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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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.
What is the primary source of mental stimulation in early childhood?
- A. Television
- B. Parental interaction
- C. Toys
- D. School lessons
Correct Answer: B
Rationale: Parental interaction (B) provides responsive, tailored stimulation critical for early mental development. TV (A) and toys (C) are less interactive, and school lessons (D) come later.
A patient is referred to the visiting nurse agency due to cognitive impairment. Which functional problems is this patient most likely to exhibit?
- A. Inability to bathe and dress independently.
- B. Wandering in and away from his home.
- C. Lability of moods, from sociable to irritable.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Inability to bathe and dress independently. Cognitive impairment can impact a person's ability to remember tasks and follow routines, resulting in difficulties with self-care activities like bathing and dressing. This is a common functional problem seen in patients with cognitive impairment.
Choice B (Wandering) is more indicative of behavioral symptoms like agitation and restlessness. Choice C (Mood lability) is related to emotional regulation and not directly related to functional problems caused by cognitive impairment. Choice D (None of the above) is incorrect as cognitive impairment often leads to difficulties with self-care tasks.
A victim of rape says, "My family is not very supportive."Â Which belief contributes to a negative family response?
- A. No one asks to be raped.
- B. Rape is an act of aggression.
- C. Rape should not be discussed.
- D. Anyone is a potential rape victim.
Correct Answer: C
Rationale: The correct answer is C: Rape should not be discussed. This belief contributes to a negative family response because it promotes silence and stigma around the topic of rape, leading to lack of support and understanding for the victim. By not discussing rape, the victim may feel isolated, ashamed, and unable to seek help or share their experience. Choices A and B are incorrect as they acknowledge the victim's innocence and the violent nature of rape. Choice D is incorrect as it recognizes the reality that anyone can be a victim, but it does not directly address the issue of discussing rape within the family.
The nurse who sees a number of battered women each year decides to put together a set of guidelines for nurses. An appropriate guideline to include, with the victims' informed consent, would be to:
- A. Take at least two photographs of each trauma area
- B. Assess for sexually transmitted disease
- C. Follow rape protocol even when rape is not suspected
- D. Make protective services aware of the abuse
Correct Answer: A
Rationale: The correct answer is A because taking photographs of trauma areas can provide crucial evidence for legal and medical purposes. It can help document the extent of injuries and aid in the prosecution of the abuser. This step is essential in ensuring proper documentation and care for the victims.
Option B is incorrect because assessing for sexually transmitted diseases may not be the immediate priority in cases of domestic violence. Option C is incorrect as following rape protocol when rape is not suspected may not be necessary and could potentially retraumatize the victim. Option D is incorrect because making protective services aware of the abuse should only be done with the victim's consent to ensure their safety and autonomy.
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