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During a treatment team meeting, the point is made that a client with schizophrenia has recovered from the acute psychosis but continues to demonstrate apathy, avolition, and blunted affect. The nurse who relates these symptoms to serotonin (SHT2) excess will suggest that the client receive:
- A. Haloperidol (Haldol)
- B. Chlorpromazine (Thorazine)
- C. Olanzapine (Zyprexa)
- D. Phenelzine (NardiI)
Correct Answer: C
Rationale: Rationale: Olanzapine (Zyprexa) is an atypical antipsychotic that targets multiple neurotransmitter systems, including serotonin. Serotonin excess is associated with symptoms like apathy, avolition, and blunted affect. Olanzapine, by blocking serotonin receptors, can help alleviate these symptoms in schizophrenia.
Summary of Incorrect Choices:
A: Haloperidol and B: Chlorpromazine are typical antipsychotics that primarily target dopamine receptors, not serotonin. They are more effective for positive symptoms of schizophrenia, not apathy and avolition.
D: Phenelzine is a monoamine oxidase inhibitor (MAOI) used for depression and anxiety disorders, not for schizophrenia symptoms related to serotonin excess.
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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.
Which of the following would be the first priority for nurses caring for autistic children?
- A. Assist the psychiatrist and mental health team in providing treatments to cure the disorder
- B. Determine which of the two different types of autism the child has
- C. Discourage and prevent self-destructive behavior
- D. Provide behavior modification tools, specifically limit setting and reward systems
Correct Answer: C
Rationale: Safety is the primary nursing intervention. Behavior modification tools are important, but safety comes first. Autism at this point is not curable. Determining the type of autism is not a nursing goal.
A nurse is caring for a patient with bulimia nervosa who is experiencing frequent purging. What is a priority assessment?
- A. Monitor electrolyte levels and cardiac function.
- B. Observe for signs of dehydration and low blood pressure.
- C. Assess for any compulsive exercise behaviors.
- D. Monitor for changes in eating patterns and food preferences.
Correct Answer: A
Rationale: The correct answer is A, to monitor electrolyte levels and cardiac function. This is a priority assessment because frequent purging in bulimia nervosa can lead to electrolyte imbalances and cardiac complications, such as arrhythmias and heart failure. Monitoring these parameters is crucial for early detection and intervention to prevent serious health consequences. Observing for signs of dehydration and low blood pressure (Choice B) is important but not as critical as monitoring electrolyte levels and cardiac function. Assessing for compulsive exercise behaviors (Choice C) and monitoring changes in eating patterns and food preferences (Choice D) are also relevant but secondary to the immediate risk of electrolyte imbalances and cardiac issues.
The plan of care for a patient who has demonstrated outbursts of physical violence against his family when frustrated, followed by periods of remorse after each outburst, would be considered successful when the patient:
- A. Expresses frustration verbally instead of physically.
- B. Agrees to seek group counseling at a future time.
- C. Explains the reason for his behavior toward the victim.
- D. Identifies three personal strengths and coping strategies.
Correct Answer: A
Rationale: The correct answer is A because expressing frustration verbally instead of physically shows progress in managing emotions constructively. This approach helps prevent harm and promotes effective communication. Choice B doesn't address immediate behavior change. Choice C focuses on explaining behavior rather than changing it. Choice D is more about self-awareness and coping strategies, which is important but doesn't directly address the violent behavior.
When planning nursing care for a client with a dependent personality disorder, the nurse recognizes which of the following as characteristic behavior for someone with this disorder? The client:
- A. Perceives his or her behavior to be embarrassing
- B. Believes he or she cannot function without help of others
- C. Exaggerates the potential dangers of ordinary situations
- D. Demands excessive attention from others
Correct Answer: B
Rationale: The correct answer is B because individuals with dependent personality disorder typically believe they cannot function without the help of others. This is a key characteristic of the disorder as they rely heavily on others for decision-making and day-to-day tasks. This behavior stems from an intense fear of separation and abandonment.
Choice A (perceiving behavior as embarrassing) is incorrect as it is more aligned with social anxiety disorder rather than dependent personality disorder. Choice C (exaggerating dangers) is incorrect as it is more characteristic of individuals with anxiety disorders. Choice D (demanding excessive attention) is incorrect as it is more typical of individuals with histrionic personality disorder.