Nokea
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.
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A 10-year-old boy presents with a history of central abdominal pain of a few hours' duration. On examination he has minimal tenderness in the right iliac fossa and no abnormal findings on rectal examination. Which of the following alternatives should be carried out?
- A. Arrange a barium meal follow through.
- B. Arrange to see the patient later on in the day for review.
- C. Send the patient away with instructions to return if the pain becomes worse.
- D. Tell the patient to come back in a week.
Correct Answer: B
Rationale: Early appendicitis can present subtly. Minimal right iliac fossa tenderness warrants observation, so reviewing later (B) is appropriate. Imaging (A), dismissal (C, D), or immediate surgery (E) without further assessment are not justified yet.
A client with schizophrenia is medication compliant and has well-controlled symptoms. He has, however, never been successful in holding a job because of poor social skills and lack of understanding of basic job skills. The nurse case manager should consider referring the client:
- A. To a day hospital program
- B. For psychosocial rehabilitation
- C. For cognitive therapy
- D. To assertiveness training
Correct Answer: B
Rationale: The correct answer is B: For psychosocial rehabilitation. This option is the best choice as it focuses on improving the client's social skills and job-related abilities through structured programs. Psychosocial rehabilitation helps individuals with mental health conditions develop the necessary skills for successful integration into the community, including job skills training and social skill development. Referring the client to a day hospital program (A) may not address the specific needs related to job skills and social skills. Cognitive therapy (C) primarily focuses on addressing cognitive distortions and may not directly target the client's social and job-related deficits. Assertiveness training (D) may be helpful, but it may not address the broader range of skills needed for successful job placement and retention.
The nurse is explaining to the family of a patient diagnosed with schizophrenia that the disorder is considered to have neurobiological origins. When the patient's mother asks, 'What part of the brain is dysfunctional?' the nurse should reply, 'Research has implicated the:
- A. medulla and cortex.'
- B. cerebellum and cerebrum.'
- C. hypothalamus and medulla.'
- D. prefrontal and limbic cortices.'
Correct Answer: D
Rationale: The correct answer is D: prefrontal and limbic cortices. The prefrontal cortex is involved in decision-making, problem-solving, and social behavior, functions that are often impaired in schizophrenia. The limbic cortex is responsible for emotions and memory, both of which are affected in schizophrenia. Research has shown abnormalities in these brain regions in individuals with schizophrenia, supporting the neurobiological origins of the disorder. Choices A, B, and C are incorrect as they do not specifically address the brain regions known to be involved in schizophrenia.
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.
Assist her in developing an emergency plan, since the pattern of violence is likely to continue.
- A. Developing an emergency plan is crucial in situations of potential violence.
- B. The pattern of violence may decrease over time.
- C. The pattern of violence is unpredictable.
- D. None of the above.
Correct Answer: A
Rationale: Rationale for Choice A:
1. Developing an emergency plan is crucial as it ensures safety during potential violent situations.
2. It empowers the individual to have a plan of action in place to protect themselves.
3. By having an emergency plan, the individual can respond quickly and effectively to ensure their safety.
Summary of Other Choices:
B. The pattern of violence decreasing is uncertain and doesn't address the immediate need for safety.
C. Labeling the pattern of violence as unpredictable doesn't provide a proactive solution for the individual's safety.
D. "None of the above" is incorrect as developing an emergency plan is a proactive and necessary step in situations of potential violence.