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Which neighborhood in Boston had the highest rates of Chlamydia in 2006?
- A. Allston/Brighton
- B. Roxbury
- C. Jamiaca Plain
- D. Roslindale
Correct Answer: B
Rationale: Roxbury, a historically underserved area, had higher Chlamydia rates in 2006, likely due to socioeconomic factors and limited healthcare access.
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A highly suspicious patient who has delusions of persecution about being poisoned has refused all hospital meals for 3 days. Which of the following interventions would be most appropriate under these circumstances?
- A. Feed the patient via tube, involuntarily via court order if needed.
- B. Offer to taste each food item on the tray yourself while he watches.
- C. Allow the patient to contact a local restaurant to deliver his meals.
- D. Allow him supervised access to use food vending machines in the hospital lobby.
Correct Answer: D
Rationale: Step 1: In this scenario, the patient is refusing hospital meals due to delusions of being poisoned, indicating a lack of trust.
Step 2: By allowing supervised access to food vending machines in the hospital lobby, the patient can choose his own food, promoting autonomy and trust-building.
Step 3: This intervention respects the patient's autonomy while ensuring access to food.
Step 4: In contrast, feeding via tube involuntarily (Option A) violates autonomy, tasting food yourself (Option B) doesn't address the issue of trust, and ordering from a restaurant (Option C) may not be feasible or safe in a hospital setting.
Summary: Option D is the most appropriate as it balances patient autonomy and safety, addressing the refusal of hospital meals effectively.
The most widely used system of psychological classification today is
- A. the Freudian Psychoanalytic System (FPS)
- B. found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
- C. the system designed by Emil Kraepelin and Eugen Bleuler
- D. to be found in the Federal Uniform Code of Psychopathology (UCP)
Correct Answer: B
Rationale: The DSM-IV (now DSM-5) is the standard diagnostic system globally used in psychology.
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: Step 1: The patient is showing signs of abnormal movements like lip smacking, grimacing, and snakelike motions, which are indicative of tardive dyskinesia (TD).
Step 2: TD is a side effect of long-term antipsychotic use, such as fluphenazine decanoate.
Step 3: The Abnormal Involuntary Movement Scale is a validated tool to assess the severity of TD.
Step 4: Administering the Abnormal Involuntary Movement Scale will help confirm the diagnosis of TD.
Step 5: Prompt recognition of TD is crucial as it may be irreversible and can worsen over time if not addressed.
Summary:
- A: Agranulocytosis is a condition characterized by low white blood cell count, not related to the patient's symptoms.
- C: Tourette's syndrome presents with different symptoms and requires specialized evaluation.
- D: Anticholinergic effects do not typically manifest as the described
A patient diagnosed with schizophrenia has difficulty completing tasks and seems forgetful and disinterested in unit activities. A nurse can best select successful strategies by understanding that these behaviors are due to:
- A. a lack of self-esteem.
- B. manipulative tendencies.
- C. shyness and embarrassment.
- D. problems in cognitive functioning.
Correct Answer: D
Rationale: The correct answer is D: problems in cognitive functioning. In schizophrenia, cognitive deficits are common, leading to difficulties in completing tasks, forgetfulness, and lack of interest. Understanding this helps the nurse select appropriate strategies, such as breaking tasks into smaller steps. Choice A (lack of self-esteem) is incorrect as cognitive deficits in schizophrenia are not solely related to self-esteem. Choice B (manipulative tendencies) is incorrect as these behaviors are not indicative of manipulation. Choice C (shyness and embarrassment) is incorrect as cognitive deficits in schizophrenia go beyond social anxiety.
Which statement by a patient with bulimia nervosa suggests the need for further education?
- A. I understand that purging is harmful to my health.
- B. I have learned to control my binge eating episodes.
- C. I feel that I can continue purging occasionally without harm.
- D. I know that therapy can help me change my eating behaviors.
Correct Answer: C
Rationale: The correct answer is C because it indicates a lack of awareness about the harmful consequences of purging. The statement suggests a rationalization of continuing the harmful behavior, showing a need for further education on the risks associated with purging. Choice A demonstrates understanding of the harm, B shows progress in controlling binge eating, and D acknowledges the potential benefits of therapy. Educating the patient about the dangers of purging is crucial in addressing their condition effectively.