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Which point should be included in teaching patients and families about relapse?
- A. Patients who relapse are those who have failed to take their medications.
- B. Caffeine and nicotine can reduce the effectiveness of antipsychotic drugs.
- C. With support, education, and adherence to treatment, patients will not relapse.
- D. Posthospitalization education about medication side effects is usually ineffective.
Correct Answer: B
Rationale: Step-by-step rationale for why answer B is correct:
1. Caffeine and nicotine are known to reduce the effectiveness of antipsychotic drugs.
2. Teaching patients and families about this can help them understand the importance of avoiding these substances.
3. By avoiding caffeine and nicotine, patients can improve the effectiveness of their treatment and reduce the risk of relapse.
4. This information empowers patients and families to make informed decisions to support treatment outcomes.
Summary of why other choices are incorrect:
A: Incorrect because relapse can occur due to various factors, not just medication non-adherence.
C: Incorrect because relapse is a complex issue that may not be entirely prevented even with support, education, and adherence.
D: Incorrect because education about medication side effects is still valuable, even if it may not entirely prevent relapse.
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What is the primary concern when a patient with bulimia nervosa engages in frequent purging?
- A. Electrolyte imbalances and dehydration.
- B. Increased risk of obesity and metabolic syndrome.
- C. Improvement in body image and self-esteem.
- D. Decreased risk of gastrointestinal complications.
Correct Answer: A
Rationale: The correct answer is A: Electrolyte imbalances and dehydration. Purging behaviors in bulimia nervosa, such as self-induced vomiting or laxative abuse, can lead to electrolyte imbalances and dehydration due to loss of essential minerals and fluids. This can result in serious medical complications like cardiac arrhythmias and kidney damage. The other choices are incorrect because B is unrelated to purging behaviors, C is unlikely as purging does not improve body image or self-esteem, and D is incorrect as purging actually increases the risk of gastrointestinal complications.
The characteristic in individuals with personality disorders that makes it most necessary for staff to schedule frequent meetings is:
- A. flexibility and unconventional responses to stress.
- B. a desire to achieve emotional intimacy with staff.
- C. a tendency to evoke countertransference and conflict.
- D. an impaired ability to develop trusting relationships.
Correct Answer: C
Rationale: The correct answer is C because individuals with personality disorders often evoke countertransference and conflict in staff due to their challenging behaviors and interpersonal dynamics. This can lead to potential misunderstandings and ineffective treatment if not addressed through frequent meetings. Option A is incorrect as flexibility and unconventional responses to stress are not typically the primary concern necessitating frequent meetings. Option B is incorrect as a desire for emotional intimacy is not necessarily a reason for staff to schedule frequent meetings. Option D is incorrect as an impaired ability to develop trusting relationships might be a symptom of a personality disorder, but it is not the characteristic that most necessitates frequent meetings.
The nurse is assessing a patient with anorexia nervosa. What is the most important physical examination finding to monitor?
- A. Blood pressure and heart rate.
- B. Height and weight changes.
- C. Skin turgor and hydration status.
- D. Respiratory rate and lung function.
Correct Answer: B
Rationale: The correct answer is B: Height and weight changes. In anorexia nervosa, monitoring height and weight changes is crucial as it reflects the patient's nutritional status and overall health. Weight loss and changes in height can indicate severe malnutrition and potential complications. Blood pressure and heart rate (choice A) can be affected by various factors in anorexia nervosa but may not directly reflect the patient's nutritional status. Skin turgor and hydration status (choice C) are important indicators of hydration levels but may not provide a comprehensive assessment of the patient's nutritional status. Respiratory rate and lung function (choice D) are important, but they may not be the most critical physical examination findings to monitor in anorexia nervosa.
What is the primary nursing intervention for a patient with anorexia nervosa who is refusing to eat?
- A. Offer rewards for eating meals.
- B. Provide firm encouragement and offer small, frequent meals.
- C. Enforce strict diet control and limit food choices.
- D. Allow the patient to skip meals if they do not feel hungry.
Correct Answer: B
Rationale: The correct answer is B because providing firm encouragement and offering small, frequent meals is a supportive approach to help the patient with anorexia nervosa overcome their fear of eating. It helps in gradually reintroducing food, building trust, and establishing a healthier eating pattern. Offering rewards (A) may reinforce unhealthy eating behaviors. Enforcing strict diet control (C) can exacerbate control issues and worsen the patient's condition. Allowing the patient to skip meals (D) can perpetuate malnutrition and reinforce avoidance behaviors.
A patient with many positive symptoms of schizophrenia, whose behavior is disorganized and who is highly anxious, tells the nurse in the psychiatric emergency department, 'You have got to help me. I do not know what is going on. I think someone is trying to wipe me out. I have to get a gun.' The patient, a college student, lives alone and has no family or support system in the immediate area. He has not left his room in 2 weeks, has not eaten in several days, and is unkempt. Of the available treatment settings, the nurse should recommend:
- A. admission to an unlocked residential crisis unit.
- B. inpatient hospitalization on a locked unit.
- C. attending a day treatment program for 4 weeks.
- D. admission to a partial hospital program.
Correct Answer: B
Rationale: The correct answer is B: inpatient hospitalization on a locked unit. This option is the most appropriate given the patient's presentation. The patient is experiencing severe positive symptoms of schizophrenia, such as delusions and disorganized behavior, posing a risk to himself and others by expressing intent to obtain a gun. Additionally, the patient is neglecting basic needs, indicating a need for close monitoring and intervention. Inpatient hospitalization on a locked unit provides a structured and secure environment for intensive treatment, ensuring safety and stabilization.
Incorrect choices:
A: Admission to an unlocked residential crisis unit may not provide the level of monitoring and security needed for a patient with active psychotic symptoms and self-harm potential.
C: Attending a day treatment program for 4 weeks does not address the acute safety concerns and level of impairment displayed by the patient.
D: Admission to a partial hospital program may not offer the round-the-clock supervision and immediate intervention required for someone at risk of harming themselves or others.