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The intervention that would be most appropriate of a male client develops orthostatic hypotension while taking amitriptyline (Elavil) is
- A. Consulting with the physician about substituting a different type of antidepressant
- B. Advising the client to sit up for 1 minute before getting out of bed
- C. Instructing the client to double the dosage until the problem resolves.
- D. Instruct the client to stop medication immediately
Correct Answer: B
Rationale: Advising the client to sit up slowly helps manage orthostatic hypotension, a common side effect of amitriptyline, by preventing sudden drops in blood pressure.
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A client with a personality disorder asks the nurse, 'Is it true I have an inherited brain disorder?' The nurse replies, knowing that:
- A. There is proof that personality disorders are inherited
- B. All persons with personality disorders display brain abnormalities
- C. Individuals with personality disorders show an error in brain glucose metabolism
- D. Individuals with personality disorders manifest some biological markers
Correct Answer: D
Rationale: Rationale:
D is correct because individuals with personality disorders can manifest biological markers indicating a potential biological basis for the disorder. This does not imply that all individuals with personality disorders display brain abnormalities (B), have errors in brain glucose metabolism (C), or that there is definitive proof of inheritance (A). Biological markers suggest a potential biological component but do not guarantee inheritance or specific brain abnormalities.
Most individuals with Alzheimer's disease are cared for in:
- A. Nursing homes
- B. Their homes
- C. Mental health facilities
- D. Long-term care facilities specifically set up for clients with Alzheimer's
Correct Answer: B
Rationale: The correct answer is B: Their homes. Most individuals with Alzheimer's disease are cared for in their homes because it allows for familiar surroundings and routines, which can help reduce confusion and anxiety. Home care also promotes independence and maintains a sense of normalcy. Nursing homes (choice A) may be necessary for individuals with advanced Alzheimer's who require round-the-clock care. Mental health facilities (choice C) are not typically designed to provide specialized care for Alzheimer's. Long-term care facilities specifically for Alzheimer's clients (choice D) are a subset of nursing homes and may not be the most common setting for care.
Behaviorists would say that self-defeating behaviors are maintained by immediate reinforcement in the form of
- A. relief from anxiety
- B. defending the ego
- C. protecting one's self-image
- D. avoiding existential anxiety
Correct Answer: A
Rationale: Behaviorists argue self-defeating actions persist because they provide short-term anxiety relief.
The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating. He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. This information most likely suggests:
- A. medication nonadherence.
- B. a need for psychoeducation.
- C. the chronic nature of his illness.
- D. relapse of his schizophrenia.
Correct Answer: D
Rationale: The correct answer is D: relapse of his schizophrenia. The patient is displaying symptoms such as feeling tense, difficulty concentrating, disturbed sleep, and delusional thoughts about creatures hiding in his workplace. These symptoms indicate a return of psychotic features characteristic of schizophrenia, suggesting a relapse. This is supported by the patient's history of schizophrenia and the sudden onset of symptoms after a period of stability. Medication nonadherence (choice A) could be a possible cause, but the patient's symptoms are more indicative of a relapse. While psychoeducation (choice B) is important, the patient's current symptoms require immediate attention for relapse management. The chronic nature of his illness (choice C) is a general characteristic of schizophrenia and does not explain the current symptoms.
A boy with a conduct disorder diagnosis would be most likely to have which symptom?
- A. Withdrawal
- B. Ritualistic behavior
- C. Class bully
- D. Class clown
Correct Answer: C
Rationale: A pattern of bullying is a common sign of conduct disorder. Responses A and B may reflect autism.