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Which service would be expected to provide resources 24 hours a day, 7 days a week if needed for persons with serious mental illness?
- A. Clubhouse model
- B. Cognitive Behavioral Therapy (CBT)
- C. Assertive Community Treatment (ACT)
- D. Cognitive Enhancement Therapy (CET)
Correct Answer: C
Rationale: Assertive Community Treatment (ACT) (C) offers 24/7 multidisciplinary support in the patient's environment, unlike the Clubhouse model (A), CBT (B), or CET (D), which lack such availability.
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Which information would be important to incorporate when teaching about medications for dementia in a caregiver's support group? Select all that apply.
- A. Antipsychotic medications have been shown to be the most useful category of drugs in reducing behavioral problems in dementias.
- B. Most currently available medications slow the progress of the disease in 20% to 50% of patients but usually do not significantly improve functioning.
- C. None of the currently available medications for dementias provide a cure.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B because it accurately conveys important information about medications for dementia to caregivers. It emphasizes that most medications do not significantly improve functioning but may slow disease progression in a subset of patients. This is crucial for setting realistic expectations.
Choice A is incorrect because antipsychotic medications are not the most useful category of drugs for reducing behavioral problems in dementia; they are associated with serious side effects and should be used cautiously.
Choice C is incorrect because it is essential for caregivers to understand that medications do not cure dementia; managing symptoms and slowing progression are the primary goals.
Choice D is incorrect as the correct answer is B, which provides valuable information for caregivers to understand the limitations and benefits of medications for dementia.
Therapeutic nutrition begins for a patient with anorexia nervosa who is 70% of ideal body weight. Which nursing intervention is most important to add to the plan of care?
- A. Communicate empathy for the patient's feelings.
- B. Observe for adverse effects associated with refeeding.
- C. Teach patient about psychological origins of the disorder.
- D. Direct the patient to balance energy expenditure and caloric intake.
Correct Answer: B
Rationale: The correct answer is B: Observe for adverse effects associated with refeeding. This is important because refeeding syndrome can occur when a severely malnourished individual is reintroduced to nutrition too quickly, leading to potentially life-threatening electrolyte imbalances. Monitoring for signs such as fluid retention, electrolyte abnormalities, and changes in vital signs is crucial in preventing these complications.
Choice A: Communicating empathy is important in building trust and rapport with the patient, but it is not the most critical intervention in this scenario.
Choice C: Teaching the patient about the psychological origins of the disorder is important for long-term treatment, but it is not the most immediate concern when starting therapeutic nutrition.
Choice D: Directing the patient to balance energy expenditure and caloric intake is important for overall health, but it is not the priority when the patient is severely malnourished and at risk for refeeding syndrome.
A patient's nursing care plan includes assessment for auditory hallucinations. Indicators that suggest the patient may be hallucinating include:
- A. aloofness, increased distractibility, and suspicion.
- B. elevated mood, hypertalkativeness, and distractibility.
- C. performing rituals and avoiding open places.
- D. darting eyes, distracted, and mumbling to self.
Correct Answer: D
Rationale: The correct answer, D, is indicative of auditory hallucinations. Darting eyes may suggest that the patient is hearing voices, distracted behavior aligns with responding to internal stimuli, and mumbling to oneself could be a response to hearing voices. Choices A, B, and C do not directly relate to auditory hallucinations, as they are more indicative of other mental health symptoms such as social withdrawal, mania, anxiety, or compulsive behaviors. Selecting D helps identify potential auditory hallucinations based on observed behaviors associated with hearing voices.
A patient remanded by the court after his wife had him jailed for battery told the judge how sorry he was and suggested he needed psychiatric help. His history reveals acting-out behaviors as an adolescent and several adult arrests. The nurse interviews him about his relationship with his wife. Which statement by the patient is most consistent with a diagnosis of antisocial personality disorder?
- A. I've done some stupid things in my life, but I've learned a lesson.'
- B. I'm feeling terrible about the way my behavior has hurt my family.'
- C. I have a quick temper, but I can usually keep it under control.'
- D. I hit her because she nags at me. She deserves it when I beat her up.'
Correct Answer: D
Rationale: The correct answer is D. This statement reflects a lack of remorse, empathy, and justification for violent behavior, which are key characteristics of antisocial personality disorder. The patient blames his wife for his violent actions and shows a sense of entitlement.
A: This statement shows acknowledgment of mistakes and a willingness to learn from them, which is not consistent with antisocial personality disorder.
B: Expressing feeling terrible about hurting family members demonstrates some level of empathy and remorse, which is not typical of individuals with antisocial personality disorder.
C: Acknowledging a quick temper but being able to control it does not align with the impulsivity and lack of control often seen in individuals with antisocial personality disorder.
A nurse plans a staff education program for employees of a senior living community. Which topic has priority?
- A. Late-onset schizophrenia
- B. Depression and suicide
- C. Dementia
- D. Delirium
Correct Answer: B
Rationale: Older Americans frequently experience undiagnosed depression and are disproportionately more likely to commit suicide (B). Educating staff about signs and symptoms of high-risk patients and early intervention strategies will decrease morbidity and mortality. The other conditions (A, C, D) have a lower prevalence.