Population Based Care

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The wife of a client diagnosed with paranoid schizophrenia asks, 'I've been told that my husband's illness is probably related to imbalanced brain chemicals. Can you be more specific?' The response based on the dopamine hypothesis is:

  • A. An increase in the brain chemical dopamine explains the presence of delusions and hallucinations.'
  • B. An increase in the brain chemical dopamine explains the presence of lack of motivation and disordered affect.'
  • C. Decreased amounts of the brain chemical dopamine explain the presence of delusions and hallucinations.'
  • D. Breakdown of dopamine produces LSD, which in large amounts produces psychosis.'
Correct Answer: A

Rationale: Step-By-Step Rationale:
1. The dopamine hypothesis states that an increase in dopamine is linked to delusions and hallucinations in schizophrenia.
2. Delusions and hallucinations are common positive symptoms of schizophrenia.
3. Therefore, choice A is correct as it directly aligns with the dopamine hypothesis and the symptoms observed in paranoid schizophrenia.

Summary of Incorrect Choices:
B. Incorrect because an increase in dopamine is not typically associated with lack of motivation and disordered affect in schizophrenia.
C. Incorrect because decreased amounts of dopamine are not linked to delusions and hallucinations in schizophrenia.
D. Incorrect because the breakdown of dopamine producing LSD and causing psychosis is not supported by the dopamine hypothesis in schizophrenia.

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Which neighborhood in Boston had the highest rates of Chlamydia in 2006?

  • A. Allston/Brighton
  • B. Roxbury
  • C. Jamiaca Plain
  • D. Roslindale
Correct Answer: B

Rationale: Roxbury, a historically underserved area, had higher Chlamydia rates in 2006, likely due to socioeconomic factors and limited healthcare access.

What is the priority nursing intervention for a patient with bulimia nervosa who is engaging in purging behaviors?

  • A. Monitor electrolyte levels and cardiac function.
  • B. Encourage self-monitoring of food intake.
  • C. Provide emotional support and promote body image acceptance.
  • D. Focus on encouraging weight loss through diet control.
Correct Answer: A

Rationale: The correct answer is A. The priority nursing intervention for a patient with bulimia nervosa engaging in purging behaviors is to monitor electrolyte levels and cardiac function. This is crucial due to the potential electrolyte imbalances and cardiac complications resulting from purging behaviors. Monitoring these parameters helps prevent life-threatening conditions such as hypokalemia and arrhythmias.

Option B is incorrect as self-monitoring of food intake may not address the immediate health risks associated with purging behaviors. Option C is also incorrect as emotional support and body image acceptance are important but not the immediate priority in this case. Option D is incorrect as focusing on weight loss through diet control can exacerbate the patient's eating disorder behaviors and does not address the urgent medical concerns associated with purging.

What is not the primary evidence-based approach to managing oppositional behaviour in children?

  • A. Cognitive-behavioural intervention
  • B. Psychosocial intervention
  • C. Pharmacological intervention
  • D. Family therapy
Correct Answer: C

Rationale: Pharmacological intervention is not a primary approach for oppositional behavior; psychosocial interventions like parent training are first-line.

A student nurse visiting a senior center says, 'Its depressing to see these old people. They are weak and frail. I doubt any of them can engage in a discussion.' The student is expressing:

  • A. reality
  • B. ageism
  • C. empathy
  • D. vulnerability
Correct Answer: B

Rationale: Ageism is a bias against older people because of their age. None of the other options applies to the ideas expressed by the student.

A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self. Select the best outcome related to this diagnosis. Within 2 weeks, the patient will:

  • A. appropriately express angry feelings.
  • B. verbalize two positive things about self.
  • C. verbalize the importance of eating a balanced diet.
  • D. identify two alternative methods of coping with loneliness and isolation.
Correct Answer: D

Rationale: The correct answer is D because it directly addresses the nursing diagnosis of ineffective coping related to feelings of loneliness and isolation. By identifying two alternative methods of coping, the patient can develop healthier strategies to manage these emotions instead of resorting to overeating and vomiting. This outcome promotes long-term behavioral change and helps the patient build resilience.

Choice A is incorrect because expressing angry feelings may not necessarily address the underlying issues of loneliness and isolation. Choice B is incorrect as verbalizing positive things about oneself may be beneficial but does not directly address coping mechanisms for loneliness and isolation. Choice C is also incorrect because understanding the importance of a balanced diet does not directly address coping strategies for managing emotions like loneliness and isolation.

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