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The client is hostile, angry, and suspicious. He thinks that the staff is trying to poison him. He is classified as:
- A. Paranoid
- B. Catatonic
- C. Disorganized
- D. Undifferentiated
Correct Answer: A
Rationale: The correct answer is A: Paranoid. This client's behavior aligns with paranoid schizophrenia symptoms, characterized by hostility, anger, suspicion, and delusions of persecution like being poisoned. Catatonic schizophrenia (B) involves motor disturbances, disorganized schizophrenia (C) features disorganized speech and behavior, and undifferentiated schizophrenia (D) includes a mix of symptoms without fitting a specific subtype. Paranoid schizophrenia best fits the client's presentation based on the described symptoms.
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A patient who is admitted to the psychiatric unit with a diagnosis of obsessive-compulsive disorder spends a significant amount of time during the day and night washing their hands. On the third hospital day, the patient reports feeling better and more comfortable with the staff and other patients. The psychiatric-mental health nurse knows that the most appropriate nursing intervention is to:
- A. acknowledge the ritualistic behavior each time and point out that it is inappropriate
- B. allow the patient to carry out the ritualistic behavior, since it is helping them
- C. collaborate with the patient to reduce the amount of time they engage in ritualistic behavior
- D. ignore the ritualistic behaviors, and the behaviors will be eliminated due to lack of reinforcement
Correct Answer: C
Rationale: Collaborating to reduce rituals builds on the patient's progress, promoting control without enabling the behavior.
A patient with borderline personality disorder has cut her wrists. The physician orders daily dressing changes for the lacerations. The nurse performing this care should:
- A. encourage the patient to vent anger and aggression.
- B. provide care in a matter-of-fact manner
- C. be kindly, sympathetic, and concerned.
- D. offer to listen to the patient's feelings about cutting.
Correct Answer: B
Rationale: The correct answer is B: provide care in a matter-of-fact manner. This approach is important in treating patients with borderline personality disorder as it helps maintain boundaries and consistency, which are crucial for managing their condition. By being matter-of-fact, the nurse can prevent potential manipulation or reinforcement of maladaptive behaviors. Encouraging the patient to vent anger (choice A) may escalate the situation. Being overly sympathetic (choice C) can blur professional boundaries. Offering to listen to feelings (choice D) may reinforce the behavior and not address the underlying issues effectively.
Fragile X syndrome is associated with which of the following?
- A. Language impairment
- B. Behavioural problems
- C. Moderate levels of intellectual disability
- D. All of the above
Correct Answer: D
Rationale: Fragile X Syndrome: A chromosomal abnormality causing intellectual disability, language impairment, and behavioral issues.
At what age do the synaptic connections in human brain peak?
- A. At birth
- B. End of 3 years
- C. 5 years
- D. 8 years
Correct Answer: B
Rationale: Synaptic connections peak around the end of 3 years (B), a period of rapid synaptogenesis and neural plasticity, followed by pruning. At birth (A), development begins, while 5 (C) and 8 years (D) see continued growth but past the peak, per neurodevelopmental research.
A 45-year-old patient shows marked cognitive impairment that has developed progressively over several months. A family member reports that the patient's father also had early-onset dementia. What research-based information can be given to the family in response to their concerns about the patient developing early-onset dementia?
- A. The risk for developing the condition is about 50% only if both parents were affected.
- B. The greatest risk exists for relatives of individuals diagnosed with Alzheimer disease before age 55 years.
- C. Added risk is present only for people with Down syndrome, so relatives without Down syndrome are essentially "safe."Â
- D. Results of the research on genetic predisposition and its effect on the development of early-onset dementia are still unclear.
Correct Answer: B
Rationale: The correct answer is B because individuals with a family history of early-onset dementia, particularly Alzheimer's disease before age 55, are at a higher risk of developing the condition themselves. This is supported by research showing a strong genetic component in the development of early-onset dementia. Choice A is incorrect because the risk is not solely dependent on both parents being affected. Choice C is incorrect as early-onset dementia is not limited to individuals with Down syndrome. Choice D is incorrect because research has shown a clear link between genetic predisposition and early-onset dementia.