Nokea
Bob has never met Madonna but he is convinced that she is deeply in love with him. Bob is suffering from
- A. grandiose delusions
- B. jealous delusions
- C. obsessive-compulsive disorder
- D. erotomanic delusions
Correct Answer: A
Rationale: This should be D (erotomanic delusions), where a person believes someone, often a celebrity, is in love with them; the answer key may be incorrect as grandiose delusions involve exaggerated self-importance.
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You are a nurse meeting for the first time with a stage 3 Alzheimer's patient who is newly referred to your home health agency. Which assessment data about the patient and caregiver(s) would be most important to acquire during your first visit to the family's home?
- A. Is the house design such that patient access to exits and stairways can be restricted?
- B. Does the family understand that the disease is likely to prove fatal within 3 to 5 years?
- C. What resources is the patient's family able to access in their particular community?
- D. None of the above.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Ensuring patient safety is a top priority, especially for a stage 3 Alzheimer's patient.
2. Restricting access to exits and stairways can prevent wandering and potential accidents.
3. This assessment is crucial for creating a safe environment for the patient.
4. Understanding the house design is essential for implementing appropriate safety measures.
Summary of other choices:
B. Understanding the prognosis is important but not as immediately critical as ensuring patient safety.
C. Knowing community resources is valuable but not as urgent as addressing safety concerns.
D. This choice is incorrect as assessing the house design for safety is crucial in this scenario.
A 45-year-old married woman who works full time in a factory has recently been absent for 3-day periods on several occasions. Each time, she returned to work wearing dark glasses. Facial and body bruises were apparent. Her supervisor became suspicious that she was a victim of battering and referred her to the occupational health nurse. Which initial inquiry would be most important for the nurse to make?
- A. Tell me what has happened to you.'
- B. Did your husband beat you?'
- C. Why do you let this happen?'
- D. What can you do to prevent this?'
Correct Answer: A
Rationale: The correct answer is A: "Tell me what has happened to you." This open-ended question allows the woman to share her experience without judgment or assumptions. It shows empathy and respect for her autonomy. It is crucial for the nurse to gather information directly from the patient to understand the situation fully and provide appropriate support.
Choice B is incorrect because it assumes the woman's husband is the perpetrator without giving her a chance to disclose the information herself. This can be intimidating and may not lead to a truthful response.
Choice C is incorrect because it implies blame on the victim for the abuse, which is not appropriate. It does not focus on providing support or understanding the situation.
Choice D is incorrect as it puts the responsibility on the victim to prevent the abuse, which is not a helpful approach. The focus should be on providing support and understanding the victim's situation.
During an initial patient interview, the psychiatric-mental health nurse begins by asking the patient to describe their:
- A. current situation
- B. feelings about the current situation
- C. personal history
- D. thoughts about the current situation
Correct Answer: A
Rationale: Starting with the current situation provides a concrete entry point to assess the patient's immediate needs and context.
Which of the following is an appropriate nursing intervention for a patient with anorexia nervosa?
- A. Promote gradual weight gain through a structured meal plan.
- B. Encourage the patient to restrict calorie intake to avoid weight gain.
- C. Offer emotional support without addressing food-related behaviors.
- D. Focus on daily exercise to improve physical fitness.
Correct Answer: A
Rationale: The correct answer is A because promoting gradual weight gain through a structured meal plan is essential in treating anorexia nervosa. This intervention helps the patient restore their nutritional status and physical health. By providing a structured meal plan, the patient can slowly increase their caloric intake, leading to healthy weight gain. This approach also helps address the underlying psychological and emotional issues associated with the eating disorder. Encouraging the patient to restrict calorie intake (B) is harmful as it perpetuates the cycle of malnutrition. Offering emotional support without addressing food-related behaviors (C) neglects the crucial aspect of nutritional rehabilitation. Focusing on daily exercise (D) may exacerbate the patient's physical health and reinforce unhealthy behaviors.
The nurse reports to the interdisciplinary team that an antisocial patient lies to other patients, verbally abuses a patient with Alzheimer's disease, flatters his primary nurse, and is detached and superficial during counseling sessions. Which behavior should be the priority focus of limit setting?
- A. Lying to other patients
- B. Flattering the nursing staff
- C. Verbally abusing other patients
- D. Superficiality during counseling
Correct Answer: C
Rationale: The correct answer is C: Verbally abusing other patients should be the priority focus of limit setting. This behavior poses a direct threat to the safety and well-being of other patients. By addressing verbal abuse first, the nurse can establish boundaries and maintain a safe environment for all patients. Lying to other patients (A) may be addressed but is not as immediate a concern. Flattering the nursing staff (B) is manipulative but not as harmful as verbal abuse. Superficiality during counseling sessions (D) may indicate other issues but is not as urgent as addressing the verbal abuse.