Nokea
Early manifestation of symptoms such as severe impairment in social interaction and in communication can be diagnosed as which of the following?
- A. Infantile autism
- B. Infantile amnesia
- C. Cerebral palsy
- D. Rett's syndrome
Correct Answer: A
Rationale: Infantile Autism: Early manifestations of Autistic Disorder symptoms, including impaired social interaction and communication.
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The following descriptions of a client's experience and behavior can be assessed as an illusion.
- A. The client tries to hit the clinical officer when vital signs must be taken
- B. The client says, 'I keep hearing a voice telling me to run away'
- C. The clients becomes anxious whenever the clinical officer leaves the bedside
- D. The client looks at the shadow on a wall and tells the clinical officer she sees frightening faces on the wall
Correct Answer: D
Rationale: An illusion involves misinterpreting a real stimulus (e.g., seeing faces in a shadow), unlike hallucinations, which involve perceiving something not present.
A child, age 9, is being evaluated in the Emergency Department at the hospital. Her mother is with her and describes her as withdrawn and quiet. The nurse practitioner suspects child abuse. Which of these findings indicates that physical abuse may be a chronic problem for the child?
- A. The presence of the mother and her description of the child as withdrawn and quiet.
- B. The child's refusal to speak to the nurse.
- C. The child's physical appearance.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A because the mother's description of the child as withdrawn and quiet can indicate chronic physical abuse. This is because a child who is consistently withdrawn and quiet may be exhibiting signs of trauma from ongoing abuse. The mother's presence is also important as it provides insight into the child's home environment.
Explanation for why the other choices are incorrect:
B: The child's refusal to speak to the nurse may indicate shyness or fear, but it does not specifically point to chronic physical abuse.
C: The child's physical appearance alone does not provide enough information to determine if physical abuse is chronic.
In summary, choice A is the correct answer as it directly relates to potential signs of chronic physical abuse, while choices B and C do not provide sufficient evidence to support this conclusion.
A 15-year-old boy presents with fatigue to the clinic. He reports that he is unable to wake up in the mornings and is missing a lot of school. On further questioning he reveals that he has some thoughts of suicide, but requests that the information be withheld from his parent who is in the waiting room. On examination he is noted to be obese with acanthosis. The next best step is to ensure his safety is:
- A. Refer to peds medicine for workup of obesity
- B. Breach confidentiality to inform his parent about the adolescents suicidal thoughts
- C. Refer to school for counselling
- D. Reassurance and diet and exercise advice
Correct Answer: B
Rationale: Suicidal thoughts indicate a safety risk, justifying breaching confidentiality to involve parents and ensure immediate intervention, per ethical and clinical guidelines.
A client frequently impulsively acts out suicidal impulses, including grabbing the coffee jar to smash it and attempting to hang herself with her bra. The nurse would view the client's behaviors as most consistent with:
- A. Narcissistic personality disorder
- B. Histrionic personality disorder
- C. Borderline personality disorder
- D. Antisocial personality disorder
Correct Answer: C
Rationale: The correct answer is C: Borderline personality disorder. The client's impulsive and self-destructive behaviors, such as attempting suicide, are characteristic of individuals with borderline personality disorder. These individuals often struggle with intense emotions, unstable relationships, and have a fear of abandonment. They may engage in self-harming behaviors as a way to cope with emotional distress.
A: Narcissistic personality disorder is characterized by a grandiose sense of self-importance and a lack of empathy. This does not align with the impulsive and self-destructive behaviors described in the scenario.
B: Histrionic personality disorder is characterized by attention-seeking behaviors and excessive emotions. While there may be some overlap with impulsive behaviors, it does not fully capture the severity and self-destructiveness of the client's actions.
D: Antisocial personality disorder is characterized by a disregard for the rights of others and a lack of remorse. While individuals with this disorder may engage in impulsive behaviors, the specific behaviors described in
An 85-year-old has difficulty walking after a knee replacement. The patient tells the nurse, 'It's awful to be old. Every day is a struggle. No one cares about old people.' Select the nurse's best response.
- A. Everyone here cares about old people. That's why we work here.
- B. It sounds like you're having a difficult time. Tell me about it.
- C. Let's not focus on the negative. Tell me something good.
- D. You are still able to get around, and your mind is alert.
Correct Answer: B
Rationale: The correct answer is B because it shows empathy and encourages the patient to express their feelings. By saying "Tell me about it," the nurse acknowledges the patient's struggle and opens up the opportunity for the patient to share more about their feelings and concerns. This can help build a therapeutic relationship and provide emotional support.
Choice A is incorrect because it dismisses the patient's feelings by making a general statement about everyone caring without addressing the patient's specific concerns.
Choice C is incorrect because it invalidates the patient's emotions by suggesting to focus on positivity without addressing the patient's current distress.
Choice D is incorrect because it minimizes the patient's struggle by only focusing on physical abilities and cognitive function without addressing the emotional aspect of the patient's statement.