Nokea
Marie is 16 years old. She has been referred to the clinic by the nurse at her school because she started a fight with a younger girl and hurt her badly. The school nurse reports that Marie has been troublesome beforeskipping school, bullying, and smoking on school grounds on several occasions. Of the following, which diagnosis is most likely?
- A. Bipolar depression
- B. Paranoid schizophrenia
- C. Conduct disorder
- D. Dysthymic disorder
Correct Answer: C
Rationale: Conduct disorder is characterized by a pattern of aggressive behavior and violating the rights of others, including defiance and rule breaking. The other responses are psychiatric disorders that would not be the most likely diagnosis given Maries behavior.
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In most anxiety disorders, the person's distress is
- A. focused on a specific situation
- B. related to ordinary life stresses
- C. greatly out of proportion to the situation
- D. based on a physical cause
Correct Answer: C
Rationale: Anxiety disorders feature exaggerated distress disproportionate to the trigger, unlike normal stress.
An elderly patient with dementia paces the hallway and often engages in wandering. The nurse documents that the patient is exhibiting which type of behavior that is characteristic of dementia?
- A. Passive behavior
- B. Functionally impaired behavior
- C. Involuntary psychomotor behavior
- D. Nonaggressive psychomotor behavior
Correct Answer: D
Rationale: The correct answer is D: Nonaggressive psychomotor behavior. In dementia, wandering and pacing are common behaviors due to cognitive impairment. Nonaggressive behavior refers to actions that do not involve harm or aggression towards others. The patient's behavior is voluntary and purposeless, indicating psychomotor involvement. Choices A, B, and C do not accurately describe the behavior exhibited by the patient with dementia. Passive behavior implies lack of engagement, functionally impaired behavior suggests difficulty performing activities of daily living, and involuntary psychomotor behavior implies actions beyond the patient's control, which are not the case in this scenario.
Which of the following is not a common type of water pollutant?
- A. Protists
- B. Bacteria
- C. Particulates
- D. Carbon Monoxide
Correct Answer: D
Rationale: Carbon Monoxide is an air pollutant, not a common water pollutant, unlike protists, bacteria, and particulates.
A nurse is caring for a patient with bulimia nervosa who has not eaten for 24 hours. The nurse should first:
- A. Encourage the patient to eat a full meal immediately.
- B. Assess the patient's vital signs and hydration status.
- C. Provide the patient with a menu to select food for the next meal.
- D. Contact the physician for a medication prescription.
Correct Answer: B
Rationale: The correct answer is B because assessing vital signs and hydration status is crucial in identifying potential complications from prolonged fasting in a patient with bulimia nervosa. This step helps determine the patient's immediate needs for intervention and guides further care planning. Encouraging the patient to eat a full meal immediately (Choice A) may lead to refeeding syndrome due to electrolyte imbalances. Providing a menu for the next meal (Choice C) is not the priority when the patient has not eaten for 24 hours. Contacting the physician for a medication prescription (Choice D) is not necessary at this point without first assessing the patient's current physical status.
Which intervention would be the best initial approach for a nurse to take when a young adult patient is verbally abusive?
- A. Ask the patient to define 'verbally abusive language.'
- B. Provide the patient with examples of assertive communication.
- C. Identify the patient's verbal abuse in order to set standards for future dialogue.
- D. Remove privileges from the patient until communications show less aggression.
Correct Answer: C
Rationale: The correct initial approach is to identify the patient's verbal abuse to set standards for future dialogue. This approach addresses the behavior directly, establishes boundaries, and communicates expectations for respectful communication. Asking the patient to define 'verbally abusive language' (choice A) may not effectively address the current behavior. Providing examples of assertive communication (choice B) may not directly address the abusive behavior. Removing privileges (choice D) may escalate the situation and is not a constructive communication strategy. By identifying the patient's verbal abuse, the nurse can address the behavior effectively and work towards a respectful and therapeutic relationship.