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Which outcome is realistic for a client with stage 1 Alzheimer's disease?
- A. Appropriate long-term placement will be arranged to maintain caregiver's health and well-being.
- B. The client will maintain the highest possible functional level within his or her capacity.
- C. All day-to-day decisions will be made by the caregiver to relieve client of stress.
- D. The client will remain fully functional physically, since Alzheimer's affects only the brain.
Correct Answer: B
Rationale: The correct answer is B because in stage 1 Alzheimer's, individuals can still maintain a relatively high level of functionality. This is because in the early stages, the cognitive decline is mild and individuals can still perform daily tasks independently. It is important to focus on maximizing the client's functional abilities through cognitive exercises and support services.
Choice A is incorrect because long-term placement may not be necessary in stage 1 and should only be considered if the caregiver's health is at risk. Choice C is incorrect because individuals with Alzheimer's should be encouraged to make decisions to maintain their sense of autonomy. Choice D is incorrect because Alzheimer's is a progressive disease that affects both cognitive and physical functions over time.
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Which of the following is a priority intervention for a patient with bulimia nervosa who has been purging?
- A. Ensure the patient has access to therapy and counseling.
- B. Assess and monitor the patient's electrolyte levels.
- C. Encourage the patient to maintain a balanced diet.
- D. Provide education about the dangers of eating disorders.
Correct Answer: B
Rationale: The correct answer is B: Assess and monitor the patient's electrolyte levels. This is the priority intervention because purging in bulimia nervosa can lead to electrolyte imbalances, which can be life-threatening. Monitoring electrolyte levels is crucial to prevent complications such as cardiac arrhythmias or organ damage.
A: Ensuring access to therapy and counseling is important but not the priority in this case where immediate medical attention is needed for potential electrolyte imbalances.
C: Encouraging a balanced diet is essential in the long term but not the immediate priority when dealing with the potential medical complications of purging.
D: Providing education about dangers is important, but it is not the most critical intervention at this moment compared to monitoring electrolyte levels.
A client who has been diagnosed as having bulimia nervosa is hospitalized for treatment of electrolyte imbalance. Just before lunch is finished, the client leaves the table and walks quickly in the direction of the bathroom. The nurse should say:
- A. No one is allowed to leave the dining room during meals.'
- B. I must accompany you when you go to the bathroom.'
- C. I think I understand your plan, and I cannot permit you to carry it out.'
- D. Wouldn't it be preferable to exercise rather than vomit?'
Correct Answer: B
Rationale: The correct answer is B because accompanying the client to the bathroom is essential to prevent purging behavior associated with bulimia nervosa. By doing so, the nurse can provide support, monitor the client, and intervene if necessary to ensure the client's safety. Choice A is incorrect as it may come across as punitive and restrictive. Choice C is incorrect as it may escalate the situation and lead to confrontation. Choice D is incorrect as it suggests an alternative behavior without addressing the immediate concern of potential purging. Accompanying the client to the bathroom is the most appropriate and therapeutic response in this situation.
A patient with schizophrenia has been stabilized in the Crisis Center and is about to be discharged. He will be living with his family, but the family knows nothing about the patient's illness, its treatment, or the role they can play in his recovery. Which activity would be most beneficial for the family to attend?
- A. Psychoanalytic group
- B. Psychoeducational group
- C. Individual counseling
- D. Family therapy
Correct Answer: B
Rationale: The correct answer is B: Psychoeducational group. This option is most beneficial as it provides education and information to the family about the patient's illness, treatment options, and ways they can support his recovery. It helps them understand the challenges the patient faces and equips them with practical strategies to assist in his recovery process.
A: Psychoanalytic group focuses on exploring unconscious patterns of behavior and may not provide the necessary education and tools for the family to support the patient effectively.
C: Individual counseling is focused on the patient and may not involve the family members in understanding the illness and their role in the patient's recovery.
D: Family therapy involves the whole family in therapy sessions, but may not specifically focus on educating them about schizophrenia and its treatment, which is crucial for their support.
A patient received maintenance doses of fluphenazine decanoate (Prolixin Decanoate) 25 mg IM every 2 weeks for 2 years. The clinic nurse notes the patient is grimacing and seems to be constantly smacking her lips. On the next clinic visit, the patient's neck and shoulders twist in a slow, snakelike motion. The nurse should suspect the presence of ______ and should ______.
- A. agranulocytosis"¦check the patient's complete blood count for changes
- B. tardive dyskinesia"¦administer the Abnormal Involuntary Movement Scale
- C. Tourette's syndrome"¦consult the patient's physician about a neuro evaluation
- D. anticholinergic effects"¦consult the physician about possible medication changes
Correct Answer: B
Rationale: Step 1: The patient is showing signs of abnormal movements like lip smacking, grimacing, and snakelike motions, which are indicative of tardive dyskinesia (TD).
Step 2: TD is a side effect of long-term antipsychotic use, such as fluphenazine decanoate.
Step 3: The Abnormal Involuntary Movement Scale is a validated tool to assess the severity of TD.
Step 4: Administering the Abnormal Involuntary Movement Scale will help confirm the diagnosis of TD.
Step 5: Prompt recognition of TD is crucial as it may be irreversible and can worsen over time if not addressed.
Summary:
- A: Agranulocytosis is a condition characterized by low white blood cell count, not related to the patient's symptoms.
- C: Tourette's syndrome presents with different symptoms and requires specialized evaluation.
- D: Anticholinergic effects do not typically manifest as the described
A patient diagnosed with schizophrenia has difficulty completing tasks and seems forgetful and disinterested in unit activities. A nurse can best select successful strategies by understanding that these behaviors are due to:
- A. a lack of self-esteem.
- B. manipulative tendencies.
- C. shyness and embarrassment.
- D. problems in cognitive functioning.
Correct Answer: D
Rationale: The correct answer is D: problems in cognitive functioning. In schizophrenia, cognitive deficits are common, leading to difficulties in completing tasks, forgetfulness, and lack of interest. Understanding this helps the nurse select appropriate strategies, such as breaking tasks into smaller steps. Choice A (lack of self-esteem) is incorrect as cognitive deficits in schizophrenia are not solely related to self-esteem. Choice B (manipulative tendencies) is incorrect as these behaviors are not indicative of manipulation. Choice C (shyness and embarrassment) is incorrect as cognitive deficits in schizophrenia go beyond social anxiety.