Nokea
The client in whom schizophrenia has been diagnosed usually is medicated with an ____ drug.
- A. Antianxiety
- B. Antipsychotic
- C. Antidepressant
- D. Antihypertensive
Correct Answer: B
Rationale: The correct answer is B: Antipsychotic. Antipsychotic drugs are specifically designed to treat symptoms associated with schizophrenia, such as hallucinations and delusions. These drugs help regulate dopamine levels in the brain, which are often imbalanced in individuals with schizophrenia. Antianxiety drugs (A) are not typically used to treat schizophrenia as they target different symptoms. Antidepressants (C) may be used in conjunction with antipsychotics, but they are not the primary treatment for schizophrenia. Antihypertensive drugs (D) are used to treat high blood pressure and are not indicated for schizophrenia.
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The psychiatric-mental health nurse knows that the patient's spouse clearly understands the adverse effects of lithium carbonate (Eskalith), when they say:
- A. I should call the doctor if my spouse shakes badly'
- B. I should make sure my spouse drinks as much water as possible'
- C. My spouse must remain on a salt-free diet'
- D. When the lithium level is 1.6mEq\L, my spouse can go back to work'
Correct Answer: A
Rationale: Tremors are a common lithium side effect requiring medical attention; other options reflect misunderstanding (e.g., salt-free diet increases toxicity risk, 1.6mEq\L is toxic).
An adult patient tells the case manager, 'I dont have bipolar disorder anymore, so I dont need medicine. After I was in the hospital last year, you helped me get an apartment and disability checks. Now Im bored and dont have any friends.' Where should the nurse refer the patient? Select one tha does not apply.
- A. Psychoeducational classes
- B. Vocational rehabilitation
- C. Social skills training
- D. A homeless shelter
Correct Answer: D
Rationale: The patient does not understand the illness and need for adherence to the medication regimen. Psychoeducation for the patient (and family) can address this lack of knowledge. The patient, who considers himself friendless, could also profit from social skills training to improve the quality of interpersonal relationships. Many patients with serious mental illness have such poor communication skills that others are uncomfortable interacting with them. Interactional skills can be effectively taught by breaking the skill down into smaller verbal and nonverbal components. Work gives meaning and purpose to life, so vocational rehabilitation can assist with this aspect of care. The nurse case manager will function in the role of crisis stabilizer, so no related referral is needed. The patient presently has a home and does not require a homeless shelter.
A woman who is a victim of severe emotional violence tells the nurse that her husband abuses her most often when he is intoxicated, just as his father had beaten him and his mother. The woman is aware of the location of a safe house and has considered leaving home with her two children, but she cites being brought up to believe 'you keep quiet and stay together, no matter what happens.' She states the husband is always apologetic and remorseful after an incident. The nurse responds, 'You cannot live like this; you have to defend yourself and your children.' Which statement most accurately describes the nurse's response?
- A. It is an honest and direct response that will help build trust and rapport.
- B. It suggests that the nurse herself has been a victim of physical abuse.
- C. It is unprofessional, but it will likely help by motivating the patient.
- D. It is a human but unprofessional response and is not helpful.
Correct Answer: D
Rationale: The correct answer is D because the nurse's response is not helpful. Here's a step-by-step rationale:
1. The nurse's response is human because she empathizes with the woman's situation.
2. However, the response is unprofessional as it is too directive and lacks a proper assessment or exploration of the woman's feelings and options.
3. Telling the woman to defend herself may put her at further risk and does not address the underlying issues of abuse and trauma.
4. The response fails to consider the complexities of the woman's situation, such as her cultural beliefs and the cycle of violence she is caught in.
5. Instead, a professional response would involve a more holistic approach, including safety planning, providing resources, and offering support without judgment or pressure.
Serious mental illness is characterized as:
- A. any mental illness of more than 2 weeks duration
- B. a major long-term mental illness marked by significant functional impairments
- C. a mental illness accompanied by physical impairment and severe social problems
- D. a major mental illness that cannot be treated to prevent deterioration of cognitive and social abilities
Correct Answer: B
Rationale: Serious mental illness has replaced the term chronic mental illness. Global impairments in function are evident particularly social. Physical impairments may be present. Serious mental illness can be treated, but remissions and exacerbations are part of the course of the illness.
The Omnibus Budget Reconciliation Act (OBRA) provides standards of care for which of the following:
- A. Very young
- B. Older adults
- C. Those who have certain intellectual communication difficulties
- D. Those without medical insurance
Correct Answer: B
Rationale: OBRA provides regulations for proper assessment of the elderly (B); for this reason, registered nurses have to provide the initial physical assessment.