Nokea
In Anorexia Nervosa (AN), which of the following is a characteristic clinical feature?
- A. Intense fear of gaining weight
- B. Intense desire to binge eat
- C. Intense desire to vomit
- D. Intense desire to keep themselves busy
Correct Answer: A
Rationale: Per DSM-5, an intense fear of gaining weight is a hallmark of Anorexia Nervosa, distinguishing it from other eating disorders.
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The caregiver for a client with moderate to severe dementia tells the nurse, 'I'm exhausted. He wanders at night instead of sleeping, so I get no rest. I'm afraid to leave him during the day, so I have to take him to the grocery store and to the laundromat. When I'm busy there, he often wanders off. Still, I have to do it all.' The nurse recognizes the need to provide teaching for this caregiver. An appropriate outcome is that the caregiver will:
- A. Feel justified in putting the client in a nursing home
- B. Verbalize realistic self-expectations
- C. Cease abusive interactions with the client
- D. Feel comfortable leaving the client alone one morning a week
Correct Answer: B
Rationale: The correct answer is B: Verbalize realistic self-expectations. This is the most appropriate outcome to address the caregiver's situation. By verbalizing realistic self-expectations, the caregiver can understand the importance of self-care and setting boundaries. This outcome promotes the caregiver's well-being while still providing care for the client.
Choice A is incorrect because putting the client in a nursing home may not be the best solution without exploring other options first. Choice C is incorrect as there is no mention of abusive interactions in the scenario. Choice D is incorrect because feeling comfortable leaving the client alone without addressing the caregiver's exhaustion and concerns may not be the most appropriate approach.
The nurse is told that a patient with disorganized schizophrenia is being admitted to the unit. The nurse should expect the patient to demonstrate:
- A. highly suspicious, delusional behavior.
- B. extremes of motor activity and excitement to stupor.
- C. social withdrawal and ineffective communication.
- D. severe anxiety and ritualistic behavior.
Correct Answer: C
Rationale: The correct answer is C because disorganized schizophrenia is characterized by social withdrawal and ineffective communication. This subtype of schizophrenia involves disorganized speech and behavior, flat or inappropriate affect, and disorganized thinking. Patients with this type may display bizarre or nonsensical behavior and have difficulty with daily activities. Choice A is incorrect as suspiciousness and delusions are more commonly associated with paranoid schizophrenia. Choice B is incorrect as extremes of motor activity and excitement to stupor are characteristic of catatonic schizophrenia. Choice D is incorrect as severe anxiety and ritualistic behavior are not typical features of disorganized schizophrenia.
A common form of mental disorder afflicting 10-20\% of the population is
- A. schizophrenia
- B. senile dementia
- C. depression
- D. delusional disorder
Correct Answer: C
Rationale: Depression affects 10-20\% of people at some point, making it far more common than schizophrenia or delusional disorders.
A patient receiving risperidone (Risperdal) reports severe muscle stiffness midmorning. During lunch he has difficulty swallowing food and speaking, and when vital signs are taken 30 minutes later, he is noted to be stuporous and diaphoretic, with a temperature of 38.8° C, pulse of 110 beats/min, and blood pressure of 150/90 mm Hg. The nurse should suspect ______ and should ______.
- A. neuroleptic malignant syndrome"¦place him in a cooling blanket and transfer to ICU
- B. anticholinergic toxicity"¦check vital signs and prepare to use a cooling blanket stat
- C. relapse of his psychosis"¦administer PRN antipsychotic drugs and notify his physician
- D. agranulocytosis"¦hold his antipsychotic and draw blood for a complete blood count
Correct Answer: A
Rationale: The correct answer is A: neuroleptic malignant syndrome (NMS). The patient's symptoms align with NMS, a rare but serious side effect of antipsychotic medications like risperidone. The severe muscle stiffness, difficulty swallowing, altered mental status, diaphoresis, and elevated temperature, pulse, and blood pressure are all indicative of NMS. The nurse should suspect NMS and take immediate action by placing the patient in a cooling blanket to lower the temperature and transfer him to the ICU for close monitoring and further management.
Choice B is incorrect because anticholinergic toxicity typically presents with different symptoms such as dry mouth, dilated pupils, and confusion. Choice C is incorrect as there are no signs of a psychotic relapse, and administering more antipsychotic medication could worsen the NMS. Choice D is incorrect as agranulocytosis presents with symptoms like fever and sore throat, not the combination of symptoms seen in this case.
An unusual state called 'waxy flexibility' is sometimes observed in schizophrenia
- A. borderline
- B. disorganized
- C. catatonic
- D. paranoid
Correct Answer: C
Rationale: Waxy flexibility, a motor symptom, is unique to catatonic schizophrenia.