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In DSM-IV-TR intellectual disabilities are divided into a number of degrees of severity, depending primarily on the range of IQ score provided by the sufferer. One of these is Mild Mental Retardation, corresponding to an IQ score between:
- A. 60-65 to 80
- B. 40-55 to 60
- C. 50-55 to 70
- D. 70-75 to 90
Correct Answer: C
Rationale: Mild Mental Retardation: Defined by DSM-IV-TR as an IQ score between 50-55 to 70.
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A patient with bipolar disorder is hyperactive and has not slept for 3 days. Mood and behavior are labile. The patient threatens to hit another patient. Which response by the nurse is appropriate?
- A. Stop that now. No one did anything to provoke an attack by you.
- B. If you try that again, you will be placed in seclusion immediately.
- C. Do not hit anyone. If you are unable to control yourself, we will help you.
- D. You know we will not let you hit anyone. Why do you continue this behavior?
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the patient's struggle to control their behavior and offers support. It emphasizes the importance of not hitting anyone while also reassuring the patient that help is available if needed. This response promotes a therapeutic environment by setting clear boundaries and offering assistance rather than using threats or aggression.
Choice A is incorrect as it may escalate the situation by using a confrontational tone, potentially provoking further aggression. Choice B is also incorrect as it threatens the patient with seclusion, which can be seen as punitive and may not address the underlying issues causing the behavior. Choice D is incorrect as it does not provide a clear directive to prevent violence and instead questions the patient's behavior without offering immediate support.
Several clients are members of a therapy group for clients with eating disorders. Of what particular use is this type of group therapy for treatment of eating disorders?
- A. Spending time in a group setting helps the client focus on things other than food.
- B. Interacting with clients who have similar problems helps prevent secondary gains related to being different.
- C. Focusing on problems experienced by other group members helps the client avoid having to deal with personal concerns.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B because interacting with clients who have similar problems in a therapy group for eating disorders helps prevent secondary gains related to feeling different or unique in their struggles. This interaction can offer a sense of validation, support, and understanding, which can be crucial for individuals with eating disorders. It fosters a sense of belonging and reduces the feelings of isolation that often accompany these disorders.
Choice A is incorrect because the primary focus of group therapy for eating disorders is to address and work through issues related to food and body image, rather than distracting clients from these concerns.
Choice C is incorrect because the purpose of group therapy is to provide a safe space for clients to explore and address their personal concerns within a supportive group setting, not to avoid dealing with them.
Choice D is also incorrect as interacting with similar others in a therapy group has specific benefits for individuals with eating disorders.
Which complication should a nurse monitor for when treating a patient with bulimia nervosa who is experiencing frequent vomiting?
- A. Hypokalemia and dental enamel erosion.
- B. Hyperkalemia and elevated blood pressure.
- C. Severe dehydration and low blood sugar.
- D. Hypercalcemia and weight gain.
Correct Answer: A
Rationale: The correct answer is A: Hypokalemia and dental enamel erosion.
1. Bulimia nervosa involves frequent vomiting, leading to loss of potassium (hypokalemia) due to electrolyte imbalance.
2. Vomiting also damages tooth enamel, causing dental erosion.
3. Hyperkalemia and elevated blood pressure (choice B) are not typically associated with bulimia.
4. Severe dehydration and low blood sugar (choice C) are possible but not the primary concerns.
5. Hypercalcemia and weight gain (choice D) are not common complications of bulimia.
A 72-year-old client with dementia, who resides in a long-term care facility, frequently goes to her room and cries because she misses her children. This client could benefit most from which intervention?
- A. Life review
- B. Doll therapy
- C. Comfort touch
- D. Audio presence therapy
Correct Answer: D
Rationale: The correct answer is D, Audio presence therapy. This intervention involves playing recordings of loved ones' voices to provide comfort and emotional support. For a client with dementia missing her children, hearing their voices can help reduce feelings of loneliness and provide a sense of connection. Life review (A) may not directly address the client's current emotional needs. Doll therapy (B) and comfort touch (C) may provide some comfort but may not be as effective as directly hearing the voices of her children through audio presence therapy (D).
A highly suspicious patient who has delusions of persecution about being poisoned has refused all hospital meals for 3 days. Which of the following interventions would be most appropriate under these circumstances?
- A. Feed the patient via tube, involuntarily via court order if needed.
- B. Offer to taste each food item on the tray yourself while he watches.
- C. Allow the patient to contact a local restaurant to deliver his meals.
- D. Allow him supervised access to use food vending machines in the hospital lobby.
Correct Answer: D
Rationale: Step 1: In this scenario, the patient is refusing hospital meals due to delusions of being poisoned, indicating a lack of trust.
Step 2: By allowing supervised access to food vending machines in the hospital lobby, the patient can choose his own food, promoting autonomy and trust-building.
Step 3: This intervention respects the patient's autonomy while ensuring access to food.
Step 4: In contrast, feeding via tube involuntarily (Option A) violates autonomy, tasting food yourself (Option B) doesn't address the issue of trust, and ordering from a restaurant (Option C) may not be feasible or safe in a hospital setting.
Summary: Option D is the most appropriate as it balances patient autonomy and safety, addressing the refusal of hospital meals effectively.