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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Which statement by a patient with bulimia nervosa indicates a need for further education?
- A. I understand that purging can damage my body in the long term.
- B. I feel better after purging, but I know it's not a healthy behavior.
- C. I believe I can control my eating and purging behaviors without help.
- D. I know I need therapy to address my unhealthy relationship with food.
Correct Answer: C
Rationale: Rationale:
Choice C indicates a need for further education because it suggests the patient believes they can manage bulimia without help. Patients with bulimia often require professional intervention for successful treatment. Choices A, B, and D acknowledge the need for therapy, understanding of long-term consequences, and recognition of unhealthy behaviors, respectively.
The psychiatric-mental health nurse knows that the patient's spouse clearly understands the adverse effects of lithium carbonate (Eskalith), when they say:
- A. I should call the doctor if my spouse shakes badly'
- B. I should make sure my spouse drinks as much water as possible'
- C. My spouse must remain on a salt-free diet'
- D. When the lithium level is 1.6mEq\L, my spouse can go back to work'
Correct Answer: A
Rationale: Tremors are a common lithium side effect requiring medical attention; other options reflect misunderstanding (e.g., salt-free diet increases toxicity risk, 1.6mEq\L is toxic).
A 32-year-old client with an admitting diagnosis of catatonic schizophrenia has been mute and motionless for 2 days. The priority nursing diagnosis is:
- A. Risk for deficient fluid volume
- B. Impaired physical mobility
- C. Impaired social interaction
- D. Ineffective coping
Correct Answer: A
Rationale: The correct answer is A: Risk for deficient fluid volume. The priority nursing diagnosis in this case is to address the client's physical needs to ensure their safety and well-being. The client's mutism and immobility put them at risk for dehydration and malnutrition. By prioritizing the risk for deficient fluid volume, the nurse can address the immediate physiological needs of the client.
Choice B: Impaired physical mobility is incorrect because while the client is motionless, the immediate concern is addressing the risk of dehydration.
Choice C: Impaired social interaction is incorrect as addressing social interaction is not the priority when the client's physical needs are not being met.
Choice D: Ineffective coping is incorrect because the client's presentation is indicative of a more urgent physical need for hydration and nutrition.
A nurse is providing care for a patient diagnosed with bulimia nervosa. What is a priority nursing intervention?
- A. Encourage regular exercise to promote weight loss.
- B. Provide a calm, structured environment with consistent mealtimes.
- C. Focus on weight loss as the most important goal.
- D. Offer the patient a high-protein diet to restore health.
Correct Answer: B
Rationale: The correct answer is B: Provide a calm, structured environment with consistent mealtimes. This is the priority intervention because individuals with bulimia nervosa benefit from a stable and supportive environment to establish regular eating patterns and reduce anxiety around mealtimes. This intervention helps promote a sense of safety and predictability, which are crucial for managing the eating disorder. Encouraging regular exercise (Choice A) may exacerbate compulsive behaviors related to bulimia. Weight loss (Choice C) should not be the focus as it can worsen the patient's condition. Offering a high-protein diet (Choice D) may not address the underlying psychological issues associated with bulimia.
The spouse of a man being treated with sertraline (Zoloft) calls to report that he had a grand mal seizure. Prior to the seizure, he had seemed confused and his forehead felt hot. The man does not have a seizure-disorder history. Which action should the nurse direct the spouse to take?
- A. Monitor the patient and notify the clinic if there are more seizures.
- B. Hold all medications and call 911 for transportation to the hospital.
- C. Hold tonight's sertraline and encourage him to drink more fluids.
- D. Administer an antipyretic drug to lower his fever and prevent seizures.
Correct Answer: B
Rationale: Step 1: The man had a grand mal seizure, confusion, and a hot forehead, which are signs of serotonin syndrome, a serious side effect of sertraline.
Step 2: The nurse should direct the spouse to hold all medications to prevent further serotonin syndrome symptoms.
Step 3: Calling 911 for immediate transportation to the hospital is crucial for prompt evaluation and treatment of the seizure and serotonin syndrome.
Step 4: This action ensures the man receives appropriate medical care to address the seizure and manage the potential serotonin syndrome.
Summary:
- Choice A is incorrect as monitoring the patient at home is not sufficient for a serious medical emergency like serotonin syndrome.
- Choice C is incorrect as simply holding tonight's sertraline and encouraging fluids does not address the immediate need for medical intervention.
- Choice D is incorrect as administering an antipyretic drug does not address the underlying cause of the seizure and confusion, which is serotonin syndrome.