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Which goal has priority for a patient with anorexia nervosa undergoing nutritional stabilization?
- A. Schedules meals appropriately
- B. Eats 100% of each meal served
- C. Selects food items from a menu
- D. Prepares food under supervision
Correct Answer: B
Rationale: The correct answer is B because ensuring the patient eats 100% of each meal served is crucial for nutritional rehabilitation in anorexia nervosa. This goal helps the patient meet their caloric needs and address malnutrition. It is essential to monitor and support the patient in consuming all the food provided to promote weight restoration and overall health. The other options are less critical: A focuses on timing rather than full intake, C involves choice rather than completion, and D emphasizes supervision but not necessarily full consumption.
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A patient has disorganized thinking associated with schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain?
- A. Hippocampus
- B. Frontal lobe
- C. Cerebellum
- D. Brainstem
Correct Answer: B
Rationale: The correct answer is B: Frontal lobe. Disorganized thinking in schizophrenia is often associated with executive function deficits, which are primarily controlled by the frontal lobe. This area is responsible for decision-making, problem-solving, and reasoning. Dysfunction here can lead to disorganized thoughts and behaviors. The other choices, such as the hippocampus (A), involved in memory, the cerebellum (C), involved in motor coordination, and the brainstem (D), involved in basic life functions, are less likely to be directly related to disorganized thinking in schizophrenia.
A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his sales. Today, he argued with several office mates and threatened to kill one of them. The police were called, and he was brought to the mental health center for evaluation. He has had previous admissions to the unit for stabilization of paranoid schizophrenia. When the nurse meets him, he points at staff in the nursing station and states loudly, 'They're all plotting to destroy me. Isn't that true?' Which would be the most appropriate response?
- A. No, that is not true. People here are trying to help you if you will let them.'
- B. Let's think about it: what reason would people have to want to destroy you?'
- C. Thinking that people want to destroy you must be very frightening.'
- D. That doesn't make sense; staff are health care workers, not murderers.'
Correct Answer: C
Rationale: The correct answer is C: Thinking that people want to destroy you must be very frightening.
Rationale:
1. Acknowledges the patient's feelings: By stating that thinking people want to destroy him is frightening, the nurse shows empathy and validates his experience.
2. Validates the patient's emotions: This response does not directly agree or disagree but acknowledges the emotions behind the patient's statement.
3. Builds rapport: By showing understanding and empathy, the nurse can establish trust and rapport with the patient, leading to better communication and therapeutic relationship.
Summary of other options:
A: This response denies the patient's feelings and could potentially escalate the situation by invalidating his experiences.
B: This response may come off as confrontational and does not address the patient's underlying fears.
D: This response is dismissive and does not address the patient's emotional distress, potentially leading to further agitation.
A teacher comes to the mental health clinic saying a co-worker recently confronted her about behaviors that are annoying to other co-workers. She is now experiencing moderate to severe levels of anxiety. The co-worker told the patient that others find her very difficult because she is a perfectionist and micromanages the tasks of others on the teaching team, always demanding that things should be done according to her plans. The co-worker mentioned that the patient made everyone feel as though everything they tried was inadequate, and they feel frustrated and angry. The patient states she likes her co-workers and only wanted to help them be successful. The nurse realizes the patient's behaviors are most consistent with:
- A. obsessive-compulsive personality disorder.
- B. narcissistic personality disorder.
- C. histrionic personality disorder.
- D. schizoid personality disorder.
Correct Answer: A
Rationale: The correct answer is A: obsessive-compulsive personality disorder. This is because the patient's behaviors of being a perfectionist, micromanaging tasks, demanding things be done according to her plans, and making others feel inadequate align with the diagnostic criteria for obsessive-compulsive personality disorder. Individuals with this disorder are preoccupied with orderliness, perfectionism, and control.
Choice B: narcissistic personality disorder, is incorrect because the patient's behaviors are not characterized by a sense of grandiosity, a lack of empathy, or a need for admiration, which are hallmark features of narcissistic personality disorder.
Choice C: histrionic personality disorder, is incorrect as individuals with this disorder typically display attention-seeking behavior, emotional instability, and excessive emotionality, none of which are evident in the patient's presentation.
Choice D: schizoid personality disorder, is incorrect as individuals with this disorder tend to be socially detached, have limited emotional expression, and prefer solitary activities, which do not align with the
In an art therapy session, a client with anorexia nervosa was asked to draw a picture of herself. Which drawing would likely depict the client's view of herself?
- A. A tall, slim girl with obvious muscle definition.
- B. A malnourished teenager with thin, lanky extremities.
- C. A grossly obese figure lacking feminine characteristics.
- D. A shapely figure of a model who she admires.
Correct Answer: C
Rationale: The correct answer is C because individuals with anorexia nervosa often have a distorted body image and see themselves as larger than they actually are. Drawing a grossly obese figure lacking feminine characteristics reflects the distorted self-perception common in anorexia nervosa. Choice A is incorrect as it portrays a positive body image. Choice B may be close, but it focuses more on malnourishment rather than distorted body image. Choice D is incorrect as it reflects admiration for a shapely figure, which may not align with the client's self-perception.
A patient received maintenance doses of fluphenazine decanoate (Prolixin Decanoate) 25 mg IM every 2 weeks for 2 years. The clinic nurse notes the patient is grimacing and seems to be constantly smacking her lips. On the next clinic visit, the patient's neck and shoulders twist in a slow, snakelike motion. The nurse should suspect the presence of ______ and should ______.
- A. agranulocytosis"¦check the patient's complete blood count for changes
- B. tardive dyskinesia"¦administer the Abnormal Involuntary Movement Scale
- C. Tourette's syndrome"¦consult the patient's physician about a neuro evaluation
- D. anticholinergic effects"¦consult the physician about possible medication changes
Correct Answer: B
Rationale: The correct answer is B: tardive dyskinesia"¦administer the Abnormal Involuntary Movement Scale.
1. Tardive dyskinesia is a side effect of long-term use of antipsychotic medications like fluphenazine.
2. The symptoms described - grimacing, lip smacking, twisting neck and shoulders - are characteristic of tardive dyskinesia.
3. Administering the Abnormal Involuntary Movement Scale is the appropriate assessment tool for diagnosing tardive dyskinesia.
4. Agranulocytosis (choice A) is a rare but serious side effect of some antipsychotic medications, not associated with the symptoms described.
5. Tourette's syndrome (choice C) typically presents with vocal and motor tics, not the specific symptoms mentioned.
6. Anticholinergic effects (choice D) can cause dry mouth, constipation, and blurred vision, but not the involuntary movements described.