Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A 54-year-old Latino man receives a phone call that his mother has had a stroke and is in ICU at his local hospital. Soon after, he begins trembling, then shouting and screaming. The impression is that he is completely out of control. Which culture-bound syndrome should the PMHNP include in the differential diagnosis?
A. Khayal
Khayal is a South Asian culture-bound syndrome associated with anxiety and somatic complaints, not acute episodes of shouting and aggression.
B. Ataque de nervios
Ataque de nervios is a Latino culture-bound syndrome triggered by acute stress or trauma, characterized by shouting, trembling, and emotional outbursts, matching this patient’s presentation.
C. Amok
Amok is a Southeast Asian syndrome involving sudden aggressive outbursts, but it is culturally specific to Malaysia and the Philippines.
D. Dhat
Dhat is a South Asian culture-bound syndrome involving anxiety about semen loss, not acute aggressive episodes.
This question is an excerpt from Nurse Dive's nursing test bank - Mental Health Northern Kentucky University Proctored Exam 6. Take the full exam now
Full Explanation
Choice A reason: Khayal is a South Asian culture-bound syndrome associated with anxiety and somatic complaints, not acute episodes of shouting and aggression.
Choice B reason: Ataque de nervios is a Latino culture-bound syndrome triggered by acute stress or trauma, characterized by shouting, trembling, and emotional outbursts, matching this patient’s presentation.
Choice C reason: Amok is a Southeast Asian syndrome involving sudden aggressive outbursts, but it is culturally specific to Malaysia and the Philippines.
Choice D reason: Dhat is a South Asian culture-bound syndrome involving anxiety about semen loss, not acute aggressive episodes.
Similar Questions
A 52-year-old woman is at her regular medication management appointment with her PMHNP. Her father was recently diagnosed with Alzheimer's disease, and she wants to know what herbal products she can use to prevent memory loss. She tells the PMHNP, "I have heard a lot about ginkgo biloba being good for the brain and memory. What's your opinion?"
A. "Nothing over the counter has ever been proven to work to prevent Alzheimer's disease."
While factually correct, this statement is dismissive and does not validate the patient’s autonomy or concerns.
B. "I understand your concern, and while there is no evidence that ginkgo biloba prevents Alzheimer's disease or dementia, it's certainly your choice to take this product."
This response is accurate and patient-centered, acknowledging the lack of proven benefit while respecting the patient’s choice to use ginkgo biloba.
C. "If it were me, I wouldn't waste my money."
This is a personal opinion rather than an evidence-based, professional response and may seem judgmental.
D. "Don't worry about it; there is a very small chance that you will develop dementia."
This statement minimizes the patient’s concern and may provide false reassurance.
Full Explanation
Choice A reason: While factually correct, this statement is dismissive and does not validate the patient’s autonomy or concerns.
Choice B reason: This response is accurate and patient-centered, acknowledging the lack of proven benefit while respecting the patient’s choice to use ginkgo biloba.
Choice C reason: This is a personal opinion rather than an evidence-based, professional response and may seem judgmental.
Choice D reason: This statement minimizes the patient’s concern and may provide false reassurance.
A 28-year-old woman is referred to the PMHNP with symptoms of hypomania following the birth of her first child. Which of the following statements about postpartum hypomania is correct?
A. It is more common in multiparous women
Postpartum hypomania can occur in both primiparous and multiparous women; it is not limited to those with multiple births.
B. It occurs in less than 1% of postpartum women
Postpartum hypomania is relatively common, with higher rates reported than 1%, making this incorrect.
C. It is a risk factor for postpartum depression
Postpartum hypomania often precedes or predicts postpartum depression and is considered a risk factor for its development.
D. It tends to occur late in the postpartum period
It typically occurs early in the postpartum period, not late, often within the first few days after delivery.
Full Explanation
Choice A reason: Postpartum hypomania can occur in both primiparous and multiparous women; it is not limited to those with multiple births.
Choice B reason: Postpartum hypomania is relatively common, with higher rates reported than 1%, making this incorrect.
Choice C reason: Postpartum hypomania often precedes or predicts postpartum depression and is considered a risk factor for its development.
Choice D reason: It typically occurs early in the postpartum period, not late, often within the first few days after delivery.
A 37-year-old woman who is 8 weeks pregnant presents to the nurse practitioner with a chief complaint of severe morning sickness. Which one of the following will the NP recommend?
A. Ondansetron (Zofran)
Ondansetron is a potent antiemetic that can be effective for nausea and vomiting, but it is typically not the first-line therapy in early pregnancy due to potential, albeit low, risks of fetal malformations. Its use is usually reserved for cases refractory to first-line interventions.
B. Metoclopramide (Reglan)
Metoclopramide can be used for nausea and vomiting in pregnancy, but it carries risks of extrapyramidal side effects and is generally not the first-line recommendation for mild to moderate morning sickness.
C. Promethazine (Phenergan)
Promethazine is an antihistamine antiemetic that can be used safely in pregnancy but is often reserved for more severe cases or when first-line therapy fails. Sedation is a common side effect.
D. Doxylamine (Unisom) and vitamin B6
Doxylamine, an antihistamine, combined with vitamin B6 (pyridoxine) is considered the first-line treatment for nausea and vomiting in pregnancy. This combination has demonstrated efficacy and safety in early pregnancy, making it the preferred initial therapy for severe morning sickness.
Full Explanation
Choice A reason: Ondansetron is a potent antiemetic that can be effective for nausea and vomiting, but it is typically not the first-line therapy in early pregnancy due to potential, albeit low, risks of fetal malformations. Its use is usually reserved for cases refractory to first-line interventions.
Choice B reason: Metoclopramide can be used for nausea and vomiting in pregnancy, but it carries risks of extrapyramidal side effects and is generally not the first-line recommendation for mild to moderate morning sickness.
Choice C reason: Promethazine is an antihistamine antiemetic that can be used safely in pregnancy but is often reserved for more severe cases or when first-line therapy fails. Sedation is a common side effect.
Choice D reason: Doxylamine, an antihistamine, combined with vitamin B6 (pyridoxine) is considered the first-line treatment for nausea and vomiting in pregnancy. This combination has demonstrated efficacy and safety in early pregnancy, making it the preferred initial therapy for severe morning sickness.