Nokea
Schizophrenia is usually diagnosed in:
- A. Infancy
- B. Childhood
- C. Early adulthood
- D. Old age
Correct Answer: C
Rationale: Schizophrenia typically emerges in early adulthood (late teens to early 20s), though symptoms may appear earlier or later in rare cases.
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A 34-year-old male admitted with catatonic schizophrenia has been mute and motionless for several days while at home prior to admission. He still appears stuporous in the hospital. Which nursing intervention would be an initial priority?
- A. Orienting the client to the unit
- B. Assessing the client for physical problems
- C. Establishing a nonthreatening relationship
- D. Reinforcing reality with the client
Correct Answer: B
Rationale: The correct answer is B: Assessing the client for physical problems. This is the initial priority because the client's muteness and motionless state could be due to an underlying physical issue that needs immediate attention, such as dehydration, malnutrition, or infection. By assessing for physical problems first, the nurse can rule out any urgent medical concerns before addressing the client's mental health needs.
A: Orienting the client to the unit - While important, this can be done after addressing any physical problems.
C: Establishing a nonthreatening relationship - Also essential, but assessing physical health takes precedence.
D: Reinforcing reality with the client - Not the immediate priority; physical assessment should come first.
A nurse assesses that which of the following individuals is most likely to engage in eating behaviors characteristic of bulimia?
- A. A person who weighs 225 pounds and is 5 feet 4 inches tall.
- B. A person who is 5 pounds overweight and cannot stick to a diet.
- C. A person who lost up to 40 pounds but gained it back within 1 year.
- D. None of the above.
Correct Answer: A
Rationale: Step 1: Individuals with bulimia often engage in episodes of binge eating followed by purging behaviors.
Step 2: Choice A, a person who is significantly overweight, is more likely to engage in binge eating behavior.
Step 3: Being overweight can be a risk factor for bulimia due to body image concerns.
Step 4: Choices B and C do not provide as strong indicators for bulimia as choice A.
Summary: Choice A is correct as being significantly overweight is a common characteristic of individuals with bulimia. Choices B and C lack the same level of risk factors for engaging in eating behaviors characteristic of bulimia.
A 5-year-old presents with a history of urgency of micturition, occasional enuresis, and a slight, non-offensive vaginal discharge for 3 months. She has had no vaginal bleeding. Examination reveals some reddening of the labia majora. Which one of the following is the most likely diagnosis?
- A. Trichomonal infection.
- B. Gonorrhoea.
- C. Cystitis.
- D. Non-specific vulvo-vaginitis.
Correct Answer: D
Rationale: Non-specific vulvo-vaginitis (E) is common in young girls due to hygiene or irritation, causing these symptoms. Trichomonas (A) and gonorrhoea (B) are rare without sexual history, cystitis (C) lacks vaginal signs, and foreign body (D) typically causes bleeding or foul discharge.
An appropriate short-term goal for a withdrawn, isolated patient diagnosed with schizophrenia is:
- A. The patient will participate in all therapeutic activities.'
- B. The patient will define major barriers to communication.'
- C. The patient will talk about feelings of withdrawal in group.'
- D. The patient will consistently interact with an assigned nurse.'
Correct Answer: D
Rationale: Step 1: Interacting with an assigned nurse helps build a therapeutic relationship, essential for engaging withdrawn patients.
Step 2: Consistent interaction promotes trust and communication, aiding in the patient's socialization.
Step 3: This goal is specific, measurable, achievable, relevant, and time-bound, aligning with the SMART criteria.
Summary:
A: Participation in all activities may overwhelm the patient.
B: Defining barriers to communication is too advanced for someone withdrawn.
C: Talking about feelings in a group setting may be too challenging for a withdrawn patient.
An adult experienced a myocardial infarction six months ago. At a follow-up visit, this adult says, 'I haven't had much interest in sex since my heart attack. I finished my rehabilitation program, but having sex strains my heart. I don't know if my heart is strong enough.' Which nursing diagnosis applies?
- A. Deficient knowledge related to faulty perception of health status
- B. Disturbed self-concept related to required lifestyle changes
- C. Disturbed body image related to treatment side effects
- D. Sexual dysfunction related to self-esteem disturbance
Correct Answer: A
Rationale: The correct answer is A: Deficient knowledge related to faulty perception of health status. The patient's statement indicates a lack of understanding about their health status and the impact of their myocardial infarction on their sexual activity. The patient is attributing their decreased interest in sex to a fear of straining their heart, indicating a faulty perception of their health status. This nursing diagnosis addresses the patient's need for education and clarification about their condition to alleviate their concerns and improve their confidence in engaging in sexual activity safely.
Choices B, C, and D are incorrect because they do not directly address the patient's lack of knowledge and faulty perception about their health status. Disturbed self-concept (B) relates more to how the patient perceives themselves due to lifestyle changes, while disturbed body image (C) pertains to physical appearance changes. Sexual dysfunction (D) is related to difficulties in sexual function, which is not the primary issue in this scenario.