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Tatiana has been hospitalized for an acute manic episode. On admission, the nurse suspects lithium toxicity. What assessment findings would indicate the nurse's suspicion as correct?
- A. Shortness of breath, gastrointestinal distress, chronic cough
- B. Ataxia, severe hypotension, large volume of dilute urine
- C. Gastrointestinal distress, thirst, nystagmus
- D. Electroencephalographic changes, chest pain, dizziness
Correct Answer: B
Rationale: The correct answer is B. Ataxia, severe hypotension, and a large volume of dilute urine are classic signs of lithium toxicity. Ataxia refers to a lack of muscle coordination, severe hypotension indicates dangerously low blood pressure, and the large volume of dilute urine is a result of the kidneys' inability to concentrate urine properly, a common feature of lithium toxicity.
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Adolescents often display fluctuations in mood along with undeveloped emotional regulation and poor tolerance for frustration. Emotional and behavioral control usually increases over the course of adolescence due to:
- A. Limited executive function
- B. Cerebellum maturation
- C. Cerebral stasis and hormonal changes
- D. A slight reduction in brain volume
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
When attempting to determine a teenager's mental health resilience, what assessment question should the nurse ask that is not applicable?
- A. How did you cope when your father deployed with the Army for a year in Iraq?
- B. Who did you go to for advice while your father was away for a year in Iraq?
- C. How do you feel about talking to a mental health counselor?
- D. Why would you think that is a better option than meeting with me?
Correct Answer: D
Rationale: Assessing a teenager's mental health resilience involves exploring coping mechanisms, support systems, and attitudes towards seeking help. Option D is not relevant to assessing resilience but rather focuses on the comparison between seeking advice from a counselor versus the nurse, which doesn't directly gauge the teenager's resilience.
The mental health team is determining treatment options for a male patient experiencing psychotic symptoms. Which question shouldn't the team answer to determine whether a community outpatient or inpatient setting is most appropriate?
- A. Is the patient expressing suicidal thoughts?
- B. Does the patient have intact judgment and insight into his situation?
- C. Does the patient have experiences with either community or inpatient mental healthcare facilities?
- D. Does the patient require a therapeutic environment to support the management of psychotic symptoms?
Correct Answer: C
Rationale: Assessing suicidal thoughts, judgment, insight, and the need for a therapeutic environment are crucial factors in determining the appropriate treatment setting for a patient experiencing psychotic symptoms. Past experiences with mental healthcare facilities do not play a direct role in deciding between a community outpatient or inpatient setting.
Child protective services have removed 10-year-old Christopher from his parents' home due to neglect. Christopher reveals to the nurse that he considers the woman next door his 'nice' mom, that he loves school, and gets above-average grades. The strongest explanation of this response is:
- A. Temperament
- B. Genetic factors
- C. Resilience
- D. Paradoxical effects of neglect
Correct Answer: C
Rationale: Christopher's positive outlook, strong school performance, and forming a bond with the neighbor indicate resilience. Resilience refers to the ability to adapt and thrive despite facing adversity, such as being removed from his parents' home due to neglect. His ability to maintain a positive attitude and excel in school despite the challenging circumstances highlights his resilience.
During pregnancy, a woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of:
- A. Maternal stress
- B. Parental nurturing
- C. Appropriate stress responses in the brain
- D. Memories of the abuse
Correct Answer: A
Rationale: Maternal stress during pregnancy can have long-term effects on the child's behavior and stress responses. Research shows that exposure to high levels of stress hormones in the womb can influence the developing fetal brain and the child's future behavior, potentially leading to high-risk behaviors during adolescence.