Nokea
Sleep terrors usually occur only once a night, during stages 3 and 4 of NREM sleep. They are often accompanied by which physical sign?
- A. Intense stress.
- B. Sexual arousal.
- C. Physical strength.
- D. None of the above.
Correct Answer: D
Rationale: The correct answer is D: None of the above. Sleep terrors are not typically accompanied by intense stress, sexual arousal, or increased physical strength. Sleep terrors are characterized by sudden awakening from sleep with intense fear and a physical reaction, such as screaming or thrashing. These episodes occur during stages 3 and 4 of NREM sleep and are not associated with the physical signs mentioned in the other choices. Therefore, the correct answer is D, as sleep terrors do not necessarily involve any of the physical signs listed in the other options.
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Joey is a 5-year-old who is causing his parents a lot of concern. His mother reports that he bounces off the walls all the time and cant focus on any one thing for very long. He is impulsive and has recently ran right out into the street in front of the familys home. His teacher has told his parents that he has done similar things at school. The nurse understands that:
- A. Joey shows all the signs of having ADHD and should probably be placed on Ritalin as soon as possible
- B. Joey is just an active, healthy child who needs to be disciplined more effectively
- C. Joey could be autistic, and additional testing will have to be done to confirm the diagnosis
- D. Joey shows signs of having ADHD, but is too young for that diagnosis to be made definitively now
Correct Answer: D
Rationale: Definitive diagnosis of ADHD should not be made before age 7 because developmentally the child has a shorter attention span.
A patient with anorexia nervosa is at risk for refeeding syndrome. The nurse should be most concerned with:
- A. Hyperglycemia.
- B. Electrolyte imbalances, particularly hypophosphatemia.
- C. Increased hunger and overeating.
- D. Rapid weight gain and hypertension.
Correct Answer: B
Rationale: The correct answer is B: Electrolyte imbalances, particularly hypophosphatemia. Refeeding syndrome occurs when a malnourished individual receives nutrition too quickly, leading to shifts in electrolytes like phosphate, potassium, and magnesium. Hypophosphatemia is a key concern due to its potential to cause cardiac and respiratory failure. Hyperglycemia (A) may occur but is not the primary concern. Increased hunger and overeating (C) are common symptoms of anorexia nervosa but not directly related to refeeding syndrome. Rapid weight gain and hypertension (D) are potential consequences of refeeding but are not the immediate concern compared to electrolyte imbalances.
A patient with paranoid personality disorder is noted to sit alone in a corner of the unit living room. When anyone approaches, the patient is haughty or simply ignores the other person. When staff invite her to join an activity, she tells them, 'I do not care to be with people who do not like me.' A nursing diagnosis that should be considered is:
- A. splitting.
- B. activity intolerance.
- C. powerlessness.
- D. impaired social interaction.
Correct Answer: D
Rationale: The correct answer is D: impaired social interaction. This patient's behavior of sitting alone, being haughty, and refusing to engage with others indicates difficulty in social interactions. The patient's belief that others do not like her also suggests social challenges. Impaired social interaction relates to difficulty in establishing or maintaining relationships.
A: Splitting is a defense mechanism where the patient views people as all good or all bad, which is not evident in this scenario.
B: Activity intolerance refers to insufficient physiological or psychological energy to endure or complete required or desired daily activities. This does not apply here.
C: Powerlessness refers to the perception of lack of control over a situation, which is not the primary issue in this case.
The nurse wants to enroll a patient with poor social skills in a training program for patients diagnosed with schizophrenia. Which description accurately describes social skills training?
- A. Patients learn to improve their attention and concentration
- B. Group leaders provide support without challenging patients to change
- C. Complex interpersonal skills are taught by breaking them into simpler behaviors
- D. Patients learn social skills by practicing them in a supported employment setting
Correct Answer: C
Rationale: In social skills training, complex interpersonal skills are taught by breaking them down into component behaviors that are covered in a stepwise fashion. Social skills training is not based in employment settings, although such skills can be addressed as part of supported employment services. The other distracters are less relevant to social skills training.
A nurse planning a group to help batterers learn more effective ways to cope would teach participants that the key component in wife battering is:
- A. The need for the batterer to control
- B. Alcohol abuse by the batterer
- C. History of psychotic behavior
- D. Failure of the woman to assert herself
Correct Answer: A
Rationale: The correct answer is A: The need for the batterer to control. This is the key component in wife battering, as it is rooted in the batterer's desire to establish power and dominance over their partner. Teaching batterers more effective ways to cope involves addressing this underlying need for control.
Explanation of other choices:
B: Alcohol abuse by the batterer - While alcohol abuse may exacerbate violent behavior, it is not the primary cause of wife battering.
C: History of psychotic behavior - Psychotic behavior may contribute to violence, but it is not the key component in wife battering.
D: Failure of the woman to assert herself - Blaming the victim is not appropriate; the responsibility lies with the batterer's need for control.