Nokea
Which of the following statements is true about the differences in mental health problems between children and adults?
- A. Children are affected by the same stressors as adults, but to different degrees and with different manifestations
- B. Childrens mental health disorders are generally much less severe and resolve more quickly than do those of adults
- C. Childrens mental health problems are different from those of adults because their brains are wired differently
- D. Children have better means of working off stresses than do adults
Correct Answer: A
Rationale: Mental health disorders in children have many similarities and differences from the same disorders in adults. The other responses are not correct.
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A 14-year-old client on the eating disorders unit refuses to eat her meals and says to the nurse on the unit, 'You can't make me eat! There is nothing wrong with me.' The nurse will assess this as use of which defense mechanism?
- A. Repression.
- B. Rationalization.
- C. Sublimation.
- D. Denial.
Correct Answer: D
Rationale: The correct answer is D: Denial. Denial is a defense mechanism where an individual refuses to acknowledge reality to avoid discomfort. In this scenario, the client is denying the seriousness of their situation by refusing to eat and claiming there is nothing wrong. Repression (A) involves unconsciously blocking out unpleasant thoughts or feelings. Rationalization (B) is creating logical explanations to justify behavior. Sublimation (C) is redirecting negative impulses into positive behaviors. In this case, denial is the most fitting defense mechanism as the client is refusing to accept the reality of their eating disorder.
Which of the following behaviors is characteristic of anorexia nervosa?
- A. Binge eating followed by purging.
- B. Self-induced vomiting after meals.
- C. Restricting food intake and an intense fear of gaining weight.
- D. Eating large quantities of food and then exercising excessively.
Correct Answer: C
Rationale: The correct answer is C because anorexia nervosa is characterized by restricting food intake and having an intense fear of gaining weight. This behavior leads to severe weight loss and malnutrition. Choice A is typically associated with bulimia nervosa, where binge eating is followed by purging. Choice B also aligns with bulimia, as self-induced vomiting is a common purging behavior. Choice D describes behaviors more typical of binge eating disorder, where individuals consume large quantities of food followed by excessive exercise. In anorexia nervosa, the primary focus is on severe food restriction and the fear of weight gain, leading to significantly low body weight.
The dopamine-psychosis link is based on the observation that
- A. low dopamine levels of activity in the brain seem to produce psychotic symptoms
- B. there are high levels of dopamine activity in the brains of psychotic people
- C. there are high levels of amphetamine in the brains of schizophrenics
- D. dopamine interacts with serotonin creating psychosis
Correct Answer: B
Rationale: Elevated dopamine activity is associated with psychotic symptoms, especially in schizophrenia.
A nurse is assessing a patient with anorexia nervosa. Which of the following findings would be a priority for intervention?
- A. Weight loss of 2 pounds over the past week.
- B. Denial of the need for nutrition rehabilitation.
- C. Body image disturbance and self-imposed starvation.
- D. Refusal to participate in social activities.
Correct Answer: C
Rationale: The correct answer is C: Body image disturbance and self-imposed starvation. This is a priority because it directly addresses the core issues of anorexia nervosa and poses immediate risks to the patient's health. Body image disturbance contributes to the patient's self-imposed starvation, which can lead to severe malnutrition and other serious complications. Addressing this issue is crucial for the patient's well-being.
A: Weight loss of 2 pounds over the past week is concerning but may not be an immediate priority compared to addressing the underlying psychological issues.
B: Denial of the need for nutrition rehabilitation is important to address but may not pose an immediate threat to the patient's health compared to self-imposed starvation.
D: Refusal to participate in social activities may be a consequence of anorexia nervosa but does not directly address the urgent need to address body image disturbance and self-imposed starvation.
A patient with schizophrenia is admitted to the psychiatric unit in an acutely disturbed, violent state. He is given several doses of haloperidol (Haldol) and becomes calm and approachable. During rounds the nurse notices the patient has his head rotated to one side in a stiffly fixed position. His lower jaw is thrust forward and he appears severely anxious. The patient has _____, and the nurse should _____.
- A. A dystonic reaction"¦administer PRN IM benztropine (Cogentin)
- B. Tardive dyskinesia"¦seek a change in the drug or its dosage
- C. Waxy flexibility"¦continue treatment with antipsychotic drugs
- D. Akathisia"¦administer PRN diphenhydramine (Benadryl) PO
Correct Answer: A
Rationale: The correct answer is A: A dystonic reaction"¦administer PRN IM benztropine (Cogentin). This patient is exhibiting symptoms of acute dystonia, a extrapyramidal side effect of haloperidol. Dystonic reactions are characterized by sustained muscle contractions causing abnormal postures. Benztropine is an anticholinergic medication that helps alleviate these symptoms by blocking the neurotransmitter acetylcholine. Administering benztropine is the appropriate treatment for acute dystonia.
Summary of other choices:
B: Tardive dyskinesia"¦seek a change in the drug or its dosage - Tardive dyskinesia is a side effect that occurs after long-term antipsychotic use, not acutely like in this case.
C: Waxy flexibility"¦continue treatment with antipsychotic drugs - Waxy flexibility is a symptom of catatonia, not a side effect of antipsychotic medications