Nokea
The onset of schizophrenia most commonly occurs during the decade of age in the:
- A. Teens
- B. 20s
- C. 30s
- D. 40s
Correct Answer: B
Rationale: The correct answer is B (20s) because research shows that the peak onset of schizophrenia is typically during late adolescence to early adulthood, which aligns with the age range of the 20s. During this period, the brain undergoes significant developmental changes, making individuals more vulnerable to developing schizophrenia. Choices A (Teens), C (30s), and D (40s) are incorrect because while schizophrenia can develop at any age, the majority of cases emerge during the 20s. Schizophrenia rarely starts in the teenage years (A), and onset in the 30s (C) or 40s (D) is less common compared to the 20s.
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A client with antisocial personality disorder yells, 'Shut up about that, or I'll punch you in the nose!' and shakes his fist at another client in a group meeting after the client speaks negatively of illicit drug use. The nurse quickly determines that the client is at risk to act violently against others as evidenced by his aggressive behavior, verbal threats, and a history of impulsivity. Which is the best approach for the nurse to use?
- A. Seclude the client to protect the other clients and staff.
- B. Put the client in restraints to protect the milieu.
- C. Explore alternate ways to handle frustrating topics in the group.
- D. Tell the client to leave the group until he can behave appropriately.
Correct Answer: C
Rationale: The correct answer is C: Explore alternate ways to handle frustrating topics in the group. This approach is best because it focuses on addressing the underlying issue causing the client's aggression rather than just isolating or restraining the client. By exploring alternate ways to handle frustrating topics, the nurse can help the client develop healthier coping mechanisms and communication skills. This approach promotes therapeutic engagement and supports the client's growth and development.
Secluding the client (choice A) may escalate the situation and reinforce the client's aggressive behavior. Putting the client in restraints (choice B) is a restrictive measure that should only be used as a last resort for imminent danger. Telling the client to leave the group (choice D) may not address the root cause of the aggression and could lead to avoidance of addressing the client's issues.
A client with dementia is unable to name ordinary objects. Instead, he describes them (e.g., 'the thing you cut meat with'). The nurse should assess this as:
- A. Aphasia.
- B. Paraphasia.
- C. Apraxia.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Paraphasia. Paraphasia is a language disturbance characterized by the substitution of one word for another, leading to incorrect or nonsensical speech. In the case of the client with dementia unable to name ordinary objects but describing them, such as 'the thing you cut meat with,' this behavior aligns with paraphasia. Aphasia (choice A) refers to a complete loss or impairment of language function, which is not the case here. Apraxia (choice C) involves the inability to perform purposeful movements, not language deficits. Therefore, the client's behavior is best assessed as paraphasia due to the characteristic word substitutions and descriptions given.
A nurse plans an educational program for staff of a home health agency specializing in care of the elderly. Which topic is the highest priority to include?
- A. Pain assessment techniques for older adults
- B. Psychosocial stimulation for those who live alone
- C. Preparation of psychiatric advance directives in the elderly
- D. Ways to manage disinhibition in elderly persons with dementia
Correct Answer: A
Rationale: The correct answer is A: Pain assessment techniques for older adults. This is the highest priority as pain management is crucial in the care of the elderly to ensure their comfort and well-being. By assessing pain accurately, appropriate interventions can be implemented.
- Choice B (Psychosocial stimulation): While important, it is not as critical as addressing pain, which directly impacts the individual's physical comfort.
- Choice C (Psychiatric advance directives): Important for mental health planning but not as immediately essential as pain assessment in day-to-day care.
- Choice D (Managing disinhibition in dementia): Important but secondary to addressing pain, which has a more immediate impact on the individual's quality of life.
Prioritizing pain assessment ensures holistic care for elderly patients.
The parent of a seriously mentally ill adult asks the nurse, 'Why are you making a referral to a vocational rehabilitation program? My child wont ever be able to hold a job.' Which is the nurses best reply?
- A. We make this referral to continue eligibility for federal funding.'
- B. Are you concerned that were trying to make your child too independent?'
- C. If you think the program would be detrimental, we can postpone it for a time.'
- D. Most patients are capable of employment at some level, competitive or supported.'
Correct Answer: D
Rationale: Studies have shown that most patients who complete vocational rehabilitation programs are capable of some level of employment. They also demonstrate significant improvement in assertiveness and work behaviors as well as decreased depression.
A woman was bound, taken to a remote location, and raped at gunpoint. When found, she was examined and treated in the emergency department. Which aspect of this crisis produced the greatest amount of psychological trauma?
- A. The threat to her life
- B. Collection of evidence
- C. Physical pain experienced
- D. Being in a remote location
Correct Answer: A
Rationale: The correct answer is A: The threat to her life. This aspect produced the greatest psychological trauma as the fear of losing one's life triggers intense emotional distress and long-lasting psychological effects such as anxiety and PTSD. The threat of death during a traumatic event can lead to profound feelings of helplessness and vulnerability. In comparison, while the other aspects (B: Collection of evidence, C: Physical pain experienced, D: Being in a remote location) also contribute to the trauma experienced, they do not elicit the same level of fear and existential threat as the possibility of losing one's life.