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Police bring a patient to the mental health unit. The patient was directing traffic and shouting rhymes on a busy city street. The patient's spouse reports that the patient has not slept or eaten for 3 days. Which assessment findings have priority concern for this patient's plan of care?
- A. Pressured speech and grandiosity
- B. Hyperactivity; not eating and sleeping
- C. Poor concentration and decision making
- D. Insulting
Correct Answer: B
Rationale: The correct answer is B. Hyperactivity, not eating, and not sleeping are priority concerns as they indicate potential mania or hypomania, which can be dangerous and require immediate intervention. Not eating and sleeping for days can lead to physical and mental health complications. Pressured speech and grandiosity (Choice A) are symptoms of mania but not as urgent as lack of eating and sleeping. Poor concentration and decision making (Choice C) are also symptoms of mania, but not as immediately concerning as the lack of eating and sleeping. Insulting behavior (Choice D) is not a priority concern for immediate intervention in this scenario.
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A young, newly married adult says, 'My spouse never lets me out of sight. I'm not allowed to do anything on my own, and I'm constantly accused of cheating.' Which nursing communication is most therapeutic for this patient?
- A. Have you discussed the behavior with your spouse?'
- B. How does your spouse's behavior make you feel?'
- C. Are there other examples of controlling behaviors on your spouse's part?'
- D. Do you feel that your spouse has anything to be upset or suspicious about?'
Correct Answer: B
Rationale: The correct answer is B: "How does your spouse's behavior make you feel?" This question focuses on the patient's emotions, allowing them to express their feelings and validating their experiences. It shows empathy and encourages the patient to explore and understand their own emotional responses to the situation.
Choice A focuses on addressing the behavior directly without acknowledging the patient's emotions. Choice C asks for more examples of controlling behavior, which may feel judgmental. Choice D suggests that the spouse's behavior is justified, which can further invalidate the patient's feelings. Overall, choice B is the most therapeutic as it promotes emotional exploration and support.
Drugs that treat individuals with schizophrenia interrupt neurotransmitter pathways in the brain, producing an effect throughout the entire nervous system that is:
- A. Calming
- B. Numbing
- C. Satisfying
- D. Stimulating
Correct Answer: A
Rationale: The correct answer is A: Calming. Drugs used to treat schizophrenia often target neurotransmitter pathways to reduce symptoms like hallucinations and delusions. By regulating neurotransmitters like dopamine, these drugs help calm the individual's brain activity, leading to a reduction in psychotic symptoms. Choices B, C, and D are incorrect because drugs for schizophrenia are not intended to numb, satisfy, or stimulate the nervous system; rather, they aim to restore balance and alleviate distressing symptoms.
A 19-year-old woman, prescribed a triphasic oral contraceptive for the first time one month ago, complains of frequent spotting. Which one of the following is the most appropriate management?
- A. Increase the dose of oestrogen.
- B. Increase the dose of progestogen.
- C. Advise alternative contraception.
- D. Continue the medication and review in two months.
Correct Answer: D
Rationale: Spotting is common in the first few months of oral contraceptives as the body adjusts. Continuing the medication and reviewing later (D) is standard, rather than immediate dose changes (A, B), switching methods (C, E) without trial.
If a person suffering from schizophrenia has an identical twin, that twin
- A. will have a 46 percent chance of becoming schizophrenic
- B. will be no more likely than anyone else to become schizophrenic
- C. is almost sure to become schizophrenic
- D. is also likely to have more than one personality
Correct Answer: A
Rationale: Identical twins share genetics, giving a 46% concordance rate for schizophrenia, reflecting strong genetic influence.
A client with obsessive-compulsive personality disorder is described by other staff as being perfectionistic, inflexible, and a 'master at procrastination.' The nurse learns that the client is nearly immobilized during times that call for the client to make a decision. The nurse realizes that the most likely hypothesis is this behavior is related to:
- A. A need to make others uncomfortable
- B. Needing to be the center of attention
- C. Wanting someone else to be responsible
- D. Fear of making a mistake
Correct Answer: D
Rationale: The correct answer is D: Fear of making a mistake. This is the most likely hypothesis because individuals with obsessive-compulsive personality disorder often have an intense fear of making errors or mistakes. This fear can lead to excessive preoccupation with details, perfectionism, and procrastination. The client's immobilization during decision-making moments is likely due to the overwhelming anxiety and fear of making the wrong choice, which is a common trait in individuals with this disorder.
Choice A (A need to make others uncomfortable) is incorrect because there is no indication that the client's behavior is driven by a desire to cause discomfort to others. Choice B (Needing to be the center of attention) is incorrect as individuals with obsessive-compulsive personality disorder typically focus more on their own perfectionism rather than seeking attention. Choice C (Wanting someone else to be responsible) is incorrect as this behavior is more about the individual's fear of making mistakes rather than avoiding responsibility.