Situation: The nurse assigned to the detoxification unit attends to various patients with substance-related disorders. A 45 years old male revealed that he experienced a marked increase in his intake of alcohol to achieve the desired effect This indicates:
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Solution
Tolerance
Tolerance refers to the increase in the amount of the substance to achieve the same effects.
Option A: Withdrawal refers to the physical signs and symptoms that occur when the addictive substance is reduced or withheld.
Option B: Intoxication refers to the behavioral changes that occur upon recent ingestion of substance.
Option D: Psychological dependence refers to the intake of the substance to prevent the onset of withdrawal symptoms.
A 10 year old child has very limited vocabulary and interaction skills. She has an I.Q. of 45. She is diagnosed to have Mental retardation of this classification:
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Solution
Moderate
The child with moderate mental retardation has an I.Q. of 35-50
Option A: Profound Mental retardation has an I.Q. of below 20.
Option B: Mild mental retardation 50-70.
Option D: Severe mental retardation has an I.Q. of 20-35.
School phobia is usually treated by:
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Solution
Returning the child to the school immediately with family support.
Exposure to the feared situation can help in overcoming anxiety.
Option B: This will not help in relieving the anxiety due separation from a significant other.
Options C: Anxiety in school phobia is not due to being in school but due to separation from parents/caregivers so these interventions are not applicable.
Option D: This will not help the child overcome the fear
Ritalin is the drug of choice for children with ADHD. The side effects of the following may be noted:
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Solution
increased attention span and concentration
The medication has a paradoxical effect that decreases hyperactivity and impulsivity among children with ADHD.
Options B, C, D. Side effects of Ritalin include anorexia, insomnia, diarrhea, and irritability.
The child with conduct disorder will likely demonstrate:
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Solution
Serious violations of age-related norms.
This is a disruptive disorder among children characterized by more serious violations of social standards such as aggression, vandalism, stealing, lying and truancy.
Option A: This is characteristic of attention deficit disorder.
Options B and C: These are noted among children with autistic disorder.
Situation: A nurse may encounter children with mental disorders. Her knowledge of these various disorders is vital. When planning school interventions for a child with a diagnosis of attention deficit hyperactivity disorder, a guide to remember is to:
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Solution
provide as much structure as possible for the child
Decrease stimuli for behavior control thru an environment that is free of distractions, a calm non–confrontational approach and setting limit to time allotted for activities.
Option B: The child will not benefit from a lenient approach.
Option C: Dissipate energy through safe activities.
Option D: This indicates that the classroom environment lacks structure.
What would be the best response to the client’s repeated complaints of pain:
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Solution
“I know the feeling is real tests revealed negative results.”
Shows empathy and offers information.
Option B: This is a demeaning statement.
Option C: This belittles the client’s feelings.
Option D: Giving undue attention to the physical symptom reinforces the complaint.
The following statements describe somatoform disorders:
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Solution
Expression of conflicts through bodily symptoms
Bodily symptoms are used to handle conflicts.
Option A: Manifestations do not have an organic basis.
Option B: This occurs unconsciously.
Option D: Medical treatment is not used because the disorder does not have a structural or organic basis.
The following are the appropriate nursing diagnosis for the client EXCEPT:
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Solution
Impaired social interaction
The client may not have difficulty in social exchange. The cues do not support this diagnosis.
Option A: The client maladaptively uses body symptoms to manage anxiety.
Option B: The client will have discomfort due to pain.
Option C: The client may fail to meet environmental expectations due to pain.
Freud explains anxiety as:
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Solution
Conflict between id and superego
Freud explains anxiety as due to opposing action drives between the id and the superego.
Option A: Sullivan identified 2 types of needs, satisfaction and security. Failure to gratify these needs may result in anxiety.
Option C: Biomedical perspective of anxiety.
Option D: Explanation of anxiety using the behavioral model.
Situation: A 30-year-old male employee frequently complains of low back pain that leads to frequent absences from work. Consultation and tests reveal negative results. The client has which somatoform disorder?
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Solution
Somatoform Pain Disorder
This is characterized by severe and prolonged pain that causes significant distress.
Option A: This is a chronic syndrome of somatic symptoms that cannot be explained medically and is associated with psychosocial distress.
Option B: This is an unrealistic preoccupation with a fear of having a serious illness.
Option C: Characterized by alteration or loss in sensory or motor function resulting from a psychological conflict.