Nokea
The extreme reaction known as fugue refers to
- A. physical flight to escape conflict
- B. severe depression
- C. hallucinations
- D. obsessive behavior
Correct Answer: A
Rationale: Fugue is a dissociative state involving sudden travel or flight, often to escape stress.
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Which finding for a patient with an eating disorder most clearly indicates the need for hospitalization?
- A. Weight 15% below ideal weight
- B. Urine output less than 30 mL/hr
- C. Serum potassium 3.4 mEq/L
- D. Pulse rate 54 beats/min
Correct Answer: B
Rationale: The correct answer is B because urine output less than 30 mL/hr indicates severe dehydration and compromised kidney function, which can lead to organ failure. Hospitalization is necessary for immediate fluid resuscitation and monitoring. Option A is indicative of malnutrition but does not directly signify acute medical complications. Option C suggests hypokalemia, which can be managed on an outpatient basis. Option D, a low pulse rate, may be a sign of bradycardia but typically does not require immediate hospitalization unless accompanied by other severe symptoms.
The management of nausea as a side effect of lithium carbonate (Eskalith) includes instructing the patient to take the medication:
- A. after meals
- B. between meals
- C. with a carbonated beverage
- D. with a large glass of water
Correct Answer: A
Rationale: Taking lithium after meals reduces gastrointestinal irritation, including nausea, by buffering its absorption.
When a patient with paranoid schizophrenia has a recurrence of positive symptoms after stopping his antipsychotic medication because of its postural hypotension (orthostasis) side effect, he is readmitted to the mental health unit. What measure should the nurse suggest to help the patient address this side effect?
- A. Ask the doctor to prescribe an anticholinergic drug like trihexyphenidyl (Artane).
- B. Chew sugarless gum or use sugarless hard candy to moisten your mouth.
- C. Increase the amount of sleep you get, and try to take frequent rest breaks.
- D. Wear elastic support hose, drink adequate fluids, and change position slowly.
Correct Answer: D
Rationale: The correct answer is D because wearing elastic support hose, drinking adequate fluids, and changing positions slowly can help prevent postural hypotension associated with antipsychotic medications. Elastic support hose can improve blood circulation and prevent blood pooling in the legs. Adequate fluid intake can help maintain blood volume and blood pressure. Changing positions slowly can prevent sudden drops in blood pressure upon standing.
Choice A (anticholinergic drug) is incorrect as it may worsen symptoms of schizophrenia. Choice B (sugarless gum or candy) is unrelated to postural hypotension. Choice C (increasing sleep and rest breaks) may help with fatigue but does not address postural hypotension directly.
A nurse assesses that which of the following individuals is most likely to engage in eating behaviors characteristic of bulimia?
- A. A person who weighs 225 pounds and is 5 feet 4 inches tall.
- B. A person who is 5 pounds overweight and cannot stick to a diet.
- C. A person who lost up to 40 pounds but gained it back within 1 year.
- D. None of the above.
Correct Answer: A
Rationale: Step 1: Individuals with bulimia often engage in episodes of binge eating followed by purging behaviors.
Step 2: Choice A, a person who is significantly overweight, is more likely to engage in binge eating behavior.
Step 3: Being overweight can be a risk factor for bulimia due to body image concerns.
Step 4: Choices B and C do not provide as strong indicators for bulimia as choice A.
Summary: Choice A is correct as being significantly overweight is a common characteristic of individuals with bulimia. Choices B and C lack the same level of risk factors for engaging in eating behaviors characteristic of bulimia.
Which of the following should the nurse consider when planning care for a client with antisocial personality disorder? Clients with antisocial personality disorder:
- A. Demand constant attention
- B. Tolerate frustration well
- C. Have well-developed superegos
- D. Are initially often charming
Correct Answer: D
Rationale: The correct answer is D: Are initially often charming. This is because individuals with antisocial personality disorder often exhibit charm and charisma to manipulate others for personal gain. This behavior is known as "charm offensive" and can be used to deceive and exploit others. This initial charm can make it difficult for others to recognize their true motives and manipulative nature.
Incorrect options:
A: Demand constant attention - Individuals with antisocial personality disorder may appear self-centered and manipulative but not necessarily demand constant attention.
B: Tolerate frustration well - Clients with antisocial personality disorder often have difficulty managing frustration and may resort to aggressive or impulsive behavior.
C: Have well-developed superegos - Individuals with antisocial personality disorder typically lack empathy and have a weak or underdeveloped superego, leading to a disregard for social norms and the rights of others.