Nokea
Which of the following criteria can be used to define intellectual disabilities?
- A. Significantly below average intellectual functioning
- B. Impairments in adaptive functioning generally
- C. These deficits should be manifest before the age of 18 -years
- D. All of the above
Correct Answer: D
Rationale: Intellectual Disabilities: Defined by below-average intellectual functioning, adaptive impairments, and onset before age 18.
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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.
The nursing approach that will minimize power struggles between the client with an eating disorder and the nurse is best characterized as:
- A. authoritarian and autocratic.
- B. laid-back and flexible.
- C. rigid and unyielding.
- D. compassionate and firm.
Correct Answer: D
Rationale: The correct answer is D: compassionate and firm. This approach balances empathy and boundaries, fostering trust and cooperation while maintaining structure. Compassion helps build rapport and understanding, essential for addressing the underlying issues of the eating disorder. Firmness sets clear limits and expectations, promoting accountability and progress. Authoritarian and autocratic (A) can create resistance and hinder therapeutic alliance. Laid-back and flexible (B) may enable unhealthy behaviors. Rigid and unyielding (C) can lead to power struggles and hinder therapeutic progress.
A mother discusses her concerns about genetic transmission of schizophrenia with the nurse saying, 'My son is a fraternal twin. He has been diagnosed with schizophrenia. Will my other son develop schizophrenia, too?' The response that is both sensitive and shows understanding of the genetic component is:
- A. You poor woman! I wish I could tell you he will be free of the disorder.'
- B. Studies show that 50% of twins develop schizophrenia when it is present in the other twin.'
- C. No one can say what will happen, so we will hope for the best for you and your sons.'
- D. In fraternal twins, the chance of the other twin developing the disorder is quite small.'
Correct Answer: D
Rationale: The correct answer is D because it provides an accurate and sensitive response. Fraternal twins do not share the exact genetic makeup, so the chance of the other twin developing schizophrenia is lower compared to identical twins. This response acknowledges the genetic component of schizophrenia while also offering reassurance based on the understanding of genetic transmission.
Choices A and C are incorrect because they do not provide accurate information about the genetic risk of schizophrenia in fraternal twins and may not offer the mother a clear understanding of the situation. Choice B is incorrect as it provides a generalized statistic for identical twins, not fraternal twins, which could lead to unnecessary anxiety for the mother.
The nurse at the clinic is interviewing a patient who offers a number of vague somatic complaints that might not ordinarily prompt a visit to a caregiver: fatigue, back pain, headaches, and sleep disturbance. The patient seems tense, and after having spoken of the symptoms, seems reluctant to provide more information and is in a hurry to leave. The nurse can best serve the patient by:
- A. Asking if the patient has ever had psychiatric counseling.
- B. Completing a structured abuse assessment protocol.
- C. Exploring the possibility of patient social isolation.
- D. Asking the patient to disrobe to check for signs of abuse.
Correct Answer: B
Rationale: The correct answer is B: Completing a structured abuse assessment protocol. Given the patient's vague complaints, tension, reluctance to provide more information, and hurry to leave, these could be signs of potential abuse. Completing a structured abuse assessment protocol allows the nurse to systematically assess for any signs of abuse, which could be contributing to the patient's somatic complaints. This approach is necessary to ensure the patient's safety and well-being.
Incorrect choices:
A: Asking if the patient has ever had psychiatric counseling - This choice does not directly address the potential abuse concerns indicated by the patient's behavior.
C: Exploring the possibility of patient social isolation - While social isolation could be a contributing factor, the urgency to leave and reluctance to provide information are more indicative of potential abuse.
D: Asking the patient to disrobe to check for signs of abuse - This choice is invasive and inappropriate without first completing a structured abuse assessment protocol to determine if abuse is likely.
Which of the following can potentially be diagnostic at the clinic?
- A. The Ages & Stages questionnaire
- B. The Vanderbilt Rating Scale
- C. The MCHAT R/F
- D. The Goodenough Draw a Man test
Correct Answer: C
Rationale: The MCHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-up) is a validated diagnostic screening tool for autism that can be used in a clinic setting, unlike the others which are more general developmental or cognitive assessments.