Nokea
Which patient behavior supports the diagnosis of residual schizophrenia with negative symptoms?
- A. Communicating using only rhyming phases
- B. Claims that worms are crawling in my brain
- C. Maintaining both arms suspended awkwardly overhead
- D. Shows no emotion when telling the story of a sister’s recent death
Correct Answer: D
Rationale: The correct answer is D because showing no emotion when discussing a personal tragedy is indicative of blunted affect, a negative symptom commonly seen in residual schizophrenia. This behavior aligns with the diagnostic criteria for residual schizophrenia, which includes the presence of negative symptoms like flat affect. Choices A, B, and C do not directly relate to negative symptoms of schizophrenia. A communicating style or claims about worms do not specifically indicate negative symptoms, and maintaining arms awkwardly overhead is not a typical symptom of residual schizophrenia.
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To effectively plan care for a patient, the nurse will understand that activity and adjunct therapies may be more useful in some situations than verbal therapies because adjunct therapies: a. Are readily available in the treatment setting
- A. Do not require specific training or expertise to facilitate
- B. Allow the patient to express feelings on multiple levels at the same time
- C. Provide the patient the opportunity to use ego-protective mechanisms
- D. Are readily available in the treatment setting
Correct Answer: C
Rationale: The correct answer is C because adjunct therapies provide the patient with the opportunity to use ego-protective mechanisms, such as denial or displacement, which can help them cope with difficult emotions or situations more effectively. This is important in situations where verbal therapies may not be as effective in reaching the patient's underlying emotional needs.
Choice A is incorrect because adjunct therapies may require specific training or expertise to facilitate effectively. Choice B is incorrect because while adjunct therapies can allow for expression of feelings, they do not necessarily do so on multiple levels simultaneously. Choice D is also incorrect because the availability of adjunct therapies in the treatment setting does not necessarily make them more useful than verbal therapies.
A 79-year-old white male tells a nurse, “I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing.” The nurse should analyze this comment as:
- A. Normal pessimism of the elderly.
- B. A call for sympathy
- C. Evidence of risks for suicide.
- D. Normal grieving.
Correct Answer: C
Rationale: The correct answer is C: Evidence of risks for suicide. The statement contains indicators such as feeling very sad, lack of purpose, isolation, and declining health, which are red flags for suicide risk in older adults. It is crucial for healthcare providers to assess and intervene promptly in such cases to prevent harm. Choices A, B, and D are incorrect because they do not address the seriousness of the situation or the potential risk for self-harm.
The patient’s daughter was murdered while they were customers in a local bank. Which statements would support the patient’s diagnosis of posttraumatic stress disorder (PTSD)? Select all that apply:
- A. “I feel numb, like a robot going through the motions of existing.”
- B. “I’m so nervous and jump at the slightest noise.”
- C. “I have not slept very well at all since I lost her.”
- D. “I can’t stop reliving the last time I saw her alive.”
Correct Answer: A
Rationale: The correct answer is A because feeling numb and detached from emotions is a common symptom of PTSD known as emotional numbing. This symptom is often seen in individuals who have experienced a traumatic event, such as the murder of a loved one. It is a defense mechanism that helps the person cope with overwhelming emotions.
The other choices are incorrect:
B: Being nervous and easily startled (hypervigilance) is more indicative of the hyperarousal symptom of PTSD, not emotional numbing.
C: Difficulty sleeping is a common symptom of PTSD, known as insomnia, but it does not directly relate to emotional numbing.
D: Reliving the traumatic event through flashbacks or intrusive memories is a symptom of PTSD, but it is not directly related to emotional numbing.
A nursing instructor is teaching about electroconvulsive therapy (ECT). Which student statement indicates that learning has occurred?
- A. During ECT a state of euphoria is induced
- B. ECT induces a grand mal seizure.
- C. During ECT a state of catatonia is induced
- D. ECT induces a petit mal seizure
Correct Answer: B
Rationale: The correct answer is B: ECT induces a grand mal seizure. This indicates learning has occurred because ECT does indeed induce a controlled grand mal seizure to treat severe depression. Euphoria (A) and catatonia (C) are not accurate states induced by ECT. A petit mal seizure (D) is a mild form of seizure not associated with ECT.
Immediately after electroconvulsive therapy (ECT), nursing care of the patient is most similar to care of a patient:
- A. With delirium tremens
- B. Recovering from conscious sedation
- C. With acute alcohol withdrawal
- D. Undergoing a routine diagnostic procedure
Correct Answer: B
Rationale: The correct answer is B: Recovering from conscious sedation. After ECT, patients are closely monitored as they recover from anesthesia and sedation. Nursing care involves assessing vital signs, mental status, and ensuring the patient's safety. This is similar to caring for a patient recovering from conscious sedation, where monitoring and observation are essential.
A: Delirium tremens involves severe alcohol withdrawal symptoms, which require specialized care including managing agitation and hallucinations.
C: Acute alcohol withdrawal requires specific interventions such as monitoring for seizures and providing medications to prevent complications.
D: Routine diagnostic procedures do not typically involve sedation or anesthesia, so the level of monitoring and care needed is different from post-ECT care.