Nokea
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 client with a borderline personality disorder tells the nurse, 'My doctor tells me there's something wrong with the hard wiring of my brain, and that's why I'm so impulsive and get so many mood swings. He said he's going to prescribe some medication.' Being aware of current practice guidelines, the nurse will prepare a teaching plan for:
- A. Lithium
- B. Fluoxetine
- C. Lorazepam
- D. Haloperidol
Correct Answer: B
Rationale: The correct answer is B: Fluoxetine. Borderline personality disorder (BPD) is primarily treated with psychotherapy, but in some cases, medication is used to manage symptoms like impulsivity and mood swings. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is commonly used to address mood instability and impulsivity in BPD. SSRIs help regulate serotonin levels in the brain, which can improve mood stability and decrease impulsive behaviors. Lithium (choice A) is used for bipolar disorder, not BPD. Lorazepam (choice C) is a benzodiazepine used for anxiety and not typically recommended for BPD. Haloperidol (choice D) is an antipsychotic used for conditions like schizophrenia and not typically indicated for BPD.
The nurse who works in a sleep clinic knows that approximately __________% of adults experience some form of sleep disorder.
- A. 10 to 20.
- B. 30 to 40.
- C. 50 to 60.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B (30 to 40%). This range is supported by research indicating that around 30-40% of adults experience some form of sleep disorder. This percentage reflects the prevalence of various sleep disorders such as insomnia, sleep apnea, and restless leg syndrome among adults. The range of 10 to 20% (choice A) is too low based on current data. Likewise, the range of 50 to 60% (choice C) is too high and does not align with the established prevalence rates of sleep disorders in adults. "None of the above" (choice D) is incorrect as there is a documented prevalence of sleep disorders in adults, making it necessary to provide an estimate within a certain range.
After a person was abducted and raped at gunpoint by an unknown assailant, which trauma syndrome is most likely to occur?
- A. Decreased motor activity.
- B. Confusion and disbelief.
- C. Flashbacks and dreams.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Confusion and disbelief. After experiencing a traumatic event like abduction and rape at gunpoint, it is common for individuals to feel confused and in disbelief due to the overwhelming nature of the experience. This reaction is part of the acute stress response and is a normal psychological defense mechanism. Decreased motor activity (choice A) is less likely to be the immediate response to such a traumatic event. Flashbacks and dreams (choice C) are more characteristic of post-traumatic stress disorder (PTSD), which may develop later on but are not the initial trauma syndrome. Choice D is incorrect as trauma responses are expected in this situation.
A useful strategy for helping a patient with schizophrenia manage a potential relapse is to:
- A. have the patient attend group therapy.
- B. advise the patient to continue taking medication daily.
- C. teach the patient and family about behaviors that indicate impending relapse.
- D. schedule appointments for blood tests to determine serum medication levels.
Correct Answer: C
Rationale: The correct answer is C because teaching the patient and family about behaviors indicating an impending relapse helps in early detection and intervention. This empowers them to recognize warning signs like changes in behavior or mood, allowing for prompt action.
Choice A (group therapy) may be beneficial for support but does not directly address relapse prevention. Choice B (medication adherence) is crucial but not specific to relapse management. Choice D (blood tests) is important for monitoring medication levels but does not focus on recognizing relapse indicators.
Anorexia nervosa is best described as a disorder that is potentially:
- A. serious.
- B. uncommon.
- C. psychiatric.
- D. life threatening.
Correct Answer: D
Rationale: The correct answer is D: life threatening. Anorexia nervosa is a serious eating disorder characterized by extreme restriction of food intake, leading to significant weight loss and potentially life-threatening consequences such as organ damage, heart problems, and even death. It is crucial to recognize the severity of anorexia nervosa as it can have devastating effects on physical and mental health. Choices A and C are partially correct, as anorexia nervosa is serious and psychiatric, but they do not fully capture the potential severity and life-threatening nature of the disorder. Choice B is incorrect as anorexia nervosa is not uncommon, affecting a significant number of individuals worldwide.