Nokea
The dopamine-psychosis link is based on the observation that
- A. low dopamine levels of activity in the brain seem to produce psychotic symptoms
- B. there are high levels of dopamine activity in the brains of psychotic people
- C. there are high levels of amphetamine in the brains of schizophrenics
- D. dopamine interacts with serotonin creating psychosis
Correct Answer: B
Rationale: Elevated dopamine activity is associated with psychotic symptoms, especially in schizophrenia.
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A 34-year-old male admitted with catatonic schizophrenia has been mute and motionless for several days while at home prior to admission. He still appears stuporous in the hospital. Which nursing intervention would be an initial priority?
- A. Orienting the client to the unit
- B. Assessing the client for physical problems
- C. Establishing a nonthreatening relationship
- D. Reinforcing reality with the client
Correct Answer: B
Rationale: The correct answer is B: Assessing the client for physical problems. This is the initial priority because the client's muteness and motionless state could be due to an underlying physical issue that needs immediate attention, such as dehydration, malnutrition, or infection. By assessing for physical problems first, the nurse can rule out any urgent medical concerns before addressing the client's mental health needs.
A: Orienting the client to the unit - While important, this can be done after addressing any physical problems.
C: Establishing a nonthreatening relationship - Also essential, but assessing physical health takes precedence.
D: Reinforcing reality with the client - Not the immediate priority; physical assessment should come first.
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.
A 5-year-old presents with a history of urgency of micturition, occasional enuresis, and a slight, non-offensive vaginal discharge for 3 months. She has had no vaginal bleeding. Examination reveals some reddening of the labia majora. Which one of the following is the most likely diagnosis?
- A. Trichomonal infection.
- B. Gonorrhoea.
- C. Cystitis.
- D. Non-specific vulvo-vaginitis.
Correct Answer: D
Rationale: Non-specific vulvo-vaginitis (E) is common in young girls due to hygiene or irritation, causing these symptoms. Trichomonas (A) and gonorrhoea (B) are rare without sexual history, cystitis (C) lacks vaginal signs, and foreign body (D) typically causes bleeding or foul discharge.
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.
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.