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The nurse is admitting a client with schizophrenia. The client is extremely socially withdrawn, is unable to perform activities of daily living, has an inappropriate affect, and has grimacing mannerisms. The nurse understands that this client is experiencing which type of schizophrenia?
- A. residual schizophrenia
- B. paranoid schizophrenia
- C. catatonic schizophrenia
- D. disorganized schizophrenia
- E. undifferentiated schizophrenia
Correct Answer: D
Rationale: Disorganized schizophrenia is characterized by social withdrawal, inappropriate affect, grimacing, and impaired daily functioning. Residual (A) involves milder symptoms, paranoid (B) involves delusions, catatonic (C) involves motor issues, and undifferentiated (E) lacks specific features.
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The nurse in the newborn nursery is caring for a preterm infant. Which is the best method the nurse can implement to assist the parents with developing attachment behaviors?
- A. Support visits by family and friends.
- B. Encourage the parents to touch and speak to their infant.
- C. Report only positive qualities and progress to the parents.
- D. Provide information regarding infant development and stimulation.
Correct Answer: B
Rationale: Parents' involvement through touch and voice establishes and initiates the bonding process in the parent-infant relationship. Their active participation builds their confidence and supports the parenting role. Family visits will not encourage parental attachments. Providing information and emphasizing only positives are not incorrect actions, but they do not relate to the attachment process.
The nurse is admitting a client who is to undergo ureterolithotomy. Which should the nurse assess in order to determine if the client is ready for surgery?
- A. The need for a visit from a support group
- B. The knowledge of postoperative activities
- C. An understanding of the surgical procedure
- D. Expected outcomes of the surgical procedure
- E. Feelings or anxieties about the surgical procedure
Correct Answer: B,C,D,E
Rationale: Ureterolithotomy is the removal of a calculus from the ureter using either a flank or abdominal incision. The client should have an understanding of the same items as are required for any surgery, including knowledge of the procedures, the expected outcome, the postoperative routines, and any expected discomfort. The client should also be assessed for any concerns or anxieties before surgery. Because no urinary diversion is created during this procedure, the client has no need for a visit from a member of a support group.
The nurse is preparing to care for a child with anemia from a culture that is different from the nurse's. Which is the best way to address the cultural needs of the child and family when the child is admitted to the health care facility?
- A. Address only those issues that directly affect the nurse's care of the child.
- B. Ask questions, and explain to the family why the questions are being asked.
- C. Explain that cultural practices need to be discontinued during hospitalization.
- D. Ignore cultural needs because they are not important to health care professionals.
Correct Answer: B
Rationale: When caring for individuals from a different culture, it is important to ask questions about their specific cultural needs and means of treatment. An understanding of the family's beliefs and health practices is essential to successful interventions for that particular family. Eliminate the options that ignore the cultural beliefs and values of the client.
The nurse is caring for a teenage client diagnosed with anorexia nervosa. The client's mother asks the nurse about eating disorders in general. Which information would the nurse provide? Select all that apply.
- A. Anorexia nervosa is more common than bulimia.
- B. Clients with bulimia may have erosion of the tooth enamel.
- C. Binging and purging can occur in both anorexia nervosa and bulimia.
- D. Extreme exercising and calorie restriction is common with anorexia nervosa.
- E. Clients with eating disorders may develop the disorders because of issues of power and control.
- F. Clients with anorexia have a distorted body image and think that they are fat even if they are very thin.
Correct Answer: B,C,D,E,F
Rationale: Bulimia is more common than anorexia, making A incorrect. Tooth enamel erosion, binging/purging, extreme exercising, power/control issues, and distorted body image are all accurate.
The nurse is leading a crisis intervention group comprising high school students who have experienced the recent death of a classmate who committed suicide. The students are experiencing disbelief as they review the details of the suicide. Which should be the initial therapeutic action by the nurse?
- A. Ask how the students recovered from a death event in the past.
- B. Reinforce the students' ability to work through this death event.
- C. Inquire about the students' perception of their classmate's suicide.
- D. Reinforce the students' sense of growth through this death experience.
Correct Answer: C
Rationale: It is essential to determine the students' views. Inquiring about the students' perception of the suicide will specifically identify the appraisal of the suicide and the meaning of the perception. Although option 1 is exploratory, it does not address the 'here-and-now' appraisal in terms of the classmate's suicide. Although the nurse is interested in how students have coped in the past, this inquiry should not be the most immediate assessment. Options 2 and 4 are attempts to foster students' self-esteem. Such an approach is premature at this point.