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Which statement by the nurse indicates a good understanding of postpartum blues?
- A. You need to get involved with taking care of this baby.
- B. You are lucky to have a healthy baby. The patient in the next room would give anything to be in your place.
- C. You look tired. Why dont you rest for a bit and I will come back later to start some teaching.
- D. I will call the social worker to check into alternate caregiving for the new baby.
Correct Answer: C
Rationale: This response (C) indicates understanding that postpartum blues is transient and that time and rest are major healers. The other responses (A, B, D) are judgmental or inappropriate.
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A nurse assesses four patients between the ages of 70 and 80. Which patient has the highest risk for alcohol abuse? The patient who:
- A. consumes 1 glass of wine nightly with dinner
- B. began drinking alcohol daily after retirement and says, 'A few drinks keep my mind off my arthritis.'
- C. drank socially throughout adult life and continues this pattern, saying 'Ive earned the right to do as I please.'
- D. abused alcohol between the ages of 25 and 40 but now abstains and occasionally attends Alcoholics Anonymous (AA)
Correct Answer: B
Rationale: Alcohol abuse and dependence can develop at any age, and the geriatric population is particularly at risk. Losses, such as retirement, widowhood, and loneliness, are often related. The distracters describe patients with a lower risk for alcohol abuse.
Conversion disorder and hypochondriasis are classified as
- A. physio-mental disorders
- B. somatoform disorders
- C. psychosomatic disorders
- D. somatization disorders
Correct Answer: B
Rationale: Somatoform disorders involve physical symptoms without medical cause, like conversion and hypochondriasis.
The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating. He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. This information most likely suggests:
- A. medication nonadherence.
- B. a need for psychoeducation.
- C. the chronic nature of his illness.
- D. relapse of his schizophrenia.
Correct Answer: D
Rationale: The correct answer is D: relapse of his schizophrenia. The patient's symptoms of feeling tense, difficulty concentrating, poor sleep, and delusional beliefs about creatures at work indicate a worsening of his psychotic symptoms. This suggests a relapse of schizophrenia, a chronic mental illness characterized by periods of stability and exacerbation of symptoms. The patient's previous stability for a year makes medication nonadherence less likely. While psychoeducation may be beneficial, the patient's current symptoms require more immediate intervention for relapse management. The information provided does not directly indicate the chronic nature of his illness, but rather an acute exacerbation. Therefore, D is the most appropriate choice based on the presented symptoms and clinical understanding of schizophrenia.
A researcher seeking an organic basis for schizophrenia would be well-advised to investigate the role of
- A. amphetamines and amphetamine receptors
- B. adrenaline and noradrenaline
- C. histamine and antihistamine
- D. dopamine and dopamine receptors
Correct Answer: D
Rationale: Dopamine dysregulation, particularly via receptors, is a primary organic focus in schizophrenia research.
The mother of a teenager diagnosed with an eating disorder asks, 'How long will my daughter have this problem?' The nurse answers with the knowledge that:
- A. recovery is usual after one severe episode.
- B. less than 30% show improvement after 5 years.
- C. weight restoration is sufficient for recovery.
- D. long-term therapy combined with medication results in the best outcomes.
Correct Answer: D
Rationale: The correct answer is D because long-term therapy combined with medication results in the best outcomes for individuals with eating disorders. Therapy helps address underlying psychological issues, while medication can help manage symptoms. Recovery is a complex process that often requires ongoing support. Choice A is incorrect as recovery is not always guaranteed after one severe episode. Choice B is incorrect as many individuals do show improvement over time. Choice C is incorrect as weight restoration alone may not address all aspects of the disorder.