A patient presents to the emergency department with mixed psychiatric symptoms. The admission nurse suspects the symptoms may be the result of a medical problem. Lab results show elevated BUN (blood urea nitrogen) and creatinine. What is the nurse’s next best action?

Correct Answer: A

Rationale: Rationale for Correct Answer (A): Reporting the findings to the health care provider is the next best action because elevated BUN and creatinine levels indicate possible renal dysfunction, which could be causing the psychiatric symptoms. The health care provider needs this information to determine appropriate treatment and further evaluation. Summary of Incorrect Choices: B: Assessing the patient for a history of renal problems is not the next best action because the lab results already indicate potential renal issues. C: Assessing the patient’s family history for cardiac problems is irrelevant to the elevated BUN and creatinine levels and the psychiatric symptoms. D: Arranging for the patient’s hospitalization on the psychiatric unit is premature without addressing the underlying medical issue indicated by the lab results.

Correct Answer: C

Rationale: The correct answer is C because consistent inappropriate laughing is a characteristic symptom of disorganized schizophrenia. This observation aligns with the disorganized behavior and affect commonly seen in this subtype of schizophrenia. Option A is not specific to disorganized schizophrenia. Option B does not directly relate to disorganized symptoms. Option D suggests paranoia, which is more indicative of paranoid schizophrenia rather than disorganized schizophrenia.

Correct Answer: D

Rationale: The correct answer is D because haloperidol is a dopamine receptor antagonist. By blocking dopamine receptors, it reduces the activity of dopamine in the brain, which helps in reducing disturbed thought processes. Option A is incorrect as dopamine craving is not related to the mechanism of action of haloperidol. Option B is incorrect as enhancing dopamine receptors would increase dopamine activity, opposite to the intended effect of haloperidol. Option C is incorrect as increasing cellular production of dopamine would also increase dopamine activity, contradicting the purpose of using haloperidol.

Correct Answer: B

Rationale: The correct answer is B: ECT induces a grand mal seizure. This indicates learning has occurred because ECT does indeed induce a controlled grand mal seizure to treat severe depression. Euphoria (A) and catatonia (C) are not accurate states induced by ECT. A petit mal seizure (D) is a mild form of seizure not associated with ECT.

Correct Answer: D

Rationale: The correct answer is D because the inability to concentrate for extended periods is a key characteristic of ADHD. This behavior aligns with the inattention aspect of the disorder. Choice A is incorrect as separation anxiety does not directly relate to ADHD. Choice B could indicate oppositional behavior rather than ADHD. Choice C suggests sensory-seeking behavior, which is not a defining feature of ADHD.