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It is a primary dementia that is incurable, irreversible, and fatal. It is caused by the accumulation of amyloid protein in the neurons, resulting in senile plaques.
- A. Alzheimer's disease.
- B. Frontotemporal dementia.
- C. Parkinson's disease dementia.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Alzheimer's disease. Alzheimer's disease is a primary dementia that is characterized by the accumulation of amyloid protein in neurons, leading to senile plaques. It is incurable, irreversible, and fatal. Frontotemporal dementia (B) is caused by the degeneration of frontal and temporal lobes, not amyloid protein accumulation. Parkinson's disease dementia (C) is a secondary dementia that occurs as a complication of Parkinson's disease, not due to amyloid protein accumulation. Choice D is incorrect as Alzheimer's disease fits all the criteria mentioned in the question.
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A patient has not come out of her room for breakfast. The nurse finds the patient moving restlessly about her room in a disorganized manner. The patient is talking to herself, and her verbal responses to the nurse are nonsensical and suggest disorientation. The nurse notices that the patient's skin is hot and dry, and her pupils are somewhat dilated. All these symptoms are significant departures from the patient's recent presentation. The patient is likely experiencing ______, and the nurse should ______.
- A. anticholinergic toxicity"¦check vital signs and prepare to use a cooling blanket stat
- B. relapse of her psychosis"¦administer PRN antipsychotic drugs and notify her physician
- C. neuroleptic malignant syndrome"¦contact her physician for a transfer to intensive care
- D. agranulocytosis"¦hold her antipsychotic and draw blood for a complete blood count
Correct Answer: A
Rationale: The correct answer is A: anticholinergic toxicity. The patient's symptoms align with this diagnosis due to the disorganized behavior, nonsensical speech, disorientation, hot and dry skin, dilated pupils, and recent presentation changes. Anticholinergic toxicity can cause confusion, delirium, hyperthermia, and dilated pupils. Checking vital signs and preparing to use a cooling blanket are appropriate actions to manage the symptoms.
Choice B (relapse of psychosis) is incorrect because the symptoms are not typical of a psychotic relapse. Choice C (neuroleptic malignant syndrome) is incorrect as the symptoms do not completely align with this syndrome, which typically includes muscle rigidity and autonomic dysfunction. Choice D (agranulocytosis) is incorrect because it presents with low white blood cell count and not the symptoms described in the scenario.
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. The patient is exhibiting symptoms consistent with NMS, a rare but serious side effect of antipsychotic medications like risperidone. The severe muscle stiffness, difficulty swallowing, altered mental status, diaphoresis, elevated temperature, and vital sign changes are classic signs of NMS. Treatment includes immediate cooling to lower the body temperature and transfer to the intensive care unit for close monitoring and supportive care.
Choice B: Anticholinergic toxicity does not fit the patient's presentation as there are no specific signs of anticholinergic toxicity such as dry mucous membranes, dilated pupils, or tachycardia.
Choice C: Relapse of psychosis is unlikely to present with the same constellation of symptoms, including altered mental status, fever, and vital sign changes.
Choice D: Agranulocytosis is characterized by a severe drop in white blood cells, leading to increased risk of infection, but it does
Behaviorists would say that self-defeating behaviors are maintained by immediate reinforcement in the form of
- A. relief from anxiety
- B. defending the ego
- C. protecting one's self-image
- D. avoiding existential anxiety
Correct Answer: A
Rationale: Behaviorists argue self-defeating actions persist because they provide short-term anxiety relief.
The client lives so completely in a world of her own that she does not eat, drink, or bathe regularly. She is considered to be:
- A. Exotic
- B. Anorectic
- C. Neurotic
- D. Psychotic
Correct Answer: D
Rationale: The correct answer is D: Psychotic. The client's behavior of not eating, drinking, or bathing regularly indicates a severe detachment from reality, which is a hallmark of psychosis. Psychotic individuals may have delusions or hallucinations that distort their perception of the world, leading to extreme neglect of basic needs. Choices A, B, and C are incorrect because they do not specifically address the profound disconnect from reality exhibited by the client. Exotic refers to something unusual or rare, anorectic relates to an eating disorder, and neurotic typically involves anxiety and emotional instability, none of which fully capture the level of disconnection seen in psychosis.
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 Moderate Mental Retardation, represented by an IQ score between:
- A. 60-65 - to 70-75
- B. 35-40 to 50-55
- C. 80-85 to 90-95
- D. 20-25 to 30-35
Correct Answer: B
Rationale: Moderate Mental Retardation: Defined by DSM-IV-TR as an IQ score between 35-40 to 50-55.