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Which information should the nurse include when teaching a client with a personality disorder?
- A. Journal writing will help you recognize feeling states.'
- B. Try problem solving independently to help with difficult relationships.'
- C. Identify people and circumstances that create conflict; then avoid them.'
- D. Try to alleviate behaviors that cause problems relating with others.'
Correct Answer: A
Rationale: The correct answer is A because journal writing can help individuals with personality disorders recognize and better understand their emotions, leading to improved self-awareness and emotional regulation. This can be a useful tool in therapy and self-management.
Choice B is incorrect because individuals with personality disorders often struggle with interpersonal relationships and might benefit from seeking support or guidance rather than attempting to solve problems independently.
Choice C is incorrect because avoidance does not address the underlying issues and can lead to isolation and maladaptive coping mechanisms.
Choice D is incorrect because simply trying to alleviate problematic behaviors without addressing the underlying emotional issues may not lead to long-term improvement in relationships.
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The emergency department note states, 'This patient displays positive symptoms of schizophrenia as evidenced by psychotic disorders of thinking.' The nurse can expect the patient to evidence:
- A. delusions and hallucinations.
- B. grimacing and mannerisms.
- C. echopraxia and echolalia.
- D. avolition and anhedonia.
Correct Answer: A
Rationale: The correct answer is A: delusions and hallucinations. Positive symptoms of schizophrenia include hallucinations (perceiving things that are not present) and delusions (false beliefs). In this case, the patient displaying psychotic disorders of thinking aligns with positive symptoms. Delusions are fixed false beliefs, while hallucinations involve sensory experiences without external stimuli. Choices B, C, and D involve different symptoms such as motor abnormalities (grimacing and mannerisms), echopraxia and echolalia (mimicking movements and repeating words), and negative symptoms (avolition and anhedonia - lack of motivation and pleasure), which are not specifically related to psychotic disorders of thinking in schizophrenia.
The nurse notes that a male client, who is taking an antipsychotic medication, is constantly moving from chair to chair during a group activity, and he complains that he feels 'nervous and jittery inside.' The nurse is aware that this client most likely is experiencing:
- A. Akinesia
- B. Dystonia
- C. Dyskinesia
- D. Akathisia
Correct Answer: D
Rationale: The correct answer is D: Akathisia. Akathisia is a common side effect of antipsychotic medications characterized by an inner feeling of restlessness and an inability to sit still. In this case, the client's constant movement and complaints of feeling 'nervous and jittery inside' align with the symptoms of akathisia.
A: Akinesia refers to a lack of movement or muscle weakness, which is not consistent with the client's presentation.
B: Dystonia is a movement disorder characterized by involuntary muscle contractions, typically presenting as sustained muscle contractions or abnormal postures.
C: Dyskinesia refers to abnormal, involuntary movements, which are not reflective of the client's symptoms in this scenario.
In summary, the client's symptoms of restlessness and inability to sit still indicate that he is likely experiencing akathisia, making option D the correct choice.
Which nursing intervention would be most helpful for addressing this behavior?
- A. Hold a weekly staff meeting to discuss feelings and conflicts related to such behavior.
- B. Confront the patient and advise her that if she continues this, she will lose privileges.
- C. Get all staff to agree that any and all inappropriate behavior will simply be ignored.
- D. Evaluate the patient for a medication increase or transfer to a long-term facility.
Correct Answer: A
Rationale: The correct answer is A because holding a weekly staff meeting to discuss feelings and conflicts related to the behavior promotes open communication and teamwork. This intervention allows staff to address the behavior in a collaborative and supportive manner, leading to a better understanding of the underlying issues and potential solutions.
Choice B is not the best option as confronting the patient may escalate the situation and create a power struggle, potentially worsening the behavior. Choice C of ignoring inappropriate behavior can lead to a lack of accountability and enable further misconduct. Choice D of evaluating the patient for a medication increase or transfer may not address the root cause of the behavior and could overlook the importance of addressing it through communication and teamwork.
Which of the following is the most common childhood mental disorder?
- A. ADHD
- B. Aspergers syndrome
- C. Conduct disorder
- D. Enuresis
Correct Answer: A
Rationale: ADHD (attention deficit/hyperactivity disorder) is the most common mental disorder in the 8 to 15 year old age group.
Disturbed body image is the nursing diagnosis for a patient with an eating disorder. Which outcome indicator is most applicable to this diagnosis?
- A. Weight, muscle, and fat congruence with height, frame, age, and sex.
- B. Calorie intake within required parameters of treatment plan.
- C. Weight at established normal range for the patient.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A because disturbed body image in an eating disorder patient involves a discrepancy between their perceived body image and reality. Monitoring weight, muscle, and fat congruence with height, frame, age, and sex helps assess if the patient's perception aligns with their actual physical state. Choice B focuses solely on calorie intake, which does not directly address body image perception. Choice C only considers weight, neglecting the importance of muscle and fat distribution in body image perception. Choice D is incorrect as option A is the most relevant outcome indicator for disturbed body image in this scenario.