Nokea
Of the following interventions, which one would likely be most useful when attempting to prevent or lessen the symptoms associated with sundown syndrome?
- A. Keeping the patient's room quiet and dimly lit at night
- B. Interacting frequently with the patient during evening hours
- C. Providing the patient with a large protein-based bedtime snack
- D. Giving the patient a soft stuffed animal to provide a source of security
Correct Answer: B
Rationale: The correct answer is B because interacting frequently with the patient during evening hours can help provide comfort and reassurance, reducing anxiety and agitation associated with sundown syndrome. Interacting can stimulate the patient's senses and distract from negative symptoms.
Choice A is incorrect because a quiet and dimly lit room alone may not address the underlying emotional and psychological needs of the patient during sundown syndrome.
Choice C is incorrect because a large protein-based bedtime snack may not directly impact the behavioral symptoms of sundown syndrome.
Choice D is incorrect because while a soft stuffed animal can provide some comfort, it may not address the need for human interaction and engagement during the evening hours to prevent or lessen sundown syndrome symptoms.
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Bacteria, such as E. Coli, in our water can come from
- A. Factory run-off
- B. Car exhaust
- C. Human and animal feces
- D. Littering
Correct Answer: C
Rationale: E. Coli primarily originates from fecal contamination by humans or animals, making it a common water pollutant.
A patient received maintenance doses of fluphenazine decanoate (Prolixin Decanoate) 25 mg IM every 2 weeks for 2 years. The clinic nurse notes the patient is grimacing and seems to be constantly smacking her lips. On the next clinic visit, the patient's neck and shoulders twist in a slow, snakelike motion. The nurse should suspect the presence of ______ and should ______.
- A. agranulocytosis"¦check the patient's complete blood count for changes
- B. tardive dyskinesia"¦administer the Abnormal Involuntary Movement Scale
- C. Tourette's syndrome"¦consult the patient's physician about a neuro evaluation
- D. anticholinergic effects"¦consult the physician about possible medication changes
Correct Answer: B
Rationale: The correct answer is B: tardive dyskinesia"¦administer the Abnormal Involuntary Movement Scale.
1. Tardive dyskinesia is a side effect of long-term use of antipsychotic medications like fluphenazine.
2. The symptoms described - grimacing, lip smacking, twisting neck and shoulders - are characteristic of tardive dyskinesia.
3. Administering the Abnormal Involuntary Movement Scale is the appropriate assessment tool for diagnosing tardive dyskinesia.
4. Agranulocytosis (choice A) is a rare but serious side effect of some antipsychotic medications, not associated with the symptoms described.
5. Tourette's syndrome (choice C) typically presents with vocal and motor tics, not the specific symptoms mentioned.
6. Anticholinergic effects (choice D) can cause dry mouth, constipation, and blurred vision, but not the involuntary movements described.
Which of the following is a common physical sign in patients with bulimia nervosa?
- A. Hypotension and bradycardia.
- B. Dental erosion and swollen parotid glands.
- C. Rapid weight gain and increased appetite.
- D. Severe muscle wasting and low body temperature.
Correct Answer: B
Rationale: The correct answer is B: Dental erosion and swollen parotid glands are common physical signs in patients with bulimia nervosa. Dental erosion is caused by repeated exposure of teeth to stomach acid during purging. Swollen parotid glands result from repeated vomiting. Hypotension and bradycardia (A) are more common in anorexia nervosa. Rapid weight gain and increased appetite (C) are not typical in bulimia nervosa; rather, patients often maintain a normal weight. Severe muscle wasting and low body temperature (D) are not commonly associated with bulimia nervosa.
A patient is admitted with a tentative diagnosis of delirium. The patient repeatedly mistakes one of the nursing staff for a family member. The nurse documents that this patient is experiencing a disturbance in which area of functioning?
- A. Consciousness
- B. Attention
- C. Perception
- D. Cognition
Correct Answer: C
Rationale: The correct answer is C: Perception. In this scenario, the patient's repeated mistake of identifying a nursing staff as a family member indicates a disturbance in perception, specifically in the recognition and interpretation of sensory information. This confusion is not related to consciousness (A), as the patient is awake and aware. It is also not solely an issue of attention (B), as attention involves the ability to focus on specific stimuli rather than the interpretation of those stimuli. While cognition (D) encompasses various mental processes, such as memory and problem-solving, the primary issue in this case is the misinterpretation of sensory input, aligning with the disturbance in perception.
A teacher comes to the mental health clinic saying a co-worker recently confronted her about behaviors that are annoying to other co-workers. She is now experiencing moderate to severe levels of anxiety. The co-worker told the patient that others find her very difficult because she is a perfectionist and micromanages the tasks of others on the teaching team, always demanding that things should be done according to her plans. The co-worker mentioned that the patient made everyone feel as though everything they tried was inadequate, and they feel frustrated and angry. The patient states she likes her co-workers and only wanted to help them be successful. The nurse realizes the patient's behaviors are most consistent with:
- A. obsessive-compulsive personality disorder.
- B. narcissistic personality disorder.
- C. histrionic personality disorder.
- D. schizoid personality disorder.
Correct Answer: A
Rationale: The correct answer is A: obsessive-compulsive personality disorder. This is because the patient's behaviors of being a perfectionist, micromanaging tasks, demanding things be done according to her plans, and making others feel inadequate align with the diagnostic criteria for obsessive-compulsive personality disorder. Individuals with this disorder are preoccupied with orderliness, perfectionism, and control.
Choice B: narcissistic personality disorder, is incorrect because the patient's behaviors are not characterized by a sense of grandiosity, a lack of empathy, or a need for admiration, which are hallmark features of narcissistic personality disorder.
Choice C: histrionic personality disorder, is incorrect as individuals with this disorder typically display attention-seeking behavior, emotional instability, and excessive emotionality, none of which are evident in the patient's presentation.
Choice D: schizoid personality disorder, is incorrect as individuals with this disorder tend to be socially detached, have limited emotional expression, and prefer solitary activities, which do not align with the