Nokea
The most severe psychological disorder is a(n)
- A. personality disorder
- B. psychosomatic illness
- C. anxiety disorder
- D. psychosis
Correct Answer: D
Rationale: Psychosis, involving severe reality distortion, is considered the most debilitating class of disorders.
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The nurse who works in a sleep clinic knows that approximately __________% of adults experience some form of sleep disorder.
- A. 10 to 20.
- B. 30 to 40.
- C. 50 to 60.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B (30 to 40%). This range is supported by research indicating that around 30-40% of adults experience some form of sleep disorder. This percentage reflects the prevalence of various sleep disorders such as insomnia, sleep apnea, and restless leg syndrome among adults. The range of 10 to 20% (choice A) is too low based on current data. Likewise, the range of 50 to 60% (choice C) is too high and does not align with the established prevalence rates of sleep disorders in adults. "None of the above" (choice D) is incorrect as there is a documented prevalence of sleep disorders in adults, making it necessary to provide an estimate within a certain range.
An 83-year-old man becomes lost while driving. He pulls into a driveway to turn around and cannot figure out how to put his car in reverse, so he drives into the yard, makes a circle, and drives back out of the driveway. He is stopped by police, who take him to the emergency department. The physician diagnoses him with Alzheimer's disease and refers him to the neurology clinic for follow-up. Given this diagnosis, which behaviors should the clinic nurse anticipate?
- A. Does not know today's date.
- B. Unable to shower without help.
- C. Denial of mental impairment.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Does not know today's date. This behavior is commonly associated with Alzheimer's disease due to memory impairment. The inability to recall the current date is a key symptom of cognitive decline. In this case, the man's difficulty with reversing his car and getting lost are indicative of cognitive impairment.
Choice B, Unable to shower without help, is a functional impairment and not specific to Alzheimer's disease. Choice C, Denial of mental impairment, may occur in some individuals with Alzheimer's but is not a consistent behavior. Choice D, None of the above, is incorrect as memory deficits, such as not knowing the date, are commonly seen in Alzheimer's disease.
A patient with antisocial personality disorder tells Nurse A, 'You're a much better nurse than Nurse B said you were.' The patient tells Nurse B, 'Nurse A's upset with you for some reason.' To Nurse C the patient states, 'You'd like to think you're perfect, but I've seen three of your mistakes this morning.' Which nursing intervention would be most helpful for addressing this behavior?
- A. Hold a weekly staff meeting to discuss feelings and conflicts related to such behavior.
- B. Confront the patient and advise her that if she continues this, she will lose privileges.
- C. Get all staff to agree that any and all inappropriate behavior will simply be ignored.
- D. Evaluate the patient for a medication increase or transfer to a long-term facility.
Correct Answer: A
Rationale: The correct answer is A: Hold a weekly staff meeting to discuss feelings and conflicts related to such behavior. This intervention promotes open communication among staff members to address and understand the patient's behavior. It allows for collaboration in managing challenging situations and ensures consistency in approach. Confronting the patient (B) may escalate the behavior and damage the therapeutic relationship. Ignoring inappropriate behavior (C) does not address the underlying issues and may lead to staff frustration. Evaluating for medication increase or transfer (D) should be considered only after non-pharmacological interventions have been exhausted.
A psychotic patient is delusional and has auditory hallucinations. The best statement to make when approaching the patient with an oral electronic thermometer would be:
- A. I need your vital signs. Put this in your mouth. This will not hurt.'
- B. I hope I can count on you to hold still while I take your temperature.'
- C. Please sit here while I take your temperature. I'll put the thermometer under your tongue for a few seconds.'
- D. This probe is only a thermometer that will tell us whether you have a fever. It will be all over in just a few seconds.'
Correct Answer: C
Rationale: The correct answer is C because it uses clear, simple language to explain the procedure to the patient. It acknowledges the patient's delusions by asking them to sit and calmly states the thermometer will be placed under their tongue. This approach is likely to minimize the patient's anxiety and increase cooperation.
Option A is incorrect as it may cause the patient to feel apprehensive due to the mention of "hurt." Option B is incorrect because it does not provide specific instructions about the procedure, which may lead to confusion for the patient. Option D is incorrect as it does not address the patient's delusions or provide clear instructions, potentially leading to increased resistance from the patient.
A 17-year-old client is admitted to the ED after being alternately hyperalert and difficult to arouse. His symptoms all started within the last few hours, during which time he became disoriented and confused. His behavior was agitated and restless, and his memory was impaired, especially for recent events. The client displayed some delusions and misinterpretations of his surroundings. The nurse knows she needs to assess the client further for:
- A. Dementia
- B. Depression
- C. Delirium
- D. Amnesia
Correct Answer: C
Rationale: The correct answer is C: Delirium. Delirium is characterized by acute and fluctuating changes in cognition, attention, and awareness. The client's sudden onset of symptoms, including disorientation, confusion, agitation, restlessness, impaired memory, delusions, and misinterpretations of surroundings, align with the hallmark features of delirium. The nurse needs to further assess the client for delirium to determine the underlying cause and provide appropriate interventions promptly.
Incorrect choices:
A: Dementia - Dementia is a chronic, progressive condition characterized by gradual cognitive decline. The client's acute onset of symptoms is not consistent with dementia.
B: Depression - Depression typically presents with persistent feelings of sadness, hopelessness, and loss of interest, which are different from the acute and fluctuating cognitive changes seen in delirium.
D: Amnesia - Amnesia refers to memory loss, which is only one aspect of the client's presentation. Delirium involves a broader range of cognitive