Nokea
Vascular dementia is more common in individuals living in:
- A. The United States
- B. Japan
- C. France
- D. Australia
Correct Answer: B
Rationale: The correct answer is B: Japan. Vascular dementia is more common in countries with a high prevalence of risk factors such as hypertension, diabetes, and cardiovascular diseases. Japan has a high prevalence of these risk factors due to lifestyle factors and aging population. The other choices (A, C, D) do not have the same level of risk factors or population demographics as Japan, making them less likely to have a higher incidence of vascular dementia.
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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.
Which nursing intervention should be included in the care plan for a patient with anorexia nervosa who is at risk for refeeding syndrome?
- A. Refeed with high-calorie foods initially.
- B. Monitor serum electrolytes closely after refeeding begins.
- C. Increase fluid intake gradually over several days.
- D. Encourage early ambulation to prevent complications.
Correct Answer: B
Rationale: The correct answer is B: Monitor serum electrolytes closely after refeeding begins. Refeeding syndrome can occur in patients with anorexia nervosa when there is a rapid shift in electrolytes and fluid levels. Monitoring serum electrolytes closely after refeeding begins allows for early detection of any imbalances and prompt intervention. This helps prevent serious complications such as cardiac arrhythmias or neurological issues.
Choice A is incorrect because refeeding with high-calorie foods initially can exacerbate the risk of refeeding syndrome due to rapid changes in electrolyte levels. Choice C is incorrect as increasing fluid intake gradually may not directly address electrolyte imbalances. Choice D is incorrect as encouraging early ambulation is not directly related to preventing refeeding syndrome.
A client who has been diagnosed as having paranoid schizophrenia is highly suspicious and delusional. He hears voices telling him terrorists are plotting to assassinate him. He refuses to eat, saying the food is poisoned. The nursing action that best addresses his needs is to:
- A. Explain that others eat the food and are not harmed
- B. Allow client to select food from vending machines
- C. Assist client with personal hygiene and grooming
- D. Not allow client to verbalize delusional thoughts
Correct Answer: B
Rationale: The correct answer is B: Allow client to select food from vending machines. This option respects the client's autonomy and addresses his delusion about the food being poisoned. By allowing the client to choose food from vending machines, it acknowledges his concerns and promotes a sense of control over his environment. This approach can help build trust and rapport with the client, as forcing him to eat regular hospital food might exacerbate his paranoia and resistance.
A: Explaining that others eat the food and are not harmed may not be effective as it disregards the client's beliefs and could further alienate him.
C: Assisting with personal hygiene and grooming is important but does not directly address the client's primary concern of refusing to eat due to delusional beliefs.
D: Not allowing the client to verbalize delusional thoughts is counterproductive as it suppresses communication and does not address the underlying issue of the client's fear of being poisoned.
Confidentiality should be discussed with all adolescents and parents before the consult. Confidentiality may be breached in all situations below EXCEPT:
- A. Disclosure of sexual abuse
- B. Disclosure of drug abuse
- C. Disclosure of suicidality
- D. Disclosure of dropping grades
Correct Answer: D
Rationale: Confidentiality can be breached for safety concerns (abuse, drug use, suicidality), but dropping grades is not a direct threat to safety or health, so it does not warrant breaching confidentiality.
The nurse is caring for a client who is being treated for comorbid eating or affective disorder. For which medication would the nurse expect to prepare a client teaching plan?
- A. Fluoxetine (Prozac).
- B. Diazepam (Valium).
- C. Lorazepam (Ativan).
- D. Lithium.
Correct Answer: A
Rationale: The correct answer is A: Fluoxetine (Prozac). Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat eating disorders and affective disorders like depression. The nurse would prepare a client teaching plan for fluoxetine to educate the client on its mechanism of action, potential side effects, proper dosing, and the importance of compliance. Diazepam and lorazepam are benzodiazepines used for anxiety and not typically indicated for eating or affective disorders. Lithium is primarily used for bipolar disorder and not specifically for eating or affective disorders.