Nokea
Because there is considerable overlap among the types of schizophrenia, and because patterns of behavior shift over time, many patients are simply classified as suffering from schizophrenia
- A. borderline
- B. atypical
- C. mixed
- D. undifferentiated
Correct Answer: D
Rationale: Undifferentiated schizophrenia is diagnosed when symptoms don't clearly fit other subtypes, reflecting overlap and shifting patterns.
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What is the priority nursing intervention when caring for a patient with bulimia nervosa who has a history of purging?
- A. Provide emotional support and assist with stress management.
- B. Monitor vital signs and electrolyte levels closely.
- C. Encourage the patient to exercise regularly to prevent weight gain.
- D. Help the patient identify triggers for binge eating and purging behaviors.
Correct Answer: B
Rationale: The correct answer is B because monitoring vital signs and electrolyte levels closely is crucial in managing a patient with bulimia nervosa who has a history of purging. Purging can lead to electrolyte imbalances and dehydration, which can have serious consequences such as cardiac arrhythmias and electrolyte disturbances. By closely monitoring vital signs and electrolyte levels, nurses can quickly identify and intervene in case of any abnormalities, preventing potential life-threatening complications.
Choice A is incorrect because emotional support and stress management are important but not the priority when dealing with physical complications from purging. Choice C is incorrect because encouraging exercise may exacerbate the patient's unhealthy behaviors and should be approached cautiously. Choice D is incorrect because identifying triggers is important but not as immediate as monitoring vital signs and electrolyte levels in this situation.
Which of the following is a characteristic behavior in patients with anorexia nervosa?
- A. Binge eating followed by purging.
- B. Extreme weight loss due to excessive food restriction.
- C. Frequent overeating with a lack of control.
- D. Excessive weight gain through overeating and exercise.
Correct Answer: B
Rationale: The correct answer is B: Extreme weight loss due to excessive food restriction. Patients with anorexia nervosa typically exhibit severe food restriction leading to significant weight loss. This behavior is driven by a distorted body image and fear of gaining weight. Binge eating followed by purging (choice A) is characteristic of bulimia nervosa, not anorexia nervosa. Frequent overeating with a lack of control (choice C) is a feature of binge eating disorder, not anorexia nervosa. Excessive weight gain through overeating and exercise (choice D) does not align with the weight loss seen in anorexia nervosa.
A patient has not come out of her room for breakfast. The nurse finds the patient moving restlessly about her room in a disorganized manner. The patient is talking to herself, and her verbal responses to the nurse are nonsensical and suggest disorientation. The nurse notices that the patient's skin is hot and dry, and her pupils are somewhat dilated. All these symptoms are significant departures from the patient's recent presentation. The patient is likely experiencing ______, and the nurse should ______.
- A. anticholinergic toxicity"¦check vital signs and prepare to use a cooling blanket stat
- B. relapse of her psychosis"¦administer PRN antipsychotic drugs and notify her physician
- C. neuroleptic malignant syndrome"¦contact her physician for a transfer to intensive care
- D. agranulocytosis"¦hold her antipsychotic and draw blood for a complete blood count
Correct Answer: A
Rationale: The correct answer is A: anticholinergic toxicity. The patient's symptoms align with this diagnosis due to the disorganized behavior, nonsensical speech, disorientation, hot and dry skin, dilated pupils, and recent presentation changes. Anticholinergic toxicity can cause confusion, delirium, hyperthermia, and dilated pupils. Checking vital signs and preparing to use a cooling blanket are appropriate actions to manage the symptoms.
Choice B (relapse of psychosis) is incorrect because the symptoms are not typical of a psychotic relapse. Choice C (neuroleptic malignant syndrome) is incorrect as the symptoms do not completely align with this syndrome, which typically includes muscle rigidity and autonomic dysfunction. Choice D (agranulocytosis) is incorrect because it presents with low white blood cell count and not the symptoms described in the scenario.
The nurse is administering haloperidol (Haldol) to a client experiencing delusions and hallucinations associated with schizophrenia. The nurse can expect symptom abatement as a result of the drug's action to:
- A. Reduce the number of brain cells that crave dopamine
- B. Block dopamine receptors, making dopamine less available
- C. Enhance dopamine receptors, making more dopamine available
- D. Cause increased cellular production of dopamine
Correct Answer: B
Rationale: The correct answer is B because haloperidol is a typical antipsychotic that works by blocking dopamine receptors in the brain. By blocking these receptors, haloperidol reduces the effects of excess dopamine, which is known to contribute to symptoms of schizophrenia such as delusions and hallucinations. This action helps alleviate the positive symptoms of schizophrenia.
Choice A is incorrect because haloperidol does not reduce the number of brain cells that crave dopamine; it acts on the receptors themselves. Choice C is incorrect because enhancing dopamine receptors would lead to an increase in the effects of dopamine, worsening symptoms. Choice D is incorrect because haloperidol does not cause increased cellular production of dopamine; it blocks dopamine receptors instead.
Which of these is a sign of delayed mental development in toddlers?
- A. Limited speech
- B. Preference for solo play
- C. Not walking by 12 months
- D. Dislike of loud noises
Correct Answer: A
Rationale: Limited speech (A) by toddler age (e.g., few words by 2 years) may indicate delayed mental development, per milestones. Solo play (B) is normal, walking (C) is physical, and noise dislike (D) is sensory.