Nokea
Some eating habits that seem to contribute to the incidence of cardiovascular disease are
- A. A diet that is high in fat
- B. A diet that is low in vegetables
- C. A diet that is low in fruits
- D. All of the above
Correct Answer: D
Rationale: High-fat, low-vegetable, and low-fruit diets all contribute to cardiovascular disease by increasing cholesterol and reducing nutrients.
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Which of the following personality disorders describes a person who has an extremely unstable self image, is moody, and does not develop stable relationships?
- A. borderline
- B. histrionic
- C. narcissistic
- D. schizoid
Correct Answer: A
Rationale: Borderline personality disorder involves unstable self-image, mood swings, and relationship difficulties.
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 patient was admitted to the mental health unit after arguing with co-workers and threatening to kill them. He is diagnosed with paranoid schizophrenia. On the unit he is aloof and suspicious. He mentioned that two physicians he saw talking were plotting to kill him. On the basis of data gathered at this point, which two primary nursing diagnoses should the nurse consider?
- A. Disturbed thought processes and Risk for other-directed violence
- B. Spiritual distress and Social isolation
- C. Risk for loneliness and Knowledge deficit
- D. Disturbed personal identity and Nonadherence
Correct Answer: A
Rationale: The correct answer is A: Disturbed thought processes and Risk for other-directed violence.
1. Disturbed thought processes: The patient's delusion of being plotted against by the physicians indicates impaired thought processes typical of paranoid schizophrenia.
2. Risk for other-directed violence: The patient's threatening behavior towards co-workers suggests a potential for violent acts towards others due to his paranoid beliefs.
Summary of why other choices are incorrect:
B: Spiritual distress and Social isolation are not primary concerns given the patient's acute symptoms of paranoia and risk for violence.
C: Risk for loneliness and Knowledge deficit are not crucial at this point as the patient's primary issues are related to paranoia and violence.
D: Disturbed personal identity and Nonadherence are not relevant to the immediate safety and mental health concerns presented by the patient.
An older adult patient was diagnosed with schizophrenia at age 18. A nurse at the outpatient medication clinic interviews this patient. Which communication strategy will be most helpful?
- A. Ask questions that can be answered with yes or no.
- B. Ask clear, simple questions using concrete language.
- C. Use silence often and let the patient take the lead.
- D. Use open-ended, indirect questions.
Correct Answer: B
Rationale: Communication with individuals who have schizophrenia might be difficult because of their various thought disorders. The nurse can be most effective by using simple language, keeping to concrete concepts, and clarifying and validating as needed (B). Yes/no questions (A) limit information, silence (C) may not engage, and open-ended questions (D) may confuse.
Which of the following statements by your ADHD childs parents indicate they need further teaching?
- A. We will establish firm but reasonable limits on his behavior
- B. We will give him his medication at night so it wont decrease his appetite
- C. We will set him up in a special program at his school so we he will get extra attention
- D. We will work to ensure he gets 8 hours of sleep a night
Correct Answer: B
Rationale: Stimulant medications are given for treatment of ADHD. These can cause insomnia if given later in the day.