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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 nurse is working with a family with an elderly family member who is in the predisgnostic phase of Alzheimer disease. The most important nursing intervention at this time would be to provide:
- A. family consultation to facilitate communication.
- B. information about support groups and counseling.
- C. options directed toward the reduction of caregiver stress.
- D. educational materials that help them understand their situation.
Correct Answer: D
Rationale: The correct answer is D because educating the family about Alzheimer's disease in the predisgnostic phase helps them understand what to expect and how to cope effectively. This empowers them to make informed decisions and provide appropriate care. Option A focuses on communication, which is important but not the most critical intervention at this stage. Option B is helpful but may not address the family's immediate needs. Option C addresses caregiver stress, which is important but may not be the priority in the predisgnostic phase. Therefore, providing educational materials is the most important intervention to support the family during this phase.
A patient with many positive symptoms of schizophrenia, whose behavior is disorganized and who is highly anxious, tells the nurse in the psychiatric emergency department, 'You have got to help me. I do not know what is going on. I think someone is trying to wipe me out. I have to get a gun.' The patient, a college student, lives alone and has no family or support system in the immediate area. He has not left his room in 2 weeks, has not eaten in several days, and is unkempt. Of the available treatment settings, the nurse should recommend:
- A. admission to an unlocked residential crisis unit.
- B. inpatient hospitalization on a locked unit.
- C. attending a day treatment program for 4 weeks.
- D. admission to a partial hospital program.
Correct Answer: B
Rationale: The correct answer is B: inpatient hospitalization on a locked unit. This option is the most appropriate because the patient is presenting with severe symptoms of schizophrenia, including paranoia, disorganized behavior, and potential harm to self or others by mentioning getting a gun. In this case, the patient requires a higher level of care and safety, which can only be provided in an inpatient hospital setting on a locked unit. Admission to an unlocked residential crisis unit (Choice A) may not provide the necessary level of supervision and security. Attending a day treatment program for 4 weeks (Choice C) may not be intensive enough to address the patient's current crisis. Admission to a partial hospital program (Choice D) also may not provide the required level of supervision and structure for a patient with such acute symptoms.
The quality of life of people with intellectual disabilities can be improved significantly with the help of basic training procedures that will equip them with a range of skills depending on their level of disability. The application of learning theory to training in these areas is also known as:
- A. Applied cognitive approaches
- B. Applied treatment analysis
- C. Cognitive behavioural therapy
- D. Applied behaviour analysis
Correct Answer: D
Rationale: Applied Behaviour Analysis: Applying principles of learning theory, particularly operant conditioning, to improve skills in individuals with intellectual disabilities.
A severely depressed patient with psychomotor retardation has begun activities therapy. His schedule is: 9 AM, ceramics; 10 AM, exercise group; 11 AM to noon, open; noon, lunch. The nurse creating the patient's schedule should opt to fill the hour block from 11 AM to noon with:
- A. Group therapy.
- B. A rest period.
- C. Reminiscence group.
- D. Individual counseling.
Correct Answer: B
Rationale: The correct answer is B: A rest period. Providing a rest period during the hour block from 11 AM to noon is crucial for a severely depressed patient with psychomotor retardation. This patient may experience fatigue and decreased energy levels due to their condition. Allowing for a rest period can help prevent overstimulation and promote relaxation, which is essential for mental well-being. Group therapy (choice A) may be too overwhelming for the patient at this time. Reminiscence group (choice C) may not be as beneficial for immediate symptom management. Individual counseling (choice D) may be helpful but may not align with the patient's immediate need for rest and relaxation.
Which of the following behaviors is most consistent with bulimia nervosa?
- A. Severe food restriction and extreme weight loss.
- B. Binge eating followed by vomiting or use of laxatives.
- C. Excessive exercise and rigid dietary rules.
- D. Overeating and no attempts to control food intake.
Correct Answer: B
Rationale: The correct answer is B: Binge eating followed by vomiting or use of laxatives. This behavior is most consistent with bulimia nervosa as it involves recurrent episodes of binge eating followed by compensatory behaviors like self-induced vomiting or laxative use. This pattern of behavior is a key diagnostic criteria for bulimia nervosa.
A: Severe food restriction and extreme weight loss is more indicative of anorexia nervosa, not bulimia nervosa.
C: Excessive exercise and rigid dietary rules may be seen in various eating disorders, but it is not specific to bulimia nervosa.
D: Overeating without attempts to control food intake is more characteristic of binge eating disorder, not bulimia nervosa.