Psychiatric Nursing

Why A is correct

A man in his late teens carries the greatest risk. Acute dystonia is a sudden, painful muscle spasm, often of the neck or tongue, in the first days of treatment. The haloperidol label says the risk is higher in males and younger people, and with strong older drugs like haloperidol.

Why the other options are wrong

• B — "A woman in her late teens": She is young but female, so she lacks the second risk factor, male sex. Her youth is a valid risk factor, but one risk factor counts for less than two.
• C — "A man in his seventies": He is male, yet older age lowers this risk.
• D — "A woman in her seventies": She has neither risk factor.

Why B is correct

Derealization is feeling that the surroundings or other people are unreal, while knowing it is only how things seem; he feels like himself.

Why the other options are wrong

• A — "Depersonalization": Depersonalization is a sense of being cut off from one's own self, as if watching from outside; both carry a genuine sense of unreality, but his lies in the world around him.
• C — "Illusion": An illusion is a misreading of something really there; he misreads nothing.
• D — "Visual hallucination": A visual hallucination is seeing something that has no real outside source; everything he sees is really there.

Why C is the answer

Both clocks start at the traumatic event, not at the first clinic visit. Acute stress disorder covers the reaction while it is still inside the first month after exposure. Symptoms continuing past that month move the diagnosis to post-traumatic stress disorder. When the person happened to seek help changes nothing.

Why the other options are not the answer

• A — "Symptoms that continue past one month point to post-traumatic stress disorder": Continuing past one month is exactly what moves the diagnosis, so this is accurate.
• B — "Acute stress disorder is the label while the symptoms are still inside the first month": Inside the first month the acute label is the one that applies, which is accurate.
• D — "Symptoms must have begun after the traumatic event for either label to apply": Onset after the event is a valid part of both definitions, but it says where the symptoms come from rather than how long they last.

Why B is correct

She is in acceptance: she knows the loss will be hard but acknowledges the new reality. People in this stage reengage with others and find comfort in new routines. Acceptance does not mean the sadness is gone.

Why the other options are wrong

• A — "Depression": The depression stage brings withdrawal from people and activities, which she has taken up again. Crying over the loss is a valid sign of grief, but crying alone does not place her in the depression stage.
• C — "Denial": Denial refuses to acknowledge the loss; she grieves him openly.
• D — "Bargaining": Bargaining seeks a deal, often with a higher power, to undo the loss.

Why A is correct

Unilateral electroconvulsive therapy (ECT), with the electrodes on one side of the head, carries a lower risk of memory loss. ECT uses an electric current to set off a brief seizure under anesthesia. Two settings change the memory risk: where the electrodes sit and how long each pulse lasts.

Why the other options are wrong

• B — "Placing the electrodes on both sides of the head": Placement does change the risk, but bilateral ECT, with electrodes on both sides, causes memory problems more often.
• C — "Using longer pulses of electric current": Short pulses cut memory loss because they work as well at a lower dose, so longer pulses lack that benefit.
• D — "Using a higher dose of electric current": A lower dose, which short pulses allow, cuts memory loss, so a higher dose adds risk.