Nokea
Drugs that treat individuals with schizophrenia interrupt neurotransmitter pathways in the brain, producing an effect throughout the entire nervous system that is:
- A. Calming
- B. Numbing
- C. Satisfying
- D. Stimulating
Correct Answer: A
Rationale: The correct answer is A: Calming. Drugs used to treat schizophrenia often target neurotransmitter pathways to reduce symptoms like hallucinations and delusions. By regulating neurotransmitters like dopamine, these drugs help calm the individual's brain activity, leading to a reduction in psychotic symptoms. Choices B, C, and D are incorrect because drugs for schizophrenia are not intended to numb, satisfy, or stimulate the nervous system; rather, they aim to restore balance and alleviate distressing symptoms.
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Police bring a 63-year-old woman to the emergency room, reporting that her behavior is disorganized and disruptive, that her speech makes little sense, and that she does not seem able to take care of herself. The woman has had elective surgeries at the hospital previously and was seen in the ER last week after a fall; records show no history of similar symptoms or mental illness. The ER physician speaks with the patient but does not examine her medically, diagnoses her with schizophrenia, and orders admission to the inpatient psychiatric unit. Which response by the nurse would be most appropriate?
- A. Ask another physician with more of an interest in psychiatry to also take a look at this patient, explaining that you just want to be as thorough as possible.
- B. Suggest that a psychiatric consult be requested before admitting the patient to a psychiatric unit, to validate the diagnosis and speed the initiation of medication.
- C. Remind the physician that schizophrenia usually develops earlier in life, that such presentations may be caused by medical problems, and suggest a medical work-up.
- D. Note that the patient's blood pressure and respirations were elevated when she arrived, and suggest that they be evaluated before admitting the patient to the psychiatric unit.
Correct Answer: C
Rationale: The correct answer is C because it demonstrates critical thinking and patient advocacy. By reminding the physician that schizophrenia typically develops earlier in life and suggesting a medical work-up, the nurse is advocating for a comprehensive approach to ruling out potential medical causes for the patient's symptoms before jumping to a psychiatric diagnosis. This approach aligns with best practices in patient care and ensures that all possible underlying causes are considered and addressed appropriately.
Choice A is incorrect because it does not address the need for a medical work-up to rule out physical causes of the symptoms. Choice B is incorrect as it focuses on validating the diagnosis and initiating medication rather than investigating potential medical issues. Choice D is incorrect as it only addresses the patient's vital signs, overlooking the need for a thorough medical evaluation.
Which information would be important to incorporate when teaching about medications for dementia in a caregiver's support group? Select all that apply.
- A. Antipsychotic medications have been shown to be the most useful category of drugs in reducing behavioral problems in dementias.
- B. Most currently available medications slow the progress of the disease in 20% to 50% of patients but usually do not significantly improve functioning.
- C. None of the currently available medications for dementias provide a cure.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B because it accurately conveys important information about medications for dementia to caregivers. It emphasizes that most medications do not significantly improve functioning but may slow disease progression in a subset of patients. This is crucial for setting realistic expectations.
Choice A is incorrect because antipsychotic medications are not the most useful category of drugs for reducing behavioral problems in dementia; they are associated with serious side effects and should be used cautiously.
Choice C is incorrect because it is essential for caregivers to understand that medications do not cure dementia; managing symptoms and slowing progression are the primary goals.
Choice D is incorrect as the correct answer is B, which provides valuable information for caregivers to understand the limitations and benefits of medications for dementia.
An acutely psychotic individual diagnosed with schizophreniaform disorder at admission is immediately placed on daily doses of risperidone. A hospitalization of 8 days' duration has been authorized by the HMO. By what hospital day would the nurse expect to note that client was demonstrating beginning trust in the nurse and reduction in hallucinations and delusions?
- A. Day of admission
- B. Day 3 of hospitalization
- C. Day 5 of hospitalization
- D. Day 7 of hospitalization
Correct Answer: B
Rationale: The correct answer is B: Day 3 of hospitalization. At this point, the risperidone medication would have had sufficient time to begin exerting its therapeutic effects on the individual's symptoms of hallucinations and delusions. It typically takes a few days for antipsychotic medications like risperidone to reach therapeutic levels in the body and start alleviating psychotic symptoms. By day 3, the individual may start to demonstrate improved trust in the nurse due to the reduction in distressing symptoms.
Incorrect options:
A: Day of admission - It is unlikely to see significant improvement in symptoms and trust on the same day of admission.
C: Day 5 of hospitalization - By this time, the medication would have likely already started showing some effects, and the individual would have had some time to build trust with the nurse.
D: Day 7 of hospitalization - Waiting until day 7 might be too late to note beginning trust and significant reduction in symptoms, as the
A psychiatric technician mentions to the nurse, 'All these clients with Axis II problems! It makes me wonder how so many mothers could have been such poor parents and messed up their kids so badly!' The response by the nurse that helps put the development of personality disorders into perspective is:
- A. Parenting is the responsibility of fathers, too, so don't blame only mothers.'
- B. Personality disorder is often related to sexual abuse that occurs without parental knowledge.'
- C. There is some evidence to suggest a biologic component to personality disorders.'
- D. Peer interactions may be more important in child development than parental involvement.'
Correct Answer: C
Rationale: Step-by-step rationale for why choice C is correct:
1. Personality disorders are complex conditions influenced by a combination of genetic, environmental, and biological factors.
2. Research has shown evidence suggesting a biological component in the development of personality disorders.
3. Understanding the biological component helps to destigmatize and provide a more comprehensive view of personality disorders.
4. This response helps the psychiatric technician understand that blaming parents solely is not accurate and that multiple factors contribute to the development of personality disorders.
Summary:
Choice C is correct because it highlights the importance of considering biological factors in the development of personality disorders, providing a more holistic perspective. Choices A, B, and D are incorrect as they do not address the multifactorial nature of personality disorders.
When a patient with anorexia nervosa is admitted for treatment, the milieu should provide: (Select all that apply.)
- A. Flexible mealtimes.
- B. Unscheduled weight checks.
- C. Adherence to a selected menu.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Flexible mealtimes. In the treatment of anorexia nervosa, providing flexible mealtimes allows patients to regain a sense of control over their eating habits, which is crucial in their recovery process. This approach helps to reduce anxiety around food and promotes a healthier relationship with eating.
Choice B: Unscheduled weight checks can be triggering and anxiety-provoking for patients with anorexia nervosa, as weight monitoring can be a significant source of distress for them.
Choice C: Adherence to a selected menu may reinforce rigid eating patterns and control issues related to food, which can be counterproductive in the treatment of anorexia nervosa.
Choice D: None of the above is incorrect because providing flexible mealtimes is essential in creating a supportive and therapeutic environment for patients with anorexia nervosa.