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April, a 10-year-old admitted to inpatient pediatric care, has been getting more and more wound up and is losing self-control in the day room. Time-out does not appear to be an effective tool for April to engage in self-reflection. April's mother admits to putting her in time-out up to 20 times a day. The nurse recognizes that:
- A. Time-out is an important part of April's baseline discipline.
- B. Time-out is no longer an effective therapeutic measure.
- C. April enjoys time-out, and acts out to get some alone time.
- D. Time-out will need to be replaced with seclusion and restraint.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:
- A. Medications provided are ineffective.
- B. Nurses are trying to control their minds.
- C. The medications will make them sick.
- D. They are not actually ill.
Correct Answer: D
Rationale: Anosognosia is a lack of insight that affects patients with schizophrenia, leading them to deny or lack awareness of their illness. This lack of awareness often results in patients refusing medication because they genuinely believe they are not ill and do not need treatment. It is crucial for healthcare providers to approach such situations with understanding and empathy, recognizing the impact of anosognosia on treatment adherence.
A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, 'You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing:'
- A. A higher dosage
- B. Once-weekly dosing
- C. A lower dosage
- D. A different drug
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
When providing care for 10-year-old Harper diagnosed with posttraumatic stress disorder (PTSD), which goal should be addressed initially?
- A. Harper will be able to identify feelings through the use of play therapy.
- B. Harper and her parents will have access to protective resources available through social services.
- C. Harper will demonstrate the effective use of relaxation techniques to restore a sense of control over disturbing thoughts.
- D. Harper and her parents will demonstrate an understanding of the personal human response to traumatic events.
Correct Answer: C
Rationale: The initial goal when caring for a child with PTSD like Harper is to address restoring a sense of control over disturbing thoughts by teaching relaxation techniques. This approach helps the child manage their distressing emotions and promotes a feeling of empowerment in dealing with their condition.
Which statement demonstrates a well-structured attempt at limit setting?
- A. Hitting me when you are angry is unacceptable.
- B. I expect you to behave yourself during dinner.
- C. Come here, right now!
- D. Good boys don't bite.
Correct Answer: A
Rationale: Choice A, 'Hitting me when you are angry is unacceptable,' demonstrates a well-structured attempt at limit setting because it clearly defines the unacceptable behavior without ambiguity. This statement sets a clear boundary and clearly communicates the consequence for the behavior. In contrast, choices B, C, and D are less effective in setting limits as they are either vague expectations or commands without specific consequences for crossing the limit.
Which statement made by the patient demonstrates an understanding of the effective use of newly prescribed lithium to manage bipolar mania? Select one that doesn't apply.
- A. I remind myself to consistently drink six 12-ounce glasses of fluid every day.
- B. I discussed the diuretic prescribed by my cardiologist with my psychiatric care provider.
- C. Lithium may help me lose the few extra pounds I tend to carry around.
- D. I take my lithium on an empty stomach to help with absorption.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.