and tachycardia are not specific physical signs of anorexia nervosa. While tachycardia (rapid heart rate) can occur due to the stress on the body, it is not as specific as severe weight loss.
C: Increased appetite and excessive weight gain are not characteristic of anorexia nervosa, as individuals with this disorder typically have a distorted body image and fear gaining weight.
D: High blood pressure and rapid heart rate are not typical physical signs of anorexia nervosa. Anorexia nervosa is more commonly associated with low blood pressure due to mal
A patient diagnosed with schizophrenia tells the community mental health nurse, 'I threw away my pills because they interfere with Gods voice.' The nurse identifies the etiology of the patients ineffective management of the medication regime as:
- A. inadequate discharge planning
- B. poor therapeutic alliance with clinicians
- C. dislike of antipsychotic medication side effects
- D. impaired reasoning secondary to the schizophrenia
Correct Answer: D
Rationale: The patients ineffective management of the medication regime is most closely related to impaired reasoning. The patient believes in being an exalted personage who hears Gods voice, rather than an individual with a serious mental disorder who needs medication to control symptoms. Data do not suggest any of the other factors often related to medication nonadherence.