The antisocial personality is one who
- A. is irresponsible and seems to lack remorse
- B. is frequently dangerous and out of contact with reality
- C. is always a delinquent or criminal
- D. benefits greatly from humanistic and psychoanalytic therapies
Correct Answer: A
Rationale: Antisocial personality features irresponsibility and lack of remorse, not necessarily overt danger.
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In planning aftercare for a client with schizophrenia and whose insurance benefits have been exhausted, the nurse who is concerned about overcoming negative symptoms will make provisions for the client to have stimulation, structure, socialization, and support. Which option would best incorporate these factors?
- A. Day hospitalization
- B. Attending a psychosocial club
- C. Living with his elderly mother
- D. Spending free time in the mall
Correct Answer: B
Rationale: The correct answer is B, attending a psychosocial club. This option best incorporates the factors of stimulation, structure, socialization, and support. Psychosocial clubs offer a structured environment with various activities to stimulate the client's mind and prevent social isolation. It provides opportunities for socialization and peer support, which are crucial for individuals with schizophrenia. Day hospitalization may offer structure but lacks the socialization aspect. Living with his elderly mother may provide support but not necessarily the stimulation and structure needed. Spending free time in the mall does not provide the structured environment, socialization, or support necessary for aftercare in schizophrenia.
What is the primary nursing concern for a patient with anorexia nervosa during the early stages of treatment?
- A. Ensuring rapid weight gain to restore health.
- B. Addressing the patient's psychological issues related to body image.
- C. Maintaining nutritional intake to prevent further weight loss.
- D. Promoting self-esteem and body image satisfaction.
Correct Answer: C
Rationale: The primary nursing concern for a patient with anorexia nervosa in the early stages of treatment is maintaining nutritional intake to prevent further weight loss. This is crucial as malnutrition can lead to serious health complications. Ensuring adequate nutrition supports physical health and provides a foundation for addressing psychological issues in later stages of treatment. Rapid weight gain (A) can be harmful and lead to refeeding syndrome. Addressing psychological issues (B) and promoting self-esteem (D) are important but secondary concerns once nutritional stability is achieved.
When a patient with anorexia nervosa is admitted for treatment, the milieu should provide: (Select all that apply.)
- A. Flexible mealtimes.
- B. Unscheduled weight checks.
- C. Adherence to a selected menu.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Flexible mealtimes. In the treatment of anorexia nervosa, providing flexible mealtimes allows patients to regain a sense of control over their eating habits, which is crucial in their recovery process. This approach helps to reduce anxiety around food and promotes a healthier relationship with eating.
Choice B: Unscheduled weight checks can be triggering and anxiety-provoking for patients with anorexia nervosa, as weight monitoring can be a significant source of distress for them.
Choice C: Adherence to a selected menu may reinforce rigid eating patterns and control issues related to food, which can be counterproductive in the treatment of anorexia nervosa.
Choice D: None of the above is incorrect because providing flexible mealtimes is essential in creating a supportive and therapeutic environment for patients with anorexia nervosa.
A patient experiencing delirium secondary to corticosteroid toxicity is manifesting paranoid thinking and noisy, assaultive behavior. The patient is currently pacing the hall and shouting. A nurse has placed a call to the physician and is anticipating the following order:
- A. the use of supervised restraints.
- B. a loading dose of phenytoin.
- C. a small dose of prednisone.
- D. an IV dose of thiamine.
Correct Answer: A
Rationale: The correct answer is A: the use of supervised restraints. In this situation, the patient is displaying agitated and assaultive behavior, posing a risk to themselves and others. Supervised restraints are necessary to ensure the safety of the patient and healthcare providers until the effects of corticosteroid toxicity subside. Restraints should only be used as a last resort when other interventions have failed.
Choice B: A loading dose of phenytoin is incorrect because phenytoin is not indicated for managing delirium secondary to corticosteroid toxicity.
Choice C: A small dose of prednisone is incorrect because adding more corticosteroids would exacerbate the toxicity and worsen the delirium.
Choice D: An IV dose of thiamine is incorrect as thiamine is used to treat thiamine deficiency, not corticosteroid toxicity-induced delirium.
In the elderly, administering medication is a great concern for the nurse since these patients are more prone to side effects. The primary cause of this is:
- A. Altered circulation and renal function
- B. Accelerated gastrointestinal system
- C. Enlarged Lymph nodes
- D. Musculoskeletal system weakness
Correct Answer: A
Rationale: The elderly are more likely to have side effects when there is altered metabolism through the kidneys and liver as well as altered circulatory function (A), unlike the other options (B, C, D) which are less relevant.