Nokea
Delusional thinking is characteristic of
- A. psychosis
- B. obsessive-compulsive disorder
- C. conversion disorder
- D. fugue
Correct Answer: A
Rationale: Delusions are a hallmark of psychosis, indicating a break from reality.
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A woman, abducted and raped at gunpoint by an unknown assailant, was found confused and disoriented. The nurse makes these observations about the patient: talking rapidly in disjointed phrases, unable to concentrate, indecisive when asked to make simple decisions. What is the patient's level of anxiety?
- A. Weak
- B. Mild
- C. Moderate
- D. Severe
Correct Answer: D
Rationale: The correct answer is D: Severe. The patient's symptoms of talking rapidly, inability to concentrate, and indecisiveness are indicative of severe anxiety. Rapid speech and disjointed phrases suggest heightened arousal, while the inability to concentrate and make decisions point to severe impairment in cognitive functioning. These symptoms align with the DSM-5 criteria for severe anxiety, which includes extreme levels of distress and impairment in daily functioning. Weak (A), mild (B), and moderate (C) levels of anxiety would not typically manifest in such severe cognitive and behavioral symptoms.
Which measure is critical to achieving desired outcomes in the nurse-client relationship? The nurse:
- A. develops trust in the client.
- B. uses autodiagnosis.
- C. relies on the client liking the nurse rather than limit-setting to achieve structure.
- D. analyzes the relationships among biologic, familial, and sociocultural factors that contributed to the client's disorder.
Correct Answer: B
Rationale: The correct answer is B: uses autodiagnosis. Autodiagnosis is critical in the nurse-client relationship as it involves self-awareness and reflection by the nurse to understand their own biases, emotions, and reactions. This self-awareness allows the nurse to effectively manage their responses, maintain professionalism, and provide quality care to the client. By being aware of their own thoughts and feelings, nurses can better empathize with the client, build trust, and communicate effectively. This approach helps prevent potential conflicts and misunderstandings, leading to better outcomes in the nurse-client relationship.
Summary:
A: Developing trust in the client is important but not the most critical measure.
C: Relying on the client liking the nurse is not professional and may compromise boundaries.
D: Analyzing biologic, familial, and sociocultural factors is important but not as critical as self-awareness through autodiagnosis.
Which of the following signs indicates that a patient with an eating disorder may need immediate hospitalization?
- A. Serum potassium level of 3.2 mEq/L
- B. Body mass index (BMI) of 18.5
- C. Noncompliance with meal plans
- D. Low energy and fatigue
Correct Answer: A
Rationale: The correct answer is A: Serum potassium level of 3.2 mEq/L. This indicates severe hypokalemia, which can lead to life-threatening cardiac arrhythmias in patients with eating disorders. Hospitalization is necessary for immediate monitoring and intervention to prevent serious complications. Choices B, C, and D do not indicate imminent life-threatening risks requiring immediate hospitalization.
The intervention of highest priority for a client with stage 3 Alzheimer's disease is to:
- A. Provide a stimulating environment
- B. Maintain hydration and nutrition
- C. Set limits on behavioral disinhibition
- D. Promote self-care activities
Correct Answer: B
Rationale: The correct answer is B because maintaining hydration and nutrition is crucial for the client's overall well-being and health in stage 3 Alzheimer's. Dehydration and malnutrition can lead to serious complications. Providing a stimulating environment (choice A) may be beneficial but not the highest priority. Setting limits on behavioral disinhibition (choice C) may be challenging due to the progression of the disease. Promoting self-care activities (choice D) may not be feasible as the client's cognitive abilities decline. Maintaining hydration and nutrition is essential for the client's survival and quality of life.
When undertaking care for a patient with an eating disorder, a nurse should first:
- A. perform a complete patient assessment.
- B. obtain a history from the patient's family.
- C. examine his or her own feelings about weight.
- D. question the patient as to when he or she last ate a meal.
Correct Answer: C
Rationale: The correct answer is C because examining the nurse's own feelings about weight is essential to ensure they have a neutral and non-judgmental attitude towards the patient. This self-awareness helps the nurse avoid projecting biases onto the patient and fosters a therapeutic relationship. Performing a complete patient assessment (A) is important but not the first step. Obtaining a history from the patient's family (B) may be helpful but is not the initial priority. Questioning the patient about their last meal (D) is important but does not address the nurse's own attitudes and biases that could impact care.