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Which of the following is an example of a peri-natal cause of intellectual disability when there is a significant period without oxygen occurring during or immediately after delivery?
- A. Anoxia
- B. Pronoxia
- C. Anaphylaxia
- D. Dysnoxia
Correct Answer: A
Rationale: Anoxia: A peri-natal cause of intellectual disability due to a significant period without oxygen during or after delivery.
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When are the recommended ages for developmental screening to be done according to AAP guidelines?
- A. 6 months, 12 months, and 18 months
- B. 6 months, 18 months, and 36 months
- C. 18 months, 24 months, and 36 months
- D. 9 months, 18 months, and 30 months
Correct Answer: D
Rationale: The American Academy of Pediatrics (AAP) recommends developmental screening at 9, 18, and 30 months during well-child visits to identify developmental delays early.
The physician and advanced practice nurse are considering which antipsychotic medication to prescribe for a patient with schizophrenia who demonstrates auditory hallucinations, apathy, anhedonia, and poor social functioning. The patient is overweight and has hypertension. Bearing these facts in mind, the drug the nurse should advocate would be:
- A. clozapine (Clozaril).
- B. haloperidol (Haldol).
- C. olanzapine (Zyprexa).
- D. aripiprazole (Ability).
Correct Answer: D
Rationale: The correct answer is D: aripiprazole (Ability). Aripiprazole is a second-generation antipsychotic that is less likely to cause weight gain and metabolic side effects compared to other antipsychotics like clozapine (A), olanzapine (C), and haloperidol (B). Given that the patient is overweight and has hypertension, aripiprazole would be a better choice to minimize the risk of exacerbating these conditions. Additionally, aripiprazole has a lower risk of sedation, which can be beneficial for a patient with apathy and anhedonia, allowing for improved social functioning. Aripiprazole's unique mechanism of action as a partial dopamine agonist can also be advantageous for managing auditory hallucinations in schizophrenia. Therefore, aripiprazole is the most suitable choice for this patient based on their clinical presentation and comorbidities.
A victim of a violent rape was treated in the emergency department. As discharge preparation begins, the victim says softly, "I will never be the same again. I can't face my friends. There is no reason to go on."Â Select the nurse's most appropriate response.
- A. Are you thinking of harming yourself?
- B. It will take time, but you will feel the same.
- C. Your friends will understand when you explain it was not your fault.
- D. You will be able to find meaning in this experience as time goes on.
Correct Answer: A
Rationale: The correct answer is A: "Are you thinking of harming yourself?" This response is the most appropriate because the victim is expressing hopelessness and suicidal ideation, which indicates a need for immediate intervention and assessment for safety. By asking directly about self-harm, the nurse can assess the severity of the situation and take appropriate actions to ensure the victim's safety.
Summary of other choices:
B: This response minimizes the victim's feelings and does not address the seriousness of the situation.
C: This response ignores the victim's emotional distress and does not address the potential for self-harm.
D: This response dismisses the victim's current feelings and does not provide immediate support for the expressed hopelessness.
A patient tells the nurse, "My doctor prescribed Paxil (paroxetine) for my depression. I assume I'll have side effects like I had when I was taking Tofranil (imipramine)." The nurse's reply should be based on the knowledge that paroxetine is a:
- A. Selective norepinephrine reuptake inhibitor.
- B. Tricyclic antidepressant.
- C. MAO inhibitor.
- D. SSRI
Correct Answer: D
Rationale: The correct answer is D: SSRI. Paroxetine belongs to the class of selective serotonin reuptake inhibitors (SSRIs), which work by primarily increasing the levels of serotonin in the brain. This mechanism differs from tricyclic antidepressants like Tofranil (imipramine) and MAO inhibitors. SSRIs are known for having fewer side effects compared to tricyclic antidepressants and MAO inhibitors. Therefore, the nurse should inform the patient that the side effects experienced with Tofranil are not necessarily indicative of what they will experience with Paxil due to the different drug classes.
A 45-year-old married woman who works full time in a factory has recently been absent for 3-day periods on several occasions. Each time, she returned to work wearing dark glasses. Facial and body bruises were apparent. Her supervisor became suspicious that she was a victim of battering and referred her to the occupational health nurse. Which initial inquiry would be most important for the nurse to make?
- A. Tell me what has happened to you.'
- B. Did your husband beat you?'
- C. Why do you let this happen?'
- D. What can you do to prevent this?'
Correct Answer: A
Rationale: The correct answer is A: "Tell me what has happened to you." This open-ended question allows the woman to share her experience without judgment or assumptions. It shows empathy and respect for her autonomy. It is crucial for the nurse to gather information directly from the patient to understand the situation fully and provide appropriate support.
Choice B is incorrect because it assumes the woman's husband is the perpetrator without giving her a chance to disclose the information herself. This can be intimidating and may not lead to a truthful response.
Choice C is incorrect because it implies blame on the victim for the abuse, which is not appropriate. It does not focus on providing support or understanding the situation.
Choice D is incorrect as it puts the responsibility on the victim to prevent the abuse, which is not a helpful approach. The focus should be on providing support and understanding the victim's situation.