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Which behavior best supports the diagnosis of attention-deficit/hyperactivity disorder in an 8-year-old child?
- A. Cries when separated from his mother or father
- B. Refuses to pick up toys as instructed by his parents
- C. Is fascinated with spinning and moving toys and objects
- D. Can concentrate on schoolwork for only very short periods of time.
Correct Answer: D
Rationale: The correct answer is D because the inability to concentrate for extended periods is a key characteristic of ADHD. This behavior aligns with the inattention aspect of the disorder. Choice A is incorrect as separation anxiety does not directly relate to ADHD. Choice B could indicate oppositional behavior rather than ADHD. Choice C suggests sensory-seeking behavior, which is not a defining feature of ADHD.
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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.
A nursing instructor is teaching about electroconvulsive therapy (ECT). Which student statement indicates that learning has occurred?
- A. During ECT a state of euphoria is induced
- B. ECT induces a grand mal seizure.
- C. During ECT a state of catatonia is induced
- D. ECT induces a petit mal seizure
Correct Answer: B
Rationale: The correct answer is B: ECT induces a grand mal seizure. This indicates learning has occurred because ECT does indeed induce a controlled grand mal seizure to treat severe depression. Euphoria (A) and catatonia (C) are not accurate states induced by ECT. A petit mal seizure (D) is a mild form of seizure not associated with ECT.
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.
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: The correct answer is A: Use of multiple drugs with anticholinergic effects. This is the highest priority as anticholinergic medications can have severe side effects in older adults, including confusion, constipation, and increased risk of falls. Nurses need to assess for potential harm caused by these medications.
Choice B (Overuse of medications for erectile dysfunction) is not the highest priority as it may not pose an immediate threat to the health and safety of older adults compared to anticholinergic effects.
Choice C (Missed doses of medications for arthritis) is important but not as critical as assessing for the potential harm caused by anticholinergic medications.
Choice D (Trading medications with acquaintances) is concerning but not as urgent as assessing for the harmful effects of anticholinergic medications, which can lead to serious health complications.
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.