Nokea
Fragile X syndrome is associated with which of the following?
- A. Language impairment
- B. Behavioural problems
- C. Moderate levels of intellectual disability
- D. All of the above
Correct Answer: D
Rationale: Fragile X Syndrome: A chromosomal abnormality causing intellectual disability, language impairment, and behavioral issues.
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A patient admitted to the eating disorders unit has yellow skin, the extremities are cold, and the heart rate is 42 bpm. The patient weighs 70 pounds; height is 5 feet 4 inches. The patient is quiet during the assessment saying only, "I will not eat until I lose enough weight to look thin." Select the best initial nursing diagnosis.
- A. Anxiety related to fear of weight gain
- B. Disturbed body image related to weight loss
- C. Ineffective coping related to lack of conflict resolution skills
- D. Imbalanced nutrition: less than body requirements related to self-starvation
Correct Answer: D
Rationale: The correct initial nursing diagnosis is D: Imbalanced nutrition: less than body requirements related to self-starvation. The patient's symptoms indicate severe malnutrition from self-starvation, leading to the yellow skin, cold extremities, low heart rate, and underweight status. The patient's statement reflects their distorted perception of body image and the extreme measures taken to achieve thinness. Choice A (Anxiety related to fear of weight gain) is not the best initial diagnosis as it focuses on anxiety rather than the critical issue of malnutrition. Choice B (Disturbed body image related to weight loss) is not the best initial diagnosis as it does not address the immediate risk of severe malnutrition. Choice C (Ineffective coping related to lack of conflict resolution skills) is not the best initial diagnosis as it does not prioritize the life-threatening malnutrition present in this case.
A patient with schizophrenia refuses to take his medication because he believes he is not ill. What phenomenon most likely underlies this presentation?
- A. The patient is unable to face having an illness and is in denial.
- B. Stigma causes the patient to refuse to admit his mental illness.
- C. The illness itself is preventing the patient from realizing he is ill.
- D. Command hallucinations are instructing him to deny the illness.
Correct Answer: C
Rationale: The correct answer is C because anosognosia, a symptom of schizophrenia, can prevent patients from recognizing they are ill due to the illness itself affecting their insight and awareness. Anosognosia is a neurocognitive deficit common in schizophrenia, where the brain's ability to recognize one's own illness is impaired. This leads the patient to genuinely believe they are not ill, even when presented with evidence to the contrary.
Choice A: Denial is a psychological defense mechanism, not a symptom of schizophrenia.
Choice B: Stigma might influence perceptions of mental illness, but it does not directly cause anosognosia in schizophrenia.
Choice D: Command hallucinations can influence behavior, but they typically involve auditory commands unrelated to recognizing one's illness.
Which measure is advisable to take, considering that individuals with dramatic erratic personality disorders often have the ability to evade limits and manipulate others?
- A. Plan frequent client-centered staff meetings.
- B. Practice take-down and restraint procedures.
- C. Institute written or taped change-of-shift reports.
- D. Rotate staff assignments so no one is responsible for the client for a prolonged period of days.
Correct Answer: A
Rationale: The correct answer is A: Plan frequent client-centered staff meetings. This measure is advisable as it promotes open communication, collaboration, and consistency in care. By holding regular meetings, staff can discuss concerns, share observations, and develop strategies to effectively manage individuals with erratic personality disorders. This approach helps in setting clear boundaries, identifying manipulative behaviors, and ensuring a unified team response.
Summary:
- Choice B: Practice take-down and restraint procedures is incorrect as it focuses on physical control rather than preventive strategies.
- Choice C: Institute written or taped change-of-shift reports is incorrect as it lacks real-time communication and immediate response to potential issues.
- Choice D: Rotate staff assignments so no one is responsible for the client for a prolonged period of days is incorrect as it may disrupt continuity of care and hinder the establishment of trust and rapport.
Sudden temporary amnesia or instances of multiple personality are disorders
- A. dissociative
- B. anxiety
- C. psychotic
- D. schizophrenic
Correct Answer: A
Rationale: Dissociative disorders include amnesia and multiple personalities, linked to identity disruption.
The nurse is considering making a child abuse or neglect report to protective services. To make the report, the nurse needs to:
- A. Obtain the supervisor's permission to make the report
- B. Have strong evidence that the abuse/neglect has occurred
- C. Notify the parents of the intent to file the report
- D. Have suspicions that the abuse has occurred
Correct Answer: D
Rationale: The correct answer is D because mandatory reporting laws typically require healthcare professionals to report suspected cases of child abuse or neglect. Having suspicions that abuse has occurred is sufficient to make a report, as it is the responsibility of the healthcare provider to protect the child's safety. Obtaining the supervisor's permission (choice A) may delay the report unnecessarily. Having strong evidence (choice B) is not necessary for making a report, as suspicions should be reported for further investigation. Notifying the parents (choice C) may jeopardize the safety of the child if the abuser is aware of the report.