Nokea
Which of the following is related to recent attempts to find biochemical explanations for schizophrenia?
- A. schizotaxin
- B. psychotropin
- C. dopamine
- D. diazepam
Correct Answer: C
Rationale: Dopamine excess in the brain is a leading biochemical theory for schizophrenia, supported by antipsychotic efficacy.
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A woman, abducted and raped at gunpoint by an unknown assailant, was found confused and disoriented. The nurse makes these observations about the patient: talking rapidly in disjointed phrases, unable to concentrate, indecisive when asked to make simple decisions. What is the patient's level of anxiety?
- A. Weak
- B. Mild
- C. Moderate
- D. Severe
Correct Answer: D
Rationale: The correct answer is D: Severe. The patient's symptoms of talking rapidly, inability to concentrate, and indecisiveness are indicative of severe anxiety. Rapid speech and disjointed phrases suggest heightened arousal, while the inability to concentrate and make decisions point to severe impairment in cognitive functioning. These symptoms align with the DSM-5 criteria for severe anxiety, which includes extreme levels of distress and impairment in daily functioning. Weak (A), mild (B), and moderate (C) levels of anxiety would not typically manifest in such severe cognitive and behavioral symptoms.
A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. He occasionally curses or calls another client a 'jerk' without provocation. The nurse asks the client how he is feeling, and he responds, 'Everybody picks on me. They frobitz me.' The nurse would assess 'frobitz' as:
- A. Circumstantial speech
- B. Loose associations
- C. Evidence of delusional thinking
- D. A neologism
Correct Answer: D
Rationale: The correct answer is D: A neologism. A neologism is a newly created word or phrase that is unique to the individual and not understandable to others. In this scenario, the client's use of the word 'frobitz' is an example of a neologism. This demonstrates disorganized thinking and language typical of schizophrenia.
A: Circumstantial speech involves providing unnecessary details before reaching the main point, which is not evident in the client's response.
B: Loose associations involve a lack of logical connection between thoughts, which is not demonstrated by the client's use of 'frobitz.'
C: Delusional thinking involves fixed false beliefs, which are not explicitly present in the client's response.
In summary, the client's use of 'frobitz' indicates a neologism, reflecting disorganized thinking in schizophrenia, making it the correct assessment.
A client with antisocial personality disorder yells, 'Shut up about that, or I'll punch you in the nose!' and shakes his fist at another client in a group meeting after the client speaks negatively of illicit drug use. The nurse quickly determines that the client is at risk to act violently against others as evidenced by his aggressive behavior, verbal threats, and a history of impulsivity. Which is the best approach for the nurse to use?
- A. Seclude the client to protect the other clients and staff.
- B. Put the client in restraints to protect the milieu.
- C. Explore alternate ways to handle frustrating topics in the group.
- D. Tell the client to leave the group until he can behave appropriately.
Correct Answer: C
Rationale: The correct answer is C: Explore alternate ways to handle frustrating topics in the group. This approach focuses on addressing the underlying issue of the client's aggressive behavior by finding healthier ways to manage emotions and conflicts. It promotes therapeutic communication and helps the client develop coping strategies.
Secluding the client (choice A) may escalate the situation and reinforce negative behavior. Putting the client in restraints (choice B) is a physical intervention that should only be used as a last resort for safety reasons. Telling the client to leave the group (choice D) may not address the root cause of the behavior and could lead to further isolation and resentment. Ultimately, exploring alternate ways to handle frustrating topics is the most therapeutic and effective approach in this scenario.
Which measure is critical to achieving desired outcomes in the nurse-client relationship? The nurse:
- A. develops trust in the client.
- B. uses autodiagnosis.
- C. relies on the client liking the nurse rather than limit-setting to achieve structure.
- D. analyzes the relationships among biologic, familial, and sociocultural factors that contributed to the client's disorder.
Correct Answer: B
Rationale: The correct answer is B: uses autodiagnosis. Autodiagnosis is critical in the nurse-client relationship as it involves self-awareness and reflection by the nurse to understand their own biases, emotions, and reactions. This self-awareness allows the nurse to effectively manage their responses, maintain professionalism, and provide quality care to the client. By being aware of their own thoughts and feelings, nurses can better empathize with the client, build trust, and communicate effectively. This approach helps prevent potential conflicts and misunderstandings, leading to better outcomes in the nurse-client relationship.
Summary:
A: Developing trust in the client is important but not the most critical measure.
C: Relying on the client liking the nurse is not professional and may compromise boundaries.
D: Analyzing biologic, familial, and sociocultural factors is important but not as critical as self-awareness through autodiagnosis.
Which of the following signs indicates that a patient with an eating disorder may need immediate hospitalization?
- A. Serum potassium level of 3.2 mEq/L
- B. Body mass index (BMI) of 18.5
- C. Noncompliance with meal plans
- D. Low energy and fatigue
Correct Answer: A
Rationale: The correct answer is A: Serum potassium level of 3.2 mEq/L. This indicates severe hypokalemia, which can lead to life-threatening cardiac arrhythmias in patients with eating disorders. Hospitalization is necessary for immediate monitoring and intervention to prevent serious complications. Choices B, C, and D do not indicate imminent life-threatening risks requiring immediate hospitalization.