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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The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating. He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. This information most likely suggests:
- A. medication nonadherence.
- B. a need for psychoeducation.
- C. the chronic nature of his illness.
- D. relapse of his schizophrenia.
Correct Answer: D
Rationale: The correct answer is D: relapse of his schizophrenia. The patient's symptoms of feeling tense, difficulty concentrating, poor sleep, and delusional beliefs about creatures at work indicate a worsening of his psychotic symptoms. This suggests a relapse of schizophrenia, a chronic mental illness characterized by periods of stability and exacerbation of symptoms. The patient's previous stability for a year makes medication nonadherence less likely. While psychoeducation may be beneficial, the patient's current symptoms require more immediate intervention for relapse management. The information provided does not directly indicate the chronic nature of his illness, but rather an acute exacerbation. Therefore, D is the most appropriate choice based on the presented symptoms and clinical understanding of schizophrenia.
A severely withdrawn patient diagnosed with schizophrenia will spend time in the dayroom but will not speak to staff or to other patients. The most therapeutic nursing intervention in response to this behavior would be to:
- A. seat the patient with a group of patients who are talking to each other.
- B. ignore the silence and talk about superficial topics such as the weather.
- C. point out that the patient makes others uncomfortable by refusing to speak.
- D. plan time for staff members to sit with the patient even though the patient does not talk with them.
Correct Answer: D
Rationale: The correct answer is D because it focuses on building a therapeutic relationship with the patient without placing pressure on them to speak. By planning time for staff members to sit with the patient, even if the patient does not talk, it allows for nonverbal communication and presence to convey support and care. This approach respects the patient's boundaries and allows them to engage at their own pace, fostering trust and a sense of safety.
Choice A is incorrect as it may overwhelm the patient by placing them in a social situation they are not ready for. Choice B is incorrect as discussing superficial topics does not address the patient's underlying issues. Choice C is incorrect as it may make the patient feel judged or pressured to speak, further isolating them.
A patient with paranoid personality disorder is noted to sit alone in a corner of the unit living room. When anyone approaches, the patient is haughty or simply ignores the other person. When staff invite her to join an activity, she tells them, 'I do not care to be with people who do not like me.' A nursing diagnosis that should be considered is:
- A. splitting.
- B. activity intolerance.
- C. powerlessness.
- D. impaired social interaction.
Correct Answer: D
Rationale: The correct answer is D: impaired social interaction. This patient's behavior of sitting alone, being haughty, and refusing to engage with others indicates difficulty in social interactions. The patient's belief that others do not like her also suggests social challenges. Impaired social interaction relates to difficulty in establishing or maintaining relationships.
A: Splitting is a defense mechanism where the patient views people as all good or all bad, which is not evident in this scenario.
B: Activity intolerance refers to insufficient physiological or psychological energy to endure or complete required or desired daily activities. This does not apply here.
C: Powerlessness refers to the perception of lack of control over a situation, which is not the primary issue in this case.
A patient has recently been under significant stress and worked long hours. At home, the patient watches television and eats until going to bed. The patient is too tired to exercise and has gained 25 pounds in 1 month. A desired outcome for the patient is to recognize anxiety that precedes binge eating and reduce it. Which intervention addresses the outcome
- A. Teach stress-reduction techniques such as relaxation and imagery.
- B. Encourage the patient to design and implement an exercise program.
- C. Explore ways in which the patient may feel more in control of the environment.
- D. Encourage the patient to attend a support group such as Overeaters Anonymous.
Correct Answer: A
Rationale: The correct answer is A: Teach stress-reduction techniques such as relaxation and imagery. This intervention directly addresses the desired outcome of recognizing anxiety that precedes binge eating and reducing it. By teaching stress-reduction techniques, the patient can learn to identify triggers, manage stress, and reduce the likelihood of turning to binge eating. Relaxation and imagery can help the patient relax and focus on positive thoughts, thus breaking the cycle of stress-induced binge eating.
Option B is incorrect because while exercise is beneficial for overall health, it does not directly address recognizing and reducing anxiety that leads to binge eating. Option C is incorrect as feeling more in control of the environment may help, but it does not specifically target anxiety reduction related to binge eating. Option D is incorrect as attending a support group may be helpful for some aspects of recovery, but it does not focus on recognizing and reducing anxiety specifically.
Theories based on study of the brain and its activities are called:
- A. Social
- B. Biological
- C. Psychological
- D. Psychobiological
Correct Answer: B
Rationale: The correct answer is B: Biological. Theories based on the brain and its activities fall under the field of biological psychology, which focuses on how biological factors influence behavior and mental processes. This includes studying brain structures, neural pathways, neurotransmitters, and their impact on behavior. Social (A) theories focus on interactions between individuals, Psychological (C) theories relate to mental processes and behavior, and Psychobiological (D) is a term that could be used interchangeably with Biological but is less commonly used. Hence, the most specific and appropriate term for theories related to the brain is Biological.