Nokea
How should the nurse respond to a family member who asks how Alzheimer's disease is diagnosed?
- A. It is impossible to know for certain that a person has Alzheimer's disease until the person dies and his or her brain can be examined via autopsy.
- B. Positron emission tomography (PET) scans can identify the amyloid plaques and tangles of Alzheimer's disease in living clients.
- C. Alzheimer's disease can be diagnosed by using chemical markers that demonstrate decreased cerebral blood flow.
- D. It will be necessary for the patient to undergo positron emission tomography (PET) scans regularly for a long period of time to know if the patient has Alzheimer's disease.
Correct Answer: B
Rationale: Positron emission tomography (PET) scans can identify the amyloid plaques and tangles of Alzheimer's disease in living clients, allowing diagnosis without autopsy. Decreased cerebral blood flow is not specific to Alzheimer's, and regular PET scans are not necessary for diagnosis.
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A patient with bipolar disorder asks the nurse, 'Why did I get this illness? I don't want to be sick.' The nurse would best respond with,
- A. People who develop mental illnesses often had very traumatic childhood experiences.
- B. There is some evidence that contracting a virus during childhood can cause mental disorders.
- C. Sometimes people with mental illness have an overactive immune system.
- D. We don't fully understand the cause, but mental illnesses do seem to run in families.
Correct Answer: D
Rationale: Current theories and studies indicate that several mental disorders may be linked to a specific gene or combination of genes, but that the source is not solely genetic; nongenetic factors also play important roles. Traumatic childhood experiences, viral infections, and immune system activity may contribute to mental illness in genetically predisposed individuals, but these are not definitive causes.
A patient is being seen in the crisis unit reporting that poison letters are coming in the mail. The patient has no history of psychiatric illness. Which of the following medications would the patient most likely be started on?
- A. Aripiprazole (Abilify)
- B. Risperidone (Risperdal Consta)
- C. Fluphenazine (Prolixin)
- D. Fluoxetine (Prozac)
Correct Answer: A
Rationale: New-generation antipsychotics like aripiprazole are preferred for initial treatment of psychotic symptoms due to fewer side effects. Injectable antipsychotics like Risperdal Consta are used after stabilization, and fluoxetine is an antidepressant, not indicated for psychosis.
A client on the unit suddenly cries out in fear. The nurse notices that the client's head is twisted to one side, his back is arched, and his eyes have rolled back in their sockets. The client has recently begun drug therapy with haloperidol (Haldol).
- A. Get a stat order for a serum drug level.
- B. Hold the client's medication until the symptoms subside.
- C. Place an urgent call to the client's physician.
- D. Give a PRN dose of benztropine (Cogentin).
Correct Answer: D
Rationale: The client is experiencing an acute dystonic reaction, common with high-potency antipsychotics like haloperidol. Immediate treatment with an anticholinergic like benztropine provides rapid relief.
Which of the following was the first nonstimulant medication specifically designed and tested for ADHD?
- A. Methylphenidate (Ritalin)
- B. Amphetamine (Adderall)
- C. Atomoxetine (Strattera)
- D. Pemoline (Cylert)
Correct Answer: C
Rationale: Atomoxetine (Strattera) was the first nonstimulant medication specifically designed and tested for ADHD, unlike the stimulant medications Ritalin, Adderall, and Cylert.
A client is seen in the clinic with clinical manifestations of an inability to sit still and a rigid posture. These side effects would be correctly identified as which of the following?
- A. Tardive dyskinesia
- B. Neuroleptic malignant syndrome
- C. Dystonia
- D. Akathisia
Correct Answer: D
Rationale: Akathisia is characterized by an intense need to move about, restlessness, and rigid posture, matching the described symptoms.