Nokea
What is a key indicator of mental development in preschool children?
- A. Ability to count to 10
- B. Following multi-step instructions
- C. Recognizing colors
- D. Walking independently
Correct Answer: B
Rationale: Following multi-step instructions (B) reflects cognitive processing and memory, key mental development indicators in preschoolers. Counting (A) and colors (C) are simpler skills, while walking (D) is physical, not mental.
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A client who received chlorpromazine (Thorazine) for 15 years to treat schizophrenia developed tardive dyskinesia as evidenced by tongue thrusting and chewing motions. The physician discontinued the chlorpromazine and prescribed Seroquel (quetiapine). As a result of this change, the nurse should carefully monitor for:
- A. Development of pseudoparkinsonism
- B. Development of dystonic reactions
- C. Improvement in tardive dyskinesia
- D. Worsening of anticholinergic symptoms
Correct Answer: C
Rationale: The correct answer is C: Improvement in tardive dyskinesia. Tardive dyskinesia is a side effect of long-term antipsychotic use, such as chlorpromazine. Quetiapine (Seroquel) is a second-generation antipsychotic with a lower risk of causing tardive dyskinesia. By discontinuing chlorpromazine and switching to quetiapine, the client is less likely to experience worsening of tardive dyskinesia symptoms. Monitoring for improvement in tardive dyskinesia is essential in this situation.
Choices A, B, and D are incorrect:
A: Development of pseudoparkinsonism is less likely with quetiapine compared to first-generation antipsychotics like chlorpromazine.
B: Dystonic reactions are acute side effects and are not typically associated with switching to quetiapine.
D: Anticholinergic symptoms are not directly related to tardive dyskinesia
Which disorder is associated with persons with a body weight that is normal or even slightly above average?
- A. Pica.
- B. Bulimia.
- C. Obesity.
- D. Anorexia nervosa.
Correct Answer: B
Rationale: The correct answer is B: Bulimia. Individuals with bulimia nervosa typically have a normal or slightly above average body weight due to the cycle of binge eating and purging behaviors. This is because they consume large amounts of food during binges but then engage in compensatory behaviors such as vomiting or excessive exercise to prevent weight gain. In contrast, choices A (Pica) and D (Anorexia nervosa) are associated with low body weight. Choice C (Obesity) is characterized by excess body weight. Bulimia is the only disorder in the list where individuals can have a normal or slightly above average body weight due to the nature of their eating behaviors.
The dopamine-psychosis link is based on the observation that
- A. low dopamine levels of activity in the brain seem to produce psychotic symptoms
- B. there are high levels of dopamine activity in the brains of psychotic people
- C. there are high levels of amphetamine in the brains of schizophrenics
- D. dopamine interacts with serotonin creating psychosis
Correct Answer: B
Rationale: Elevated dopamine activity is associated with psychotic symptoms, especially in schizophrenia.
A client is admitted to a day hospital following an episode in which he purchased a gun to use while standing guard over his property to prevent a neighbor from erecting a boundary fence. His wife describes him as distrustful of the motives of others and often interpreting others' motives as threats. She mentions that one time he accused her of having an affair with a neighbor with whom she chatted occasionally. The care plan will list the priority outcome as 'Client will:
- A. admit his action was excessive based on the circumstance.
- B. write the neighbor a letter of apology.
- C. demonstrate trust in the nurse.
- D. identify positive role models.'
Correct Answer: C
Rationale: The correct answer is C: demonstrate trust in the nurse. This is the priority outcome because the client's lack of trust and tendency to perceive threats need to be addressed first. By demonstrating trust in the nurse, the client can begin to develop a therapeutic relationship, which is essential for addressing his distrustful behavior and interpreting threats. This outcome focuses on building rapport and establishing a foundation for therapeutic interventions.
Choice A is incorrect because admitting his action was excessive may not address the underlying issues of distrust and misinterpretation of motives. Choice B is incorrect as it does not address the client's core issues and may not be appropriate in this context. Choice D is also incorrect as identifying positive role models is not a priority when the client's trust and perception issues need immediate attention.
A client with obsessive-compulsive personality disorder is described by other staff as being perfectionistic, inflexible, and a 'master at procrastination.' The nurse learns that the client is nearly immobilized during times that call for the client to make a decision. The nurse realizes that the most likely hypothesis is this behavior is related to:
- A. A need to make others uncomfortable
- B. Needing to be the center of attention
- C. Wanting someone else to be responsible
- D. Fear of making a mistake
Correct Answer: D
Rationale: The correct answer is D: Fear of making a mistake. This is because individuals with obsessive-compulsive personality disorder often have an intense fear of making errors or mistakes. This fear can lead to indecisiveness and procrastination when faced with decision-making tasks. The client's behavior of being nearly immobilized during times requiring decision-making is characteristic of this fear of making a mistake.
Incorrect choices:
A: A need to make others uncomfortable - This is not related to the fear of making a mistake commonly seen in individuals with obsessive-compulsive personality disorder.
B: Needing to be the center of attention - This is not a typical characteristic of individuals with obsessive-compulsive personality disorder.
C: Wanting someone else to be responsible - This is not directly related to the fear of making a mistake, which is a core feature of the disorder.