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Which assessment observation supports a patient’s diagnosis of disorganized schizophrenia?
- A. Reports suicidal ideations
- B. Last relapse was 6 years ago
- C. Consistent inappropriate laughing
- D. Believes that the government is out to get me
Correct Answer: C
Rationale: The correct answer is C because consistent inappropriate laughing is a characteristic symptom of disorganized schizophrenia. This observation aligns with the disorganized behavior and affect commonly seen in this subtype of schizophrenia. Option A is not specific to disorganized schizophrenia. Option B does not directly relate to disorganized symptoms. Option D suggests paranoia, which is more indicative of paranoid schizophrenia rather than disorganized schizophrenia.
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A health care provider writes these new prescriptions for a resident in a skilled nursing facility: 2 G sodium diet, Restraint as needed, Limit fluids to 1800 mL daily, Continue antihypertensive medication, Milk of magnesia 30 mL PO once if no bowel movement for 3 days. The nurse should:
- A. Question the fluid restriction.
- B. Question the order for restraint.
- C. Transcribe the prescriptions as written.
- D. Assess the resident’s bowel elimination
Correct Answer: A
Rationale: Step 1: Fluid restriction of 1800 mL may not be appropriate for all residents in a skilled nursing facility. Step 2: Excessive fluid restriction can lead to dehydration, especially in elderly residents. Step 3: It is crucial for the nurse to question the fluid restriction to ensure it is safe for the resident. Therefore, the correct answer is A.
Summary:
- Option A is correct as questioning the fluid restriction is essential for the resident's safety.
- Option B is incorrect as restraining a resident should only be used as a last resort and should be questioned if not necessary.
- Option C is incorrect as blindly transcribing without assessing appropriateness can be harmful.
- Option D is incorrect as assessing bowel elimination is important but addressing the fluid restriction is more urgent in this scenario.
When asked, the nurse explains that “grief work” refers to:
- A. Establishing new methods of coping with stress
- B. Evaluating progress made toward accepting the loss
- C. The means by which one moves through the grief process
- D. Actively seeking assistance to cope with the loss.
Correct Answer: C
Rationale: The correct answer is C because "grief work" refers to the psychological process of actively working through and resolving the emotions and thoughts associated with a loss. This involves facing and processing the feelings of grief rather than avoiding them, ultimately leading to acceptance and healing. Choice A is incorrect as it focuses on coping with stress, not specifically grief. Choice B is incorrect as it emphasizes evaluating progress rather than the process of grieving itself. Choice D is incorrect as it pertains to seeking assistance, which is a part of coping but not the definition of grief work.
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.
The patient’s daughter was murdered while they were customers in a local bank. Which statements would support the patient’s diagnosis of posttraumatic stress disorder (PTSD)? Select all that apply:
- A. “I feel numb, like a robot going through the motions of existing.”
- B. “I’m so nervous and jump at the slightest noise.”
- C. “I have not slept very well at all since I lost her.”
- D. “I can’t stop reliving the last time I saw her alive.”
Correct Answer: A
Rationale: The correct answer is A because feeling numb and detached from emotions is a common symptom of PTSD known as emotional numbing. This symptom is often seen in individuals who have experienced a traumatic event, such as the murder of a loved one. It is a defense mechanism that helps the person cope with overwhelming emotions.
The other choices are incorrect:
B: Being nervous and easily startled (hypervigilance) is more indicative of the hyperarousal symptom of PTSD, not emotional numbing.
C: Difficulty sleeping is a common symptom of PTSD, known as insomnia, but it does not directly relate to emotional numbing.
D: Reliving the traumatic event through flashbacks or intrusive memories is a symptom of PTSD, but it is not directly related to emotional numbing.
When a novice nurse asks why the unit has a multidisciplinary approach to therapeutic activities, the nurse should explain that multidisciplinary collaboration:
- A. Reduces the incidence of aggressive behavior by patients
- B. Produces quicker results and earlier discharge to the community
- C. Produces better outcomes than when only one perspective is used
- D. Helps to improve staffing efficiency and resource allocation.
Correct Answer: C
Rationale: Rationale for Correct Answer (C): Multidisciplinary collaboration in therapeutic activities involves the input of professionals from various disciplines, leading to a holistic approach that considers all aspects of a patient's condition. This approach is more likely to result in better outcomes because it combines diverse perspectives, expertise, and skills to address complex patient needs comprehensively.
Summary of Incorrect Choices:
A: Reducing aggressive behavior is not the primary goal of multidisciplinary collaboration in therapeutic activities.
B: While multidisciplinary collaboration may lead to efficient care, the primary focus is on achieving better outcomes rather than quicker discharge.
D: Although improving staffing efficiency and resource allocation may be benefits of multidisciplinary collaboration, the main purpose is to enhance patient care outcomes through diverse perspectives and expertise.