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Which statement best describes postpartum blues?
- A. A rare condition that impacts bonding between mother and baby.
- B. A transient, self-limiting period of sadness after the birth of the baby.
- C. A psychiatric diagnosis similar to dysthymia.
- D. A transient period of sadness that usually moves into postpartum depression.
Correct Answer: B
Rationale: This definition of postpartum blues (B) differentiates it from dysthymia and postpartum depression. It occurs in 70 percent of new mothers, making it common, transient, and self-limiting.
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An 82-year-old widow with Alzheimer's disease lives with her daughter's family, which owns a catering business. During the week, the patient attends a daycare center for patients. During the evenings, members of the family care for the patient. One day, the nurse at the daycare center notices the patient's appearance is disheveled and that she has bruises on her wrists and back when escorted to the bathroom. What most likely explains the nurse's observations?
- A. The patient is being neglected and abused within the family.
- B. The dementia is progressing, reducing self-care and increasing falls.
- C. The patient is experiencing normal aging symptoms.
- D. The patient is suffering from a new medical condition.
Correct Answer: A
Rationale: The correct answer is A because the nurse's observations of disheveled appearance, bruises, and signs of physical abuse indicate possible neglect and abuse within the family. This is supported by the presence of Alzheimer's disease, vulnerability due to age, and the patient's living situation with family members who own a catering business. Choice B is incorrect as it does not explain the bruises and neglect observed. Choice C is incorrect as normal aging symptoms would not typically include bruises and neglect. Choice D is incorrect as there is no indication of a new medical condition causing these specific observations.
A 72-year-old patient has the medical diagnosis of delirium secondary to anticholinergic medication toxicity. Family members are very anxious and express their concerns about the patient's condition. What information should serve as the basis for the nurse's reply?
- A. Provide education and information regarding the medical diagnosis, delirium secondary to anticholinergic medication toxicity.
- B. Reassure the family that the patient will recover fully.
- C. Suggest that the family consider nursing home placement.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A. The nurse should provide education and information about the medical diagnosis, delirium secondary to anticholinergic medication toxicity. This is important because it helps the family understand the condition, its causes, symptoms, and treatment. By educating the family, they can better support the patient and be involved in the care plan.
Choice B is incorrect because it provides false reassurance without addressing the underlying issue or providing necessary information.
Choice C is incorrect because suggesting nursing home placement is premature and not based on the patient's current condition or needs.
Therefore, the best approach is to choose option A to empower the family with knowledge and understanding to better assist the patient.
During a treatment team meeting, the point is made that a client with schizophrenia has recovered from the acute psychosis but continues to demonstrate apathy, avolition, and blunted affect. The nurse who relates these symptoms to serotonin (SHT2) excess will suggest that the client receive:
- A. Haloperidol (Haldol)
- B. Chlorpromazine (Thorazine)
- C. Olanzapine (Zyprexa)
- D. Phenelzine (NardiI)
Correct Answer: C
Rationale: Rationale: Olanzapine (Zyprexa) is the correct choice because it is an atypical antipsychotic that targets serotonin receptors, particularly 5-HT2 receptors known to be involved in negative symptoms of schizophrenia like apathy, avolition, and blunted affect. Olanzapine's mechanism of action helps alleviate these symptoms by modulating serotonin levels in the brain.
Incorrect Choices:
A: Haloperidol and B: Chlorpromazine are typical antipsychotics that primarily target dopamine receptors and are less effective in treating negative symptoms associated with schizophrenia.
D: Phenelzine is a monoamine oxidase inhibitor used to treat depression and anxiety disorders, not schizophrenia symptoms related to serotonin excess.
Which is a key nursing consideration when planning care for a patient with bulimia nervosa?
- A. Allow the patient to choose their preferred food options.
- B. Provide a structured environment with clear expectations around eating behaviors.
- C. Monitor for signs of weight gain and decrease calorie intake accordingly.
- D. Encourage the patient to participate in regular exercise routines.
Correct Answer: B
Rationale: The correct answer is B: Provide a structured environment with clear expectations around eating behaviors. This is important in managing bulimia nervosa as it helps establish a routine, promotes healthy eating habits, and prevents binge-purge cycles. It provides consistency and boundaries, reducing the likelihood of impulsive behaviors.
Incorrect choices:
A: Allowing the patient to choose their preferred food options can enable unhealthy eating patterns and reinforce disordered behaviors.
C: Monitoring for weight gain and decreasing calorie intake can worsen the patient's condition and perpetuate their obsession with weight and food.
D: Encouraging regular exercise routines may exacerbate the patient's unhealthy relationship with food and body image, leading to excessive exercising or compensatory behaviors.
A client displays disorganized thinking, difficult-to-follow speech, and silly, inappropriate affect. The client isolates himself from other clients and staff, ignores unit activities, and often seems to be listening and responding to unseen stimuli. This client's behavior most closely conforms to the characteristic behavior of:
- A. Residual schizophrenia
- B. Schizoaffective disorder
- C. Paranoid schizophrenia
- D. Disorganized schizophrenia
Correct Answer: D
Rationale: The correct answer is D: Disorganized schizophrenia. This client's presentation aligns with the symptoms of disorganized schizophrenia, characterized by disorganized thinking, speech, and behavior, inappropriate affect, social withdrawal, and hallucinations. Residual schizophrenia (A) refers to a milder form of schizophrenia with lingering symptoms. Schizoaffective disorder (B) involves symptoms of both schizophrenia and mood disorders. Paranoid schizophrenia (C) is characterized by delusions and auditory hallucinations, which are not the primary symptoms displayed by the client in the question.