Nokea
Consider these three drugs: divalproex (Depakote), carbamazepine (Tegretol), gabapentin (Neurontin). Which drug also belongs with this group?
- A. Clonazepam (Klonopin)
- B. Lamotrigine (Lamictal)
- C. Risperidone (Risperdal)
- D. Aripiprazole (Abilify)
Correct Answer: B
Rationale: The correct answer is B: Lamotrigine (Lamictal). All the drugs listed are commonly used in the treatment of epilepsy and mood disorders. Lamotrigine is often prescribed alongside divalproex, carbamazepine, and gabapentin as a mood stabilizer and antiepileptic medication. It works by stabilizing electrical activity in the brain and preventing seizures. Clonazepam (A) is a benzodiazepine used for anxiety and seizures, not in the same class as the other drugs. Risperidone (C) and Aripiprazole (D) are antipsychotics used for schizophrenia and bipolar disorder, not primarily for epilepsy.
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Which assessment data suggests a person who appears to have dementia instead has depression and pseudodementia?
- A. Demonstrates impaired judgment.
- B. Demonstrates impaired concentration.
- C. Has a history of significant losses or crises.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B because impaired concentration is a key indicator of depression and pseudodementia rather than dementia. In depression, individuals may experience difficulties focusing and maintaining attention, leading to impaired concentration. Pseudodementia, which mimics dementia but is caused by depression, also presents with similar cognitive symptoms like impaired concentration. Choices A and C are incorrect because impaired judgment and significant losses or crises can be present in both dementia and depression, making them less specific to differentiating between the two conditions. Choice D is incorrect as choice B clearly distinguishes the cognitive symptomatology between dementia and depression/pseudodementia.
A 19-year-old client is admitted for the second time in 9 months and is acutely psychotic with a diagnosis of undifferentiated schizophrenia. The client sits alone rubbing her arms and smiling. She tells the nurse her thoughts cause earthquakes and that the world is burning. The nurse assesses the primary deficit associated with the client's condition as:
- A. Altered mood states
- B. Disturbed thinking
- C. Social isolation
- D. Poor impulse control
Correct Answer: B
Rationale: The correct answer is B: Disturbed thinking. In this scenario, the client's belief that her thoughts cause earthquakes and the world is burning are examples of delusions, which are a key symptom of schizophrenia. This demonstrates a disturbance in the client's thought process, indicating a primary deficit in thinking. Altered mood states (A) may be present as well but are not the primary deficit in this case. Social isolation (C) is a consequence of the client's symptoms rather than the primary deficit. Poor impulse control (D) is not the primary issue presented in the scenario.
A client with dementia is unable to name ordinary objects. Instead, he describes them (e.g., 'the thing you cut meat with'). The nurse should assess this as:
- A. Aphasia.
- B. Paraphasia.
- C. Apraxia.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Paraphasia. Paraphasia is a language disturbance characterized by the substitution of one word for another, leading to incorrect or nonsensical speech. In the case of the client with dementia unable to name ordinary objects but describing them, such as 'the thing you cut meat with,' this behavior aligns with paraphasia. Aphasia (choice A) refers to a complete loss or impairment of language function, which is not the case here. Apraxia (choice C) involves the inability to perform purposeful movements, not language deficits. Therefore, the client's behavior is best assessed as paraphasia due to the characteristic word substitutions and descriptions given.
The priority nursing focus for the period immediately after electroconvulsive therapy treatment should be on:
- A. Monitoring for the return of the capacity for full range of motion.
- B. Assessing the degree of accumulating memory impairment.
- C. Making positive comments while the patient is more receptive.
- D. Assessing the level of consciousness and normal body functions.
Correct Answer: D
Rationale: The correct answer is D: Assessing the level of consciousness and normal body functions. After electroconvulsive therapy (ECT), it is crucial to monitor the patient's level of consciousness and ensure all body functions are normal to detect any potential complications immediately. This includes assessing vital signs, neurological status, respiratory function, and cardiovascular stability. Monitoring for the return of full range of motion (A) is not a priority immediately post-ECT. Assessing memory impairment (B) may be important but is not the immediate priority. Making positive comments (C) is helpful for emotional support but does not address the critical need to assess physical status.
Which of the following would indicate that a therapeutic activity program for a client with Alzheimer's disease had been successful? Client demonstrates:
- A. Accurate recent memory, positive emotional response, increased verbal expression
- B. Increased attention span, verbal expression of remote memory, positive emotional response
- C. Positive use of perseveration, reduction in use of habitual skills, improved abstract reasoning
- D. Positive emotional response, ability to remember multiple steps, accurate recent memory
Correct Answer: B
Rationale: The correct answer is B because increased attention span, verbal expression of remote memory, and positive emotional response indicate successful therapeutic program for Alzheimer's client. Attention span and verbal expression show cognitive improvement, while positive emotional response indicates overall well-being. Option A lacks improvement in remote memory. Option C mentions reduction in habitual skills, which is not desirable. Option D emphasizes recent memory and remembering multiple steps, but doesn't cover improvement in attention span or remote memory.