Nokea
Stuttering is a disturbance in the normal fluency and time patterning of speech that is inappropriate for the individual's age. It involves which of the following?
- A. Frequent repetitions or prolongations of sounds
- B. Pauses within words
- C. Filled or unfilled pauses in speech
- D. All of the above
Correct Answer: D
Rationale: Stuttering: A disturbance in the normal fluency and time patterning of speech that includes frequent repetitions, prolongations, and pauses.
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A nurse cares for a rape victim who was given flunitrazepam (Rohypnol) by the assailant. Which intervention has priority? Monitoring for:
- A. Coma
- B. Seizures
- C. Hypotonia
- D. Respiratory depression
Correct Answer: D
Rationale: The correct answer is D: Respiratory depression. Flunitrazepam is a sedative-hypnotic drug that can cause central nervous system depression, leading to respiratory depression, which is life-threatening. Monitoring respiratory status is crucial to prevent respiratory failure.
A: Coma may occur but is a consequence of severe respiratory depression, hence monitoring respiratory status is more critical.
B: Seizures are not a common side effect of flunitrazepam and do not pose immediate life-threatening risks compared to respiratory depression.
C: Hypotonia (muscle weakness) is a potential side effect but does not require immediate intervention like respiratory depression.
In summary, monitoring for respiratory depression is the priority as it can lead to respiratory failure and death, while the other choices are not as immediately life-threatening.
An elderly client was well until 12 hours ago, when she reported to her family that during the evening she saw strange faces peering in her windows and in the middle of the night awakened to see a man standing at the foot of her bed. She admits to being very frightened. She is presently pacing and somewhat agitated in the examining room. The client's family reports that the client has recently been to the doctor, who made some medication changes, although they are unsure what the changes were. Which nursing intervention should the nurse implement at the time of this client's admission?
- A. Interact with the client on an adult to child level.
- B. Place the client in a safe, nonstimulating environment.
- C. Ask client why she thinks someone would be trying to frighten her.
- D. Explain to the family that the client will be restrained for her own good.
Correct Answer: B
Rationale: The correct answer is B: Place the client in a safe, nonstimulating environment. This is the most appropriate nursing intervention because the client is experiencing hallucinations and agitation, which could be due to the recent medication changes. Placing the client in a safe, calm environment can help reduce stimulation and provide a sense of security. This intervention addresses the client's immediate needs by ensuring her safety and promoting a sense of comfort.
Incorrect answers:
A: Interact with the client on an adult to child level - This is not appropriate as it does not address the client's current state of distress and could potentially worsen the situation.
C: Ask client why she thinks someone would be trying to frighten her - This is not the priority at this time, as the client is experiencing hallucinations and agitation that need to be managed first.
D: Explain to the family that the client will be restrained for her own good - Restraints should only be used as a last resort and should not be considered
An advance directive gives legally binding direction for health care interventions when a patient
- A. has a new diagnosis of cancer.
- B. is diagnosed with Parkinson's disease.
- C. is unable to make decisions for self because of illness.
- D. diagnosed with amyotrophic lateral sclerosis is unable to speak.
Correct Answer: C
Rationale: The correct answer is C because an advance directive is a legal document that specifies a person's wishes for healthcare decisions if they are unable to make decisions for themselves due to illness. This ensures their preferences are followed. Choices A and B are specific diagnoses and do not address decision-making capacity. Choice D focuses on the inability to speak, which is just one aspect of decision-making ability, but not comprehensive enough for an advance directive.
State four (4) negative symptoms of schizophrenia
- A. Apathy
- B. Social withdrawal
- C. Blunted affect
- D. Poverty of speech
Correct Answer: A
Rationale: Negative symptoms involve diminished function, such as lack of emotion, isolation, flat affect, and reduced verbal output.
A patient tells the nurse, 'I can't go to any unit meetings because when I get in that room, everyone can hear my thoughts.' The nurse can correctly assess this symptom as:
- A. concrete thinking.
- B. loose associations.
- C. thought broadcasting.
- D. auditory hallucinations.
Correct Answer: C
Rationale: The correct answer is C: thought broadcasting. This is when a person believes that others can hear their thoughts. In this scenario, the patient's belief that everyone in the unit meetings can hear their thoughts aligns with the symptom of thought broadcasting. It is a common manifestation of certain psychiatric disorders like schizophrenia.
Choice A, concrete thinking, refers to literal thinking without abstract reasoning and is not applicable in this context. Choice B, loose associations, involves disorganized and illogical thought patterns, which are not evident in the patient's statement. Choice D, auditory hallucinations, refers to hearing voices when no external stimulus is present, which is different from the patient's belief that others can hear their thoughts.