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What is the basis for the reduction in disturbed thought processes when a patient is administered haloperidol (Haldol)?
- A. Reduction in the number of brain cells that crave dopamin
- B. Dopamine receptors are enhanced, making more dopamine available.
- C. Medication causes an increased cellular production of dopamine
- D. Dopamine receptors are blocked, making dopamine less available.
Correct Answer: D
Rationale: The correct answer is D because haloperidol is a dopamine receptor antagonist. By blocking dopamine receptors, it reduces the activity of dopamine in the brain, which helps in reducing disturbed thought processes. Option A is incorrect as dopamine craving is not related to the mechanism of action of haloperidol. Option B is incorrect as enhancing dopamine receptors would increase dopamine activity, opposite to the intended effect of haloperidol. Option C is incorrect as increasing cellular production of dopamine would also increase dopamine activity, contradicting the purpose of using haloperidol.
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The nurse determines that the most effective point of intervention for bereavement is:
- A. Promotion of mental and spiritual health across the life spa
- B. At the time a newly discovered loss is impending
- C. Immediately after the loss has occurred
- D. When requested by the patient
Correct Answer: C
Rationale: The correct answer is C because intervening immediately after the loss has occurred allows for timely support and processing of emotions. This is crucial for healthy grieving and preventing complications. Choice A is too broad and not specific to the immediate need post-loss. Choice B focuses on pre-loss, which is not the most effective time for intervention. Choice D puts the responsibility on the patient, which may delay necessary support.
The mother of a child describes her child's annoying behavior as not being able to sit still or to stop jerking his arms when told to. Which disorder does the nurse suspect?
- A. Oppositional-defiant disorder
- B. Tourette’s disorder
- C. Oppositional-defiant disorder
- D. What makes you think he is doing that out of defiance?
Correct Answer: B
Rationale: The correct answer is B: Tourette’s disorder. The child's inability to sit still and jerking arms suggest motor tics, which are common in Tourette's disorder. Tourette's is characterized by involuntary repetitive movements or sounds. Choice A is incorrect as oppositional-defiant disorder does not involve physical tics. Choice C is a duplicate. Choice D is incorrect as it assumes defiance rather than considering a neurological explanation for the behavior.
A patient presents to the emergency department with mixed psychiatric symptoms. The admission nurse suspects the symptoms may be the result of a medical problem. Lab results show elevated BUN (blood urea nitrogen) and creatinine. What is the nurse’s next best action?
- A. Report the findings to the health care provider.
- B. Assess the patient for a history of renal problems.
- C. Assess the patient’s family history for cardiac problems.
- D. Arrange for the patient’s hospitalization on the psychiatric unit.
Correct Answer: A
Rationale: Rationale for Correct Answer (A): Reporting the findings to the health care provider is the next best action because elevated BUN and creatinine levels indicate possible renal dysfunction, which could be causing the psychiatric symptoms. The health care provider needs this information to determine appropriate treatment and further evaluation.
Summary of Incorrect Choices:
B: Assessing the patient for a history of renal problems is not the next best action because the lab results already indicate potential renal issues.
C: Assessing the patient’s family history for cardiac problems is irrelevant to the elevated BUN and creatinine levels and the psychiatric symptoms.
D: Arranging for the patient’s hospitalization on the psychiatric unit is premature without addressing the underlying medical issue indicated by the lab results.
Which remark by one of the grief support group members would the nurse interpret as indicating unresolved feelings of guilt?
- A. The Christmas season is always a sad time for me.
- B. I know that my husband had a good life.
- C. It seems I miss my son more as time goes on.
- D. I am still wishing I had gotten help to him sooner.
Correct Answer: D
Rationale: The correct answer is D because expressing a wish for getting help sooner implies a sense of responsibility and guilt for not doing so. This indicates unresolved feelings of guilt. Choice A refers to sadness during a specific time of the year, not guilt. Choice B reflects acceptance and closure. Choice C indicates a natural progression of grief, not necessarily guilt.
To effectively plan care for a patient, the nurse will understand that activity and adjunct therapies may be more useful in some situations than verbal therapies because adjunct therapies: a. Are readily available in the treatment setting
- A. Do not require specific training or expertise to facilitate
- B. Allow the patient to express feelings on multiple levels at the same time
- C. Provide the patient the opportunity to use ego-protective mechanisms
- D. Are readily available in the treatment setting
Correct Answer: C
Rationale: The correct answer is C because adjunct therapies provide the patient with the opportunity to use ego-protective mechanisms, such as denial or displacement, which can help them cope with difficult emotions or situations more effectively. This is important in situations where verbal therapies may not be as effective in reaching the patient's underlying emotional needs.
Choice A is incorrect because adjunct therapies may require specific training or expertise to facilitate effectively. Choice B is incorrect because while adjunct therapies can allow for expression of feelings, they do not necessarily do so on multiple levels simultaneously. Choice D is also incorrect because the availability of adjunct therapies in the treatment setting does not necessarily make them more useful than verbal therapies.