When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value?
- A. Evidence of spasticity or flaccidity
- B. The patient's level of motor activity
- C. Medications the patient has recently taken
- D. Level of preoccupation with somatic symptoms
Correct Answer: C
Rationale: The correct answer is C: Medications the patient has recently taken. This information is crucial because certain medications can cause delirium in elderly patients. By reviewing the patient's recent medications, healthcare providers can identify potential drug-induced delirium and adjust treatment accordingly. Spasticity or flaccidity (choice A) is more indicative of neurologic conditions, not delirium. The patient's level of motor activity (choice B) may provide some insight but is not as specific to delirium as medication history. The level of preoccupation with somatic symptoms (choice D) is more relevant to other psychiatric conditions and does not directly help in distinguishing delirium.
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A victim of partner abuse, parent of one child, describes the partner as someone who is easily frustrated and more likely to be abusive after experiencing an event in which the most recent episodes of violence were related to feeling 'upset' over a job loss. What type of therapy would provide the greatest help to the abuser?
- A. Voluntary individual or group therapy
- B. Court-ordered individual or group therapy
- C. Voluntary couples or family therapy
- D. None of the above
Correct Answer: A
Rationale: The correct answer is A: Voluntary individual or group therapy. This type of therapy would be most helpful as it focuses on addressing the abuser's personal issues and behaviors, such as managing frustration and anger. By participating voluntarily, the abuser is more likely to be open to introspection and change.
Summary of other choices:
B: Court-ordered therapy may not be as effective as voluntary therapy, as the abuser may feel forced and less motivated to engage in the process.
C: Couples or family therapy may not be appropriate initially as the abuser needs to work on personal issues first before addressing relationship dynamics.
D: None of the above is incorrect as voluntary individual or group therapy is the most suitable option for addressing the abuser's behavior.
An infant develops jaundice 6 hours after birth. Which one of the following is the most likely diagnosis?
- A. Haemolytic disease of the newborn.
- B. Umbilical sepsis.
- C. Physiological jaundice.
- D. Atresia of the bile ducts.
Correct Answer: A
Rationale: Jaundice within 24 hours of birth is pathological, often due to haemolytic disease of the newborn (A), such as Rh incompatibility causing rapid red cell breakdown. Physiological jaundice (C) typically appears after 24 hours, while umbilical sepsis (B), bile duct atresia (D), and neonatal hepatitis (E) are less likely to cause such early onset.
An individual accompanied by a friend was brought by ambulance to the emergency room. A nurse notes that the patient's skin is flushed and dry. Further assessment reveals the patient has not voided or ingested food or fluid in 18 hours. Temperature, pulse, blood pressure, and respirations are elevated, and sensorium alternates between clouded and clear. The physician diagnoses fever of unknown origin. Because the patient is restless and agitated, the plan is to make an effort to orally hydrate before attempting to start an IV line. The intervention most likely to be effective will be:
- A. placing a pitcher of water at the patient's bedside.
- B. placing a "force fluids"Â sign at the head of the bed.
- C. asking the friend to give the patient a drink whenever the patient is alert.
- D. staying with the patient to ensure that a glass of liquid is ingested once every hour.
Correct Answer: D
Rationale: The correct answer is D: staying with the patient to ensure that a glass of liquid is ingested once every hour. This choice is the most effective intervention because the patient is in a state of restlessness and agitation, making it crucial to closely monitor fluid intake. By staying with the patient and ensuring regular liquid consumption, the nurse can help maintain hydration and potentially alleviate symptoms.
Choice A (placing a pitcher of water at the patient's bedside) may not be effective as the patient may not be able to independently drink the water when needed. Choice B (placing a "force fluids" sign at the head of the bed) might not address the patient's agitation and restlessness and could lead to increased anxiety. Choice C (asking the friend to give the patient a drink whenever the patient is alert) may not provide consistent monitoring and support needed for the patient's condition.
Therefore, choice D is the best option as it addresses the patient's need for hydration, agitation, and restlessness effectively
Because there is considerable overlap among the types of schizophrenia, and because patterns of behavior shift over time, many patients are simply classified as suffering from schizophrenia
- A. borderline
- B. atypical
- C. mixed
- D. undifferentiated
Correct Answer: D
Rationale: Undifferentiated schizophrenia is diagnosed when symptoms don't clearly fit other subtypes, reflecting overlap and shifting patterns.
The nurse who assesses a patient previously diagnosed as having paranoid personality disorder is most likely to describe the patient as:
- A. superficially charming.
- B. intense and impulsive.
- C. guarded and distant.
- D. friendly and open.
Correct Answer: C
Rationale: The correct answer is C: guarded and distant. This is because individuals with paranoid personality disorder typically exhibit suspiciousness, mistrust, and a reluctance to confide in others. They tend to be hypervigilant and wary of others, leading them to appear guarded and distant.
A: Superficially charming is incorrect because individuals with paranoid personality disorder are more likely to be cautious and suspicious rather than charming.
B: Intense and impulsive is incorrect as this description is more characteristic of individuals with borderline personality disorder, not paranoid personality disorder.
D: Friendly and open is incorrect because individuals with paranoid personality disorder are more likely to be reserved and cautious in their interactions.
In summary, the correct answer is C because individuals with paranoid personality disorder typically exhibit guarded and distant behavior due to their suspicious and mistrustful nature.
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