Nokea
Which response is appropriate when a patient’s mother expresses guilt over causing my child to be schizophrenic?
- A. I can see how you would be upset over this turn of events
- B. New findings suggest this disorder is biological in nature.
- C. Don’t be so hard on yourself; your daughter needs you to be strong
- D. It’s difficult to see what produces stress for the child at the time it’s occurring.
Correct Answer: B
Rationale: Schizophrenia is primarily linked to biological factors, including genetic predispositions, neurochemical imbalances, and brain structure abnormalities. This response helps dispel guilt and provides reassurance to the mother.
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Which older adult patient’s medical conditions support the hypothesis upon which the immunologic theory of aging is based?
- A. Has, at age 64, been diagnosed with type 2 diabete
- B. Has been treated for multiple sclerosis since age 30.
- C. Is managing a 36-year history of chronic Graves’ disease.
- D. Has begun to experience symptoms of rheumatoid arthritis.
Correct Answer: B, C
Rationale: he immunologic theory of aging suggests that aging is associated with increased autoimmunity. Conditions like multiple sclerosis, rheumatoid arthritis, and Graves’ disease reflect immune dysfunction.
Which nursing diagnosis is appropriate for a patient who insists on being called "Your Highness" and demonstrates loosely associated thoughts?
- A. Risk for violence
- B. Defensive coping
- C. Impaired memory
- D. Disturbed thought processes
Correct Answer: D
Rationale: nsisting on being called "Your Highness" and demonstrating loose associations suggests a disturbance in thought processing typical of schizophrenia.
A nurse administers ordered preoperative glycopyrrolate (Robinul) 30 minutes prior to a client’s electroconvulsive therapy (ECT) procedure. What is the rationale for administering this medication?
- A. Robinul decreases anxiety during the ECT procedure.
- B. Robinul induces an unconscious state to prevent pain during the ECT procedure
- C. Robinul prevents severe muscle contractions during the ECT procedure.
- D. Robinul decreases secretions to prevent aspiration during the ECT procedure.
Correct Answer: D
Rationale: Glycopyrrolate is an anticholinergic that reduces salivation and other secretions, which helps to prevent aspiration during ECT, where muscle relaxants are used.
The physician has ordered atropine 5 mg intramuscularly (IM) for a patient to be administered 30 minutes prior to ECT. The rationale for use of this medication is that it reduces secretions and:
- A. Improves the scope of convulsive activity
- B. Reduces the need for recovery room staff
- C. Prevents incontinence of bladder and bowel
- D. Increases the patient's alertness post-procedure.
Correct Answer: A
Rationale: The rationale for using atropine 5 mg IM prior to ECT is to protect against vagal bradycardia, not to improve the scope of convulsive activity, reduce the need for recovery room staff, or prevent incontinence of bladder and bowel. Atropine is a muscarinic antagonist that blocks the effects of acetylcholine on muscarinic receptors, leading to an increase in heart rate and protection against bradycardia that can occur during ECT.
A new nurse asks the mentor, “How can I be sure I’m developing a therapeutic environment for my unit?” The mentor uses as a basis for the response the fact that a therapeutic milieu is characterized by:
- A. Rigid adherence to timelines and unit routine
- B. Relaxation of boundaries when doing so is accepted by all
- C. Working with a member to help improve their communication skill
- D. The focus of the staff is directed to the most critically disturbed patients
Correct Answer: D
Rationale: A therapeutic milieu is characterized by focusing on the needs and goals of the patients. By establishing specific patient-centered goals that are agreed upon mutually by the patient and the staff, it ensures that the care provided is individualized and tailored to the patient's needs. This approach fosters a collaborative and empowering environment where the patient feels heard and supported in their recovery journey. It also promotes a sense of ownership and accountability for both the patient and the staff in working towards these goals together. In contrast, rigid adherence to timelines and unit routine (option A) may not always take into account the unique needs of each patient, and relaxation of boundaries (option B) can potentially compromise the therapeutic process by blurring professional boundaries. Therefore, establishing patient-centered goals is a key component of creating a therapeutic environment on a nursing unit.