Nokea
The physician has ordered atropine 5 mg intramuscularly (IM) for a patient to be administered 30 minutes prior to ECT. The rationale for use of this medication is that it reduces secretions and:
- A. Improves the scope of convulsive activity
- B. Reduces the need for recovery room staff
- C. Prevents incontinence of bladder and bowel
- D. Increases the patient's alertness post-procedure.
Correct Answer: A
Rationale: The rationale for using atropine 5 mg IM prior to ECT is to protect against vagal bradycardia, not to improve the scope of convulsive activity, reduce the need for recovery room staff, or prevent incontinence of bladder and bowel. Atropine is a muscarinic antagonist that blocks the effects of acetylcholine on muscarinic receptors, leading to an increase in heart rate and protection against bradycardia that can occur during ECT.
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Which response is appropriate when a patient’s mother expresses guilt over causing my child to be schizophrenic?
- A. I can see how you would be upset over this turn of events
- B. New findings suggest this disorder is biological in nature.
- C. Don’t be so hard on yourself; your daughter needs you to be strong
- D. It’s difficult to see what produces stress for the child at the time it’s occurring.
Correct Answer: B
Rationale: Schizophrenia is primarily linked to biological factors, including genetic predispositions, neurochemical imbalances, and brain structure abnormalities. This response helps dispel guilt and provides reassurance to the mother.
When asked, the nurse explains that grief work refers to:
- A. Establishing new methods of coping with stress
- B. Evaluating progress made toward accepting the loss
- C. The means by which one moves through the grief process
- D. Actively seeking assistance to cope with the loss experiences
Correct Answer: C
Rationale: Grief work involves actively processing emotions, integrating the loss, and adapting to life without the deceased. It is not solely about stress coping or progress evaluation.
The desired outcome for a patient experiencing insomnia is, "Patient will sleep for a minimum of 5 hours nightly within 7 days." At the end of 7 days, review of sleep data shows the patient sleeps an average of 4 hours nightly and takes a 2-hour afternoon nap. What is the nurse’s next action?
- A. Continue the current plan without changes.
- B. Remove this nursing diagnosis from the plan of care.
- C. Write a new nursing diagnosis that better reflects the problem.
- D. Examine interventions for possible revision of the target date.
Correct Answer: D
Rationale: When goals are partially met, the plan of care should be re-evaluated, and adjustments should be made to interventions or timelines.
A patient returned from attending the service memorializing his wife, who died after a sudden illness. Although those around him were visibly saddened, he smiled and remained in control. He refused support from friends, stating, “I can handle anything that comes my way.” The patient’s behavior is an example of grief.
- A. Inhibited
- B. Distorted
- C. Conflicted
- D. Normal
Correct Answer: B
Rationale: The patient's behavior of smiling and remaining in control while refusing support from friends, despite attending a service memorializing his wife's death, is indicative of distorted grief. In distorted grief, individuals may show seemingly inappropriate reactions or behaviors that do not align with the typical grieving process. The patient's avoidance of accepting support and expression of excessive self-reliance in the face of a significant loss suggest a distorted way of coping with grief. In normal grief, individuals may experience a range of emotions and accept support from others as they navigate through the grieving process.
In the elderly, administering medication is a great concern for the nurse since these patients are more prone to side effects. The primary cause of this is:
- A. Altered circulation and renal function
- B. Accelerated gastrointestinal system
- C. Enlarged Lymph nodes
- D. Musculoskeletal system weakness
Correct Answer: A
Rationale: Aging causes decreased renal and hepatic function, leading to slower metabolism and clearance of drugs, making older adults more vulnerable to drug toxicity and side effects. Other options, such as accelerated gastrointestinal function, are incorrect as GI motility often slows with age.