Nokea
When should a child be assessed for a possible attention disorder as the primary condition?
- A. A 7-year-old who speaks well and reads fluently who cannot complete his work on time and often forgets to hand in his assignments
- B. A 4-year-old who walks around in class whenever it is time to sit to do colouring. She is not able to use a spoon to feed herself and has trouble drawing straight lines
- C. A 5-year-old who does not look at you when you call his name and spends his time staring at the wheels of his toy car
- D. A 6-year-old who reverses the b and d when writing and has trouble sounding out words in print
Correct Answer: A
Rationale: A 7-year-old with good language skills but persistent inattention and forgetfulness suggests ADHD as a primary condition, per DSM-5 criteria, unlike the others who show broader developmental or autism-related concerns.
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Which of the following statements by a patient with anorexia nervosa indicates a need for further education?
- A. I want to gain weight, but only if I can stay under 120 pounds.
- B. I understand that my body weight is dangerously low.
- C. I know that food is the enemy and I need to avoid it at all costs.
- D. I am willing to work with my healthcare team to improve my nutrition.
Correct Answer: C
Rationale: The correct answer is C because it indicates a misunderstanding of anorexia nervosa. Patients with anorexia often see food as the enemy, which is a distorted perception. Understanding that food is necessary for nourishment and health is crucial in recovery. Choice A shows an unhealthy weight goal, choice B shows awareness of low weight, and choice D shows willingness to work with the healthcare team, all of which are positive signs.
A 75-year-old male client is brought to the clinic by his son. The son states, 'Ever since Mom died, Dad hasn't been the same. At first he just seemed sad, but now he seems to get mixed up about everything.' The nurse is aware that based on the client's history, the source of confusion is most likely:
- A. Dementia
- B. Depression from the loss of his wife
- C. Hypoxia of the brain
- D. Delirium from medications
Correct Answer: B
Rationale: Correct Answer: B - Depression from the loss of his wife
Rationale: Given the client's recent loss of his wife and subsequent changes in behavior, the most likely cause of his confusion is depression. Depression can manifest as cognitive impairment in older adults, leading to symptoms such as confusion and memory problems. Additionally, grief and loss can exacerbate depressive symptoms in elderly individuals, further contributing to cognitive difficulties.
Summary of other choices:
A: Dementia - Dementia typically presents with gradual cognitive decline over time, not a sudden onset following a specific event like the loss of a loved one.
C: Hypoxia of the brain - Hypoxia would likely present with more acute symptoms and physical signs, such as shortness of breath or cyanosis.
D: Delirium from medications - Delirium is characterized by acute onset and fluctuating course, often related to medication changes or other medical conditions, rather than an emotional trigger like grief.
A much-feared outcome of Alzheimer's disease is
- A. functional psychosis
- B. paranoia
- C. general paresis
- D. senile dementia
Correct Answer: D
Rationale: Senile dementia is a progressive cognitive decline feared in Alzheimer's, impairing memory and daily functioning.
The treatment team implements a behavior modification approach using a contract for a client with antisocial personality disorder. An expected outcome of this approach is that client will:
- A. Learn how to avoid punishment
- B. Explain why he breaks rules
- C. Comply with behaviors specified in the contract
- D. Develop empathy in interpersonal contacts with peers
Correct Answer: C
Rationale: The correct answer is C because compliance with the behaviors specified in the contract is a key goal of behavior modification. This outcome focuses on specific, observable behaviors that the client agrees to follow. This approach helps in setting clear expectations and consequences, which is beneficial for individuals with antisocial personality disorder.
Explanation for why the other choices are incorrect:
A: Learning how to avoid punishment may not necessarily lead to behavior change or compliance with the contract terms.
B: Explaining why he breaks rules may not necessarily result in actual behavior change or adherence to the contract.
D: Developing empathy is a more complex and long-term goal that may not directly relate to compliance with the contract terms.
Which service would be expected to provide resources 24 hours a day, 7 days a week if needed for persons with serious mental illness?
- A. Clubhouse model
- B. Cognitive Behavioral Therapy (CBT)
- C. Assertive Community Treatment (ACT)
- D. Cognitive Enhancement Therapy (CET)
Correct Answer: C
Rationale: Assertive Community Treatment (ACT) (C) offers 24/7 multidisciplinary support in the patient's environment, unlike the Clubhouse model (A), CBT (B), or CET (D), which lack such availability.