Nokea
The physician's admission note mentions that a patient has sundown syndrome. The nurse can expect that the patient will:
- A. exhibit chronic fatigue.
- B. evidence extreme lethargy at night.
- C. manifest confusion and agitation at night.
- D. be more alert between 6 PM and 11 PM.
Correct Answer: C
Rationale: The correct answer is C: manifest confusion and agitation at night. Sundown syndrome refers to a pattern of behavior where individuals with dementia experience increased confusion, agitation, or restlessness in the late afternoon or evening. This is due to disruptions in the person's internal body clock. It is important for the nurse to anticipate and manage these symptoms during the evening shift.
Choice A: Chronic fatigue is not a typical symptom of sundowning.
Choice B: Extreme lethargy at night is not a common feature of sundown syndrome.
Choice D: Being more alert between 6 PM and 11 PM is not characteristic of sundowning, as individuals with this syndrome typically experience worsening symptoms during these hours.
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The following condition is an indication for electroconvulsive therapy (ECT)
- A. Serene depression
- B. Schizophrenia
- C. Autistic disorders
- D. Tourettes syndrome
Correct Answer: A
Rationale: Severe (likely intended as 'serene') depression, especially when treatment-resistant, is a primary indication for ECT due to its rapid efficacy.
Reading Disorder is a developmental disorder and is characterised by reading achievement (e.g. accuracy, speed and comprehension) being significantly below standards expected for which of the following
- A. Chronological age
- B. IQ
- C. Schooling experience.
- D. All of the above
Correct Answer: D
Rationale: Reading Disorder: A specific learning disability characterised by the accuracy, speed and comprehension of reading being significantly below standards expected for chronological age and IQ.
When teaching a patient with binge-purge bulimia, the nurse should give priority to information about:
- A. Self-monitoring of daily food and fluid intake.
- B. Establishing the desired daily weight gain.
- C. Symptoms of hypokalemia.
- D. Self-esteem maintenance
Correct Answer: C
Rationale: The correct answer is C: Symptoms of hypokalemia. This is the priority because individuals with binge-purge bulimia often have electrolyte imbalances, including hypokalemia, which can lead to serious cardiac complications. Educating the patient on recognizing symptoms of hypokalemia, such as weakness, fatigue, and irregular heartbeats, is crucial for early intervention.
A: Self-monitoring of daily food and fluid intake is important but not the priority when dealing with potential life-threatening complications like hypokalemia.
B: Establishing the desired daily weight gain is not appropriate for individuals with binge-purge bulimia as the focus should be on addressing the underlying psychological issues rather than weight gain.
D: Self-esteem maintenance is important in the long term but does not take precedence over addressing immediate health risks such as hypokalemia.
A patient is noted to be bending over backward in the group room. A peer asks what he is doing, and he replies, 'People say they are bending over backwards to help me, so I am bending over backwards to help myself.' This is an example of:
- A. abstract thinking.
- B. concrete thinking.
- C. impaired reality testing.
- D. boundary impairment.
Correct Answer: B
Rationale: The correct answer is B: concrete thinking. Concrete thinking refers to interpreting things in a literal or straightforward manner without grasping abstract concepts or metaphors. In this scenario, the patient is taking the expression "bending over backward" literally, demonstrating a lack of understanding of its figurative meaning.
A: Abstract thinking involves understanding complex concepts and interpreting information beyond the literal meaning. The patient's response does not demonstrate abstract thinking.
C: Impaired reality testing refers to an inability to distinguish between what is real and what is not. The patient's response does not suggest a detachment from reality.
D: Boundary impairment involves difficulty in recognizing and maintaining personal boundaries. The patient's response does not relate to boundary issues.
In summary, the patient's literal interpretation of the expression "bending over backward" reflects concrete thinking, making choice B the correct answer.
A history reveals that a patient virtually stopped eating 5 months ago and lost 25% of body weight. The nurse says, 'Describe what you think about your present weight and how you look.' Which response would be most consistent with anorexia nervosa?
- A. I'm fat and ugly.'
- B. What I think about myself is my business.'
- C. I'm grossly underweight, but I cover it well.'
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A. This response is most consistent with anorexia nervosa because it reflects a distorted body image common in individuals with this condition. Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image, leading to extreme weight loss and restrictive eating habits. Choice B suggests a lack of insight or denial, which is not typical of anorexia nervosa. Choice C acknowledges being underweight but does not reflect the negative body image associated with anorexia nervosa. Choice D is incorrect as option A aligns with the characteristic body image distortion seen in anorexia nervosa.