When screening families for post-traumatic stress disorder following a major natural disaster, psychiatric-mental health nurses are practicing which type of disease prevention?
- A. Primary
- B. Secondary
- C. Tertiary
- D. Universal
Correct Answer: B
Rationale: Secondary prevention involves early detection (screening) to mitigate PTSD after exposure, unlike primary (prevention) or tertiary (rehabilitation).
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Which of the following interventions should the nurse plan to use to reduce client focus on delusional thinking?
- A. Confronting the delusion
- B. Focusing on feelings suggested by the delusion
- C. Refuting the delusion with logic
- D. Exploring reasons the client has the delusion
Correct Answer: B
Rationale: The correct answer is B: Focusing on feelings suggested by the delusion. By addressing the underlying emotions associated with the delusion, the nurse can help the client process and cope with their feelings, ultimately reducing the intensity of the delusional thinking. Confronting the delusion (A) may lead to resistance and escalation. Refuting the delusion with logic (C) can be ineffective as it may reinforce the client's belief. Exploring reasons for the delusion (D) may not directly address the client's focus on delusional thinking.
The highest priority for assessment by nurses caring for older adults who self-administer medications is:
- A. use of multiple drugs with anticholinergic effects.
- B. overuse of medications for erectile dysfunction.
- C. missed doses of medications for arthritis.
- D. trading medications with acquaintances.
Correct Answer: A
Rationale: Anticholinergic effects are cumulative in older adults and often have adverse consequences related to accidents and injuries (A), making it the highest priority. The other issues (B, C, D) may be relevant but are less critical.
In DSM-IV-TR intellectual disabilities are divided into a number of degrees of severity, depending primarily on the range of IQ score provided by the sufferer. One of these is Mild Mental Retardation, corresponding to an IQ score between:
- A. 60-65 to 80
- B. 40-55 to 60
- C. 50-55 to 70
- D. 70-75 to 90
Correct Answer: C
Rationale: Mild Mental Retardation: Defined by DSM-IV-TR as an IQ score between 50-55 to 70.
Sleep disorders that are characterized by abnormal behavioral or physical events during sleep are called:
- A. insomnia.
- B. dyssomnias.
- C. hypersomnia.
- D. parasomnias.
Correct Answer: D
Rationale: The correct answer is D: parasomnias. Parasomnias are sleep disorders involving abnormal behaviors or physical events during sleep, such as sleepwalking or night terrors. This is the correct choice because it specifically addresses the description provided in the question.
A: Insomnia is characterized by difficulty falling or staying asleep, not abnormal behaviors during sleep.
B: Dyssomnias are a broad category of sleep disorders affecting the timing, quality, or amount of sleep, not necessarily involving abnormal behaviors during sleep.
C: Hypersomnia is a sleep disorder characterized by excessive daytime sleepiness, not abnormal behaviors during sleep.
In summary, the other choices do not align with the description of sleep disorders involving abnormal behavioral or physical events during sleep, making D the correct answer.
A patient with schizophrenia has received typical (first-generation) antipsychotics for a year. His hallucinations are less intrusive, but he remains apathetic, has poverty of thought, cannot work, and is socially isolated. To address these symptoms, the nurse might consult the prescribing health care provider to suggest a change to:
- A. Haloperidol (Haldol).
- B. Olanzapine (Zyprexa).
- C. Diphenhydramine (Benadryl).
- D. Chlorpromazine (Thorazine).
Correct Answer: B
Rationale: The correct answer is B: Olanzapine (Zyprexa). Olanzapine is an atypical (second-generation) antipsychotic that has been shown to effectively target negative symptoms of schizophrenia, such as apathy, poverty of thought, and social isolation. It also helps with mood stabilization and cognitive function, which can improve the patient's ability to work and engage in social interactions.
Choice A: Haloperidol (Haldol) is a typical (first-generation) antipsychotic like the current medication, which is less effective in treating negative symptoms and can potentially worsen them.
Choice C: Diphenhydramine (Benadryl) is an antihistamine and not indicated for treating schizophrenia symptoms.
Choice D: Chlorpromazine (Thorazine) is another typical (first-generation) antipsychotic, similar to the current medication, and may not adequately address the negative symptoms the patient is experiencing.