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Which of the following best describes a social gambler
- A. Someone who gambles for the heightened thrill and needs higher bets to achieve the same feeling
- B. Gambles for fun during New Year gatherings
- C. Believes gambling is a way to make money, similar to financial investment
- D. Steals money to feed the gambling habit
Correct Answer: B
Rationale: A social gambler engages in gambling recreationally, such as during social events like New Year gatherings, without dependency.
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A patient with schizophrenia has received typical (first-generation) antipsychotics for a year. His hallucinations are less intrusive, but he remains apathetic, has poverty of thought, cannot work, and is socially isolated. To address these symptoms, the nurse might consult the prescribing health care provider to suggest a change to:
- A. haloperidol (Haldol).
- B. olanzapine (Zyprexa).
- C. diphenhydramine (Benadryl).
- D. chlorpromazine (Thorazine).
Correct Answer: B
Rationale: The correct answer is B: olanzapine (Zyprexa). Olanzapine is an atypical (second-generation) antipsychotic that is known to be effective in treating negative symptoms of schizophrenia, such as apathy, poverty of thought, and social withdrawal. These symptoms are often resistant to typical antipsychotics like haloperidol (A) and chlorpromazine (D), which are more effective for positive symptoms like hallucinations. Diphenhydramine (C) is an antihistamine and not used to treat schizophrenia symptoms. In summary, olanzapine is the best choice to address the specific symptoms described in the scenario.
A patient with mania has not eaten or slept for 3 days. Which nursing diagnosis has priority?
- A. Risk for injury
- B. Ineffective coping
- C. Ineffective management of therapeutic regime
- D. Imbalanced nutrition
Correct Answer: D
Rationale: The correct answer is D: Imbalanced nutrition. Priority is given to physiological needs. The patient not eating for 3 days can lead to serious health complications. This nursing diagnosis addresses the immediate risk to the patient's physical well-being. Choices A, B, and C are important but addressing the patient's nutritional needs is the priority to prevent further deterioration in their condition.
The medical records of a patient diagnosed with schizophrenia state that the patient has cognitive dysfunction. From this statement, the nurse can expect to see evidence of:
- A. anxiety, fear, and agitation.
- B. aggression, anger, hostility, or violence.
- C. blunted or flat affect or inappropriate affective responses.
- D. impaired memory and attention as well as formal thought disorder.
Correct Answer: D
Rationale: The correct answer is D because cognitive dysfunction in schizophrenia typically involves impaired memory, attention, and formal thought disorder. This is due to the underlying neurobiological and neurocognitive deficits associated with the disorder. Choices A, B, and C are incorrect because they primarily align with emotional and affective symptoms commonly seen in schizophrenia, not specifically cognitive dysfunction. Symptoms such as anxiety, fear, agitation, aggression, anger, hostility, violence, blunted affect, or inappropriate affective responses are more related to the emotional and behavioral aspects of schizophrenia, rather than cognitive deficits.
A patient living independently had command hallucinations to shout warnings to neighbors. After a short hospitalization, the patient was prohibited from returning to the apartment. The landlord said, 'You cause too much trouble.' What problem is the patient experiencing?
- A. Grief
- B. Stigma
- C. Homelessness
- D. Nonadherence
Correct Answer: B
Rationale: The inability to obtain shelter because of negative attitudes about mental illness is an example of stigma. Stigma is defined as damage to reputation, shame, and ridicule society places on mental illness. Data are not present to identify grief as a patient problem. Data do not suggest that the patient is actually homeless.
An individual is brought by ambulance to the emergency room. The patient's roommate reports that the patient was weak and confused on awakening and began "rambling and talking crazy"Â about 3 hours ago. A nurse notes that the patient's skin is flushed and dry. When transferred to a bed, the patient strikes out at the staff and shouts, "You're not going to kill me!"Â The most likely analysis of this behavior is:
- A. disturbed self-esteem related to catastrophic reaction.
- B. disturbed sensory perception related to altered brain function.
- C. other-directed violence related to fear associated with hospitalization.
- D. impaired environmental interpretational syndrome related to metabolic disturbance.
Correct Answer: B
Rationale: The correct answer is B: disturbed sensory perception related to altered brain function. The patient's presenting symptoms of confusion, rambling speech, physical aggression, and paranoia suggest an altered mental state. The flushed and dry skin may indicate dehydration, which can affect brain function. The behavior is likely a result of the patient's distorted sensory perceptions due to an underlying physiological or neurological issue.
Incorrect choices:
A: disturbed self-esteem related to catastrophic reaction - This choice does not address the patient's specific symptoms and is not supported by the scenario.
C: other-directed violence related to fear associated with hospitalization - While fear of hospitalization may contribute to violence, it does not explain the patient's overall presentation of altered mental status.
D: impaired environmental interpretational syndrome related to metabolic disturbance - This choice does not directly address the patient's symptoms and does not explain the confusion and paranoia displayed.