Nokea
The signs and symptoms of schizophrenia must be present for at least _____ months before a diagnostic label is assigned.
- A. 3
- B. 6
- C. 12
- D. 18
Correct Answer: C
Rationale: The correct answer is C (12 months) because the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) requires symptoms to be present for at least 6 months before a diagnosis of schizophrenia can be made. This prolonged duration helps ensure that the symptoms are not due to temporary factors. Therefore, option C is the most appropriate choice. Options A (3 months), B (6 months), and D (18 months) do not align with the established diagnostic criteria for schizophrenia.
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What is the primary nursing intervention for a patient with anorexia nervosa who is refusing to eat?
- A. Offer rewards for eating meals.
- B. Provide firm encouragement and offer small, frequent meals.
- C. Enforce strict diet control and limit food choices.
- D. Allow the patient to skip meals if they do not feel hungry.
Correct Answer: B
Rationale: The correct answer is B because providing firm encouragement and offering small, frequent meals is a supportive approach to help the patient with anorexia nervosa overcome their fear of eating. It helps in gradually reintroducing food, building trust, and establishing a healthier eating pattern. Offering rewards (A) may reinforce unhealthy eating behaviors. Enforcing strict diet control (C) can exacerbate control issues and worsen the patient's condition. Allowing the patient to skip meals (D) can perpetuate malnutrition and reinforce avoidance behaviors.
An adolescent claims to have been physically abused by a parent. The adolescent's other parent angrily tells the nurse, 'It's ridiculous for our child to accuse my spouse, who's a prominent doctor and is respected by the community.' Which of these nursing communications would be most effective for the parent?
- A. You believe that abuse does not exist in well-respected, professional families?'
- B. Your spouse seems to have a very stressful, demanding practice. That can be a risk factor for losing your temper when angry.'
- C. I know that it is difficult to believe what your child is saying about your spouse, but abuse has occurred.'
- D. I know your spouse from working in the emergency room. Your spouse is always kind to patients, but that can be misleading.'
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. This response challenges the parent's belief that abuse does not exist in respected families, highlighting the misconception that abuse can happen in any family.
2. It addresses the parent's disbelief directly, encouraging them to reconsider their assumptions and beliefs about abuse.
3. It promotes critical thinking and reflection on the parent's part, fostering a more open-minded and empathetic approach towards the adolescent's disclosure.
Summary of Other Choices:
B: This choice focuses on the stress of the accused parent, deflecting from the issue of abuse and potentially excusing their behavior.
C: This choice acknowledges the difficulty of the situation but does not effectively challenge the parent's disbelief or misconceptions about abuse.
D: This choice uses a positive characteristic of the accused parent to deflect from the allegations of abuse, which does not address the parent's denial or the seriousness of the situation.
When a patient with paranoid schizophrenia has a recurrence of positive symptoms after stopping his antipsychotic medication because of its postural hypotension (orthostasis) side effect, he is readmitted to the mental health unit. What measure should the nurse suggest to help the patient address this side effect?
- A. Ask the doctor to prescribe an anticholinergic drug like trihexyphenidyl (Artane).
- B. Chew sugarless gum or use sugarless hard candy to moisten your mouth.
- C. Increase the amount of sleep you get, and try to take frequent rest breaks.
- D. Wear elastic support hose, drink adequate fluids, and change position slowly.
Correct Answer: D
Rationale: The correct answer is D because orthostatic hypotension is a common side effect of antipsychotic medications. Elastic support hose can help improve venous return, adequate fluids can prevent dehydration which worsens hypotension, and changing position slowly can prevent sudden drops in blood pressure. This measure directly addresses the side effect.
A: Anticholinergic drugs can worsen orthostatic hypotension.
B: Chewing gum or using candy does not address the physiological issue of orthostatic hypotension.
C: Increasing sleep and rest breaks may help overall well-being but does not directly address orthostatic hypotension.
A client with paranoid schizophrenia has said she feels like throwing a chair. The nurse in the dayroom hears this and wishes to encourage verbalization as a desecalation technique. Which response by the nurse would fulfill this plan?
- A. Tell me what's going on.'
- B. If you throw something, you will be restrained.'
- C. Why are you so upset?'
- D. It's time for group therapy. You can talk there.'
Correct Answer: A
Rationale: The correct answer is A because it encourages the client to express their feelings verbally, promoting communication and potentially preventing escalation of behavior. By saying "Tell me what's going on," the nurse acknowledges the client's emotions and creates a safe space for them to talk. Option B threatens restraint, likely increasing tension. Option C may come off as confrontational. Option D distracts from the immediate need for the client to process their feelings.
After 5 years in a state hospital, an adult diagnosed with schizophrenia was discharged to the community. This patient now requires persistent direction to accomplish activities of daily living and expects others to provide meals and do laundry. The nurse assesses this behavior as the probable result of:
- A. side effects of antipsychotic medications.
- B. dependency caused by institutionalization.
- C. cognitive deterioration from schizophrenia.
- D. stress associated with acclimation to the community.
Correct Answer: B
Rationale: Institutions impede independent functioning, fostering dependency (B) over time as daily activities are directed by staff. Antipsychotic side effects (A) and cognitive issues (C) may contribute, but the scenario suggests institutional adaptation. Stress (D) is less likely the primary cause.