Nokea
The nurse is trying to help a mother understand what is happening with her son who has recently been diagnosed with paranoid schizophrenia. At present, he is experiencing hallucinations and delusions of persecution and suffers from poor hygiene. The nurse can best help her understand her son's condition by which of the following statements?
- A. Sometimes these symptoms are caused by an overstimulation of a chemical called dopamine in the brain.'
- B. Has anyone in your family ever had schizophrenia?'
- C. If your son has a twin, he probably will eventually develop schizophrenia, too.'
- D. Some of his symptoms may be a result of his lack of a strong mother-child bonding relationship.'
Correct Answer: A
Rationale: The most plausible theory to date is that dopamine causes an overstimulation in the brain, which results in the psychotic symptoms.
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The nurse is preparing to administer digoxin (Lanoxin) to a client with heart failure. Which finding would require the nurse to withhold the dose?
- A. Apical pulse of 56 beats per minute
- B. Blood pressure of 130/80 mmHg
- C. Potassium level of 4.0 mEq/L
- D. Serum digoxin level of 1.2 ng/mL
Correct Answer: A
Rationale: Digoxin is withheld if the apical pulse is below 60 beats per minute in adults, as bradycardia increases the risk of toxicity. The other findings are within normal ranges for digoxin administration.
The nurse is performing discharge teaching to a client who is on isoniazid (INH). Which diet selection by the client indicates to the nurse that further instruction is needed?
- A. Tuna casserole
- B. Ham salad sandwich
- C. Baked potato
- D. Broiled beef roast
Correct Answer: A
Rationale: Isoniazid has MAOI properties, requiring avoidance of tyramine-rich foods like tuna to prevent hypertensive crisis. Tuna casserole (A) indicates a need for further teaching. Ham salad (B) may have tyramine but is less definitive. Baked potato (C) and beef roast (D) are safe.
A 14-year-old boy has had diabetes for 7 years. He takes 30 U of NPH insulin and 10 U of regular insulin every morning at 7 AM. He eats breakfast at 7:30 AM and lunch at noon. What time should he expect the greatest risk for hypoglycemia?
- A. 9:00 AM
- B. 1:00 PM
- C. 11:00 AM
- D. 3:00 PM
Correct Answer: C
Rationale: This time is incorrect because regular insulin would peak after the teenager has eaten breakfast. This time is incorrect because it is after lunch when the NPH peaks. Regular insulin peaks in 2-3 hours and has a duration of 4-6 hours. NPH insulin's onset is 4-6 hours and peaks in 8-16 hours. Blood sugar would peak after meals and be lowest before meals and during the night. This time is incorrect because it is before the NPH and after the regular insulin peak times.
The nurse is teaching a client with a new diagnosis of Parkinson’s disease about levodopa/carbidopa (Sinemet). Which instruction should be included?
- A. Take the medication on an empty stomach.'
- B. Expect immediate improvement in symptoms.'
- C. Avoid driving until the medication’s effects are known.'
- D. Take the medication only when tremors are severe.'
Correct Answer: C
Rationale: Levodopa/carbidopa can cause dizziness or drowsiness, so avoiding driving until effects are known ensures safety. It is best taken with food, improvement is gradual, and it is taken regularly, not as needed.
Which of the following characterizes peer group relationships in eight- and nine-year-olds?
- A. Activities are usually cooperative and focused on a single best friend
- B. Activities are usually competitive with loosely organized groups
- C. Children usually play in groups with members of the same sex
- D. Children usually play in groups of three with mixed sexes
Correct Answer: C
Rationale: Eight- and nine-year-olds typically form same-sex peer groups, engaging in activities that foster social skills and group identity.