NURS 218 Personal Care of Head Emergencies at Baton Rouge Community College
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Free NURS 218 Personal Care of Head Emergencies at Baton Rouge Community College Questions
The parent of a child with Tourette's disorder who was recently prescribed pimozide (Orap) says, "My child's tics come and go. I think my child is faking them." What is the nurse's best response with regard to Tourette's disorder?
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"Your observation indicates the medication is ineffective."
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"Perhaps your child was misdiagnosed."
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"Tics often change frequency or severity. That does not mean they are not real."
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"This finding indicates worsening of the condition. Let's review how you've been giving the child's medication."
Explanation
Tourette's disorder is characterized by motor tics (involuntary movements) and vocal tics (involuntary sounds), which can fluctuate in frequency and severity over time. The fact that the tics come and go does not mean that they are being faked; it is a common feature of the disorder. Tics may change or decrease in intensity during certain periods, especially with treatment or other factors, but they are still real and involuntary. It's important to educate the parent that this variability is typical in Tourette's disorder.
A nurse is caring for a client following a total laryngectomy. Which of the following is the priority nursing problem for the client?
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Patency of the intravenous line
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Need for suctioning
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Integrity of the dressing
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Level of pain
Explanation
After a total laryngectomy, ensuring airway patency is the priority. The patient will likely have a tracheostomy or a stoma, and suctioning is necessary to clear any mucus or secretions that could obstruct the airway. Difficulty breathing or labored breathing due to secretions can quickly become a life-threatening situation, so suctioning to clear the airway takes precedence over other concerns.
A client tells the nurse, "My husband lost his job. He's abusive only when he drinks too much. His family was like that when he was growing up. He always apologizes and regrets hurting me." What risk factor was most predictive for the husband to become abusive?
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Poverty
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Loss of employment
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Abuse of alcohol
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History of family violence
Explanation
A history of family violence is one of the most predictive risk factors for an individual to become abusive in relationships. Growing up in an environment where violence or abuse was present can normalize these behaviors and increase the likelihood of repeating them. While alcohol abuse and other stressors such as poverty or job loss may exacerbate violent tendencies, the most significant predictor in this scenario is the husband's history of family violence. This history increases the risk of him displaying abusive behaviors in adulthood.
A nurse is caring for a school-age child who has conduct disorder and a new prescription for methylphenidate (Daytrana) transdermal patches. What information should the nurse provide about the medication?
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Apply the patch once daily at bedtime
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Remove the patch each day after 9 hours
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Place the patch carefully in a trash can after removal
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Apply the transdermal patch to the anterior waist area
Explanation
Methylphenidate (Daytrana) is a transdermal patch used to treat Attention Deficit Hyperactivity Disorder (ADHD) and other conditions like conduct disorder. The patch should typically be applied once a day, in the morning, and worn for up to 9 hours. It is important to remove the patch after 9 hours to avoid prolonged exposure to the medication, which can lead to side effects such as insomnia or decreased appetite.
A nurse is assisting the guardians of a school-age child who has oppositional defiant disorder in identifying strategies to promote positive behavior. Which strategies should the nurse recommend?
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Allow the child to choose which behaviors are unacceptable
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Discourage the child from participating in school sports
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Use role-playing to act out unacceptable behavior
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Develop a reward system for acceptable behavior
Explanation
D. Develop a reward system for acceptable behavior A reward system is a well-established strategy to reinforce positive behavior in children with oppositional defiant disorder (ODD). By rewarding the child for exhibiting acceptable behaviors, the child is more likely to repeat these behaviors in the future. Positive reinforcement encourages compliance and can improve the child's behavior over time. The reward system should be clear, consistent, and tailored to the child's preferences to ensure its effectiveness.
A nursing student on the behavioral health unit says, "These patients with Schizophrenia and schizotypal personality disorder! What's the difference?". The nurse's response should include which information?
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A patient diagnosed with schizophrenia is not usually overtly psychotic
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With schizotypal personality disorder, the person can be made aware of misinterpretations of reality
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In schizotypal personality disorder, the patient remains psychotic much longer
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Schizotypal personality disorder causes more frequent and more prolonged hospitalizations than schizophrenia
Explanation
Schizotypal personality disorder (STPD) involves eccentric behaviors and odd beliefs but does not typically involve full psychosis like schizophrenia. People with STPD can often be made aware of their misinterpretations of reality. They may experience mild distortions in perception or thinking but are usually capable of reality testing and can understand that their beliefs are unusual. In contrast, schizophrenia often involves more severe cognitive distortions, hallucinations, and delusions that are difficult for the person to recognize as irrational.
The nurse is assessing a patient's plan for suicide. What aspect has priority?
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Patient's insight into suicidal motivation
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Availability of means and lethality of method
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Patient's financial and educational status
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Quality and availability of patient's social support
Explanation
When assessing a patient's suicide risk, the priority is to evaluate the availability of means (such as weapons, medications, or other methods) and the lethality of the chosen method. This is critical because it helps determine the immediate risk of the patient acting on their suicidal thoughts. If the patient has access to highly lethal means, the risk of a fatal outcome increases, which requires urgent intervention. Immediate safety is the highest concern in suicide risk assessments.
A nurse is caring for a patient with a newly inserted tracheostomy. Which action should the nurse take first if the tracheostomy tube becomes dislodged during repositioning?
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Attempt to reinsert the tracheostomy tube using a clean technique
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Insert the obturator and attempt to replace the tube with a new sterile tracheostomy tube
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Call the rapid response team
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Cover the stoma with a sterile dressing
Explanation
If the tracheostomy tube becomes dislodged, the nurse's priority action is to attempt to reinsert the tube immediately to maintain the airway. The obturator, which is used to facilitate reinsertion, should be inserted into the tracheostomy tube to guide it back into place. If reinsertion is not possible, the nurse should call for help and have a sterile new tracheostomy tube available for insertion. Maintaining the airway is the top priority.
A client with diagnosed early-stage laryngeal cancer is being monitored for progression. Which new symptom should prompt the nurse to notify the provider immediately as it indicates disease progression?
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Dysphagia and shortness of breath
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Mild throat dryness
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A cough occurring at night only
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Increasing hoarseness over 2 days
Explanation
Dysphagia (difficulty swallowing) and shortness of breath are concerning symptoms that may indicate progression of laryngeal cancer, particularly if the tumor is obstructing the airway or affecting the swallowing mechanism. These symptoms suggest that the cancer may be enlarging or invading structures involved in swallowing and respiration, which requires immediate medical attention. While other symptoms such as mild throat dryness, a cough at night, or hoarseness may also be related to the cancer, they are less urgent compared to symptoms affecting the patient's ability to breathe and swallow.
A nurse is caring for a patient diagnosed with avoidant personality disorder. Which behavior could impede this patient's ability to establish close interpersonal relationships?
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Fear of rejection
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Anger and aggression
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Exploitation of others
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Lack of empathy
Explanation
A hallmark of avoidant personality disorder is an intense fear of rejection or criticism, which can prevent the individual from initiating or maintaining close interpersonal relationships. This fear leads to feelings of inadequacy, social inhibition, and avoidance of social situations, all of which can make it difficult for the person to form meaningful connections with others. They often avoid relationships to protect themselves from perceived rejection.
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