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The emergency department note states, 'This patient displays positive symptoms of schizophrenia as evidenced by psychotic disorders of thinking.' The nurse can expect the patient to evidence:
- A. delusions and hallucinations.
- B. grimacing and mannerisms.
- C. echopraxia and echolalia.
- D. avolition and anhedonia.
Correct Answer: A
Rationale: The correct answer is A: delusions and hallucinations. Positive symptoms of schizophrenia include hallucinations (perceiving things that are not present) and delusions (false beliefs). In this case, the patient displaying psychotic disorders of thinking aligns with positive symptoms. Delusions are fixed false beliefs, while hallucinations involve sensory experiences without external stimuli. Choices B, C, and D involve different symptoms such as motor abnormalities (grimacing and mannerisms), echopraxia and echolalia (mimicking movements and repeating words), and negative symptoms (avolition and anhedonia - lack of motivation and pleasure), which are not specifically related to psychotic disorders of thinking in schizophrenia.
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Which information should the nurse include when teaching a client with a personality disorder?
- A. Journal writing will help you recognize feeling states.'
- B. Try problem solving independently to help with difficult relationships.'
- C. Identify people and circumstances that create conflict; then avoid them.'
- D. Try to alleviate behaviors that cause problems relating with others.'
Correct Answer: A
Rationale: The correct answer is A because journal writing can help individuals with personality disorders recognize and better understand their emotions, leading to improved self-awareness and emotional regulation. This can be a useful tool in therapy and self-management.
Choice B is incorrect because individuals with personality disorders often struggle with interpersonal relationships and might benefit from seeking support or guidance rather than attempting to solve problems independently.
Choice C is incorrect because avoidance does not address the underlying issues and can lead to isolation and maladaptive coping mechanisms.
Choice D is incorrect because simply trying to alleviate problematic behaviors without addressing the underlying emotional issues may not lead to long-term improvement in relationships.
A client who received chlorpromazine (Thorazine) for 15 years to treat schizophrenia developed tardive dyskinesia as evidenced by tongue thrusting and chewing motions. The physician discontinued the chlorpromazine and prescribed Seroquel (quetiapine). As a result of this change, the nurse should carefully monitor for:
- A. Development of pseudoparkinsonism
- B. Development of dystonic reactions
- C. Improvement in tardive dyskinesia
- D. Worsening of anticholinergic symptoms
Correct Answer: C
Rationale: The correct answer is C: Improvement in tardive dyskinesia. Tardive dyskinesia is a side effect of long-term antipsychotic use, like chlorpromazine. Quetiapine (Seroquel) is an atypical antipsychotic with a lower risk of causing tardive dyskinesia. By discontinuing chlorpromazine and switching to quetiapine, there is a higher likelihood of improvement or resolution of tardive dyskinesia symptoms. Options A and B are incorrect as they are related to other movement disorders caused by antipsychotics. Option D is incorrect as anticholinergic symptoms are not directly related to tardive dyskinesia improvement with the medication switch.
A 45-year-old man develops weakness and wasting of the right hand. Which one of the following is least likely to be the cause?
- A. Old injury to the elbow joint.
- B. Bronchogenic carcinoma of the right upper lobe.
- C. Multiple sclerosis.
- D. Syringomyelia.
Correct Answer: C
Rationale: Multiple sclerosis (C) typically causes sensory and motor symptoms but rarely isolated hand wasting, which is more characteristic of peripheral nerve or motor neuron issues. Old injury (A), lung cancer (B, via brachial plexus), syringomyelia (D), and motor neurone disease (E) are more directly linked to such symptoms.
What is a common consequence of long-term purging in patients with bulimia nervosa?
- A. Improved digestive health and better nutrient absorption.
- B. Increased risk of dehydration and electrolyte imbalances.
- C. Improved self-esteem and body image.
- D. Decreased risk of cardiovascular problems and hypertension.
Correct Answer: B
Rationale: The correct answer is B because long-term purging in patients with bulimia nervosa can lead to increased risk of dehydration and electrolyte imbalances. Purging behaviors such as vomiting or laxative abuse can disrupt the body's fluid and electrolyte balance, potentially causing dehydration and electrolyte imbalances. These imbalances can have serious health consequences, including cardiac arrhythmias, muscle weakness, and kidney damage.
Incorrect choices:
A: Improved digestive health and better nutrient absorption - Purging does not improve digestive health or nutrient absorption; rather, it can lead to nutrient deficiencies.
C: Improved self-esteem and body image - Purging behaviors are harmful and do not lead to improved self-esteem or body image.
D: Decreased risk of cardiovascular problems and hypertension - Purging behaviors can actually increase the risk of cardiovascular problems due to electrolyte imbalances and dehydration.
In autistic spectrum disorder when as individual exhibits immediate imitation of words or sounds they have just heard, this is known as:
- A. Echoastic disorder
- B. Phonological inhibition
- C. Echolalia
- D. Grapheme dysfunction
Correct Answer: C
Rationale: Echolalia: The immediate imitation of words or sounds heard, a common feature in autistic spectrum disorder.