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Prior to discharge, the nurse plans to teach the client and family about relapse. Which items will the nurse include in the teaching?
- A. Recognition of warning signs of relapse
- B. Notify the nurse of warning signs present for more than one month
- C. Lower medication dosage to manage emerging side effects
- D. Use street drugs judiciously and only in small amounts
Correct Answer: A
Rationale: The correct answer is A because recognizing warning signs of relapse is crucial for early intervention. By identifying these signs, the client and family can seek help promptly, preventing a full relapse. Choice B is incorrect as waiting for signs to persist for more than one month delays intervention. Choice C is incorrect as altering medication dosage without medical advice can be dangerous. Choice D is incorrect as using street drugs is never a safe or appropriate way to manage relapse.
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A patient with schizophrenia tells the nurse, 'Everyone must listen to me. I am the redeemer. I will bring peace to the world.' From this the nurse can determine that an appropriate nursing diagnosis is:
- A. Disturbed sensory perception: auditory.
- B. Risk for other-directed violence.
- C. Chronic low self-esteem.
- D. Nonadherence: medication.
Correct Answer: C
Rationale: Step 1: The patient's statement indicates grandiosity and delusions of grandeur, common in schizophrenia.
Step 2: Chronic low self-esteem is a common nursing diagnosis for those with grandiose delusions.
Step 3: The patient's belief of being the redeemer suggests underlying feelings of inadequacy.
Step 4: Addressing self-esteem can help the patient cope with such delusions.
Summary: A is incorrect as there is no mention of auditory hallucinations. B is incorrect as there is no immediate threat of violence. D is incorrect as nonadherence to medication is not evident in the scenario.
A psychotic patient is delusional and has auditory hallucinations. The best statement to make when approaching the patient with an oral electronic thermometer would be:
- A. I need your vital signs. Put this in your mouth. This will not hurt.'
- B. I hope I can count on you to hold still while I take your temperature.'
- C. Please sit here while I take your temperature. I'll put the thermometer under your tongue for a few seconds.'
- D. This probe is only a thermometer that will tell us whether you have a fever. It will be all over in just a few seconds.'
Correct Answer: C
Rationale: The correct answer is C because it uses clear, simple language to explain the procedure to the patient. It acknowledges the patient's delusions by asking them to sit and calmly states the thermometer will be placed under their tongue. This approach is likely to minimize the patient's anxiety and increase cooperation.
Option A is incorrect as it may cause the patient to feel apprehensive due to the mention of "hurt." Option B is incorrect because it does not provide specific instructions about the procedure, which may lead to confusion for the patient. Option D is incorrect as it does not address the patient's delusions or provide clear instructions, potentially leading to increased resistance from the patient.
The federal act that establishes the standards of care for older adults is known as the Omnibus Budget Act.
- A. Reconciliation
- B. Budget
- C. Care
- D. Standards
Correct Answer: A
Rationale: The Omnibus Budget Reconciliation Act (OBRA) (A) ensures that proper assessment of elderly people will be provided in the health care facility and in the home, as per its full name.
Which of the following should be considered in the assessment of oppositional behaviours in children?
- A. Peer relationships
- B. Child s developmental stage
- C. Behaviours exhibited at home
- D. All of the above
Correct Answer: D
Rationale: All factorsâ€â€peer relationships, developmental stage, home behavior, and family historyâ€â€are critical in assessing oppositional behaviors comprehensively.
A patient diagnosed with schizophrenia tells the community mental health nurse, 'I threw away my pills because they interfere with Gods voice.' The nurse identifies the etiology of the patients ineffective management of the medication regime as:
- A. inadequate discharge planning
- B. poor therapeutic alliance with clinicians
- C. dislike of antipsychotic medication side effects
- D. impaired reasoning secondary to the schizophrenia
Correct Answer: D
Rationale: The patients ineffective management of the medication regime is most closely related to impaired reasoning. The patient believes in being an exalted personage who hears Gods voice, rather than an individual with a serious mental disorder who needs medication to control symptoms. Data do not suggest any of the other factors often related to medication nonadherence.