Danny has been diagnosed with schizophrenia. On the unit he appears very anxious, paces back and forth, and darts his head from side to side in a continuous scanning of the area. He has refused to eat, making some barely audible comment related to 'being poisoned.' In planning care for Danny, which of the following would be the primary focus for nursing?

Correct Answer: A

Rationale: The correct answer is A: To decrease anxiety and develop trust. This is the primary focus for nursing care for Danny because his symptoms of anxiety, paranoia, and refusal to eat are indicative of his distress and lack of trust in his environment. By decreasing his anxiety and building trust, the nurse can establish a therapeutic relationship with Danny, which is essential for effective treatment and care. Setting limits on his behavior (B) may escalate his anxiety and worsen his symptoms. Ensuring group therapy attendance (C) may not be effective if Danny is not in a mental state to participate. Attending to hygiene needs (D) is important but secondary to addressing his underlying anxiety and trust issues.

Correct Answer: B

Rationale: The correct answer is B: Negative symptoms of schizophrenia. Atypical antipsychotics primarily target negative symptoms such as social withdrawal, lack of motivation, and flattened affect. They are less effective on positive symptoms like hallucinations and delusions. This is due to their mechanism of action, which involves targeting serotonin and dopamine receptors in the brain. Choices A and C are incorrect because atypical antipsychotics are not as effective in treating positive symptoms. Choice D is incorrect because atypical antipsychotics are not commonly used to treat anxiety disorders.

Correct Answer: A

Rationale: The correct answer is A because a maturational/internal crisis is typically triggered by the individual's transition to a new developmental stage, such as adolescence or midlife. This type of crisis arises from internal changes and challenges related to personal growth and self-awareness. In contrast, option B refers to external events like natural disasters, not internal processes. Option C pertains to crises resulting from external factors like loss, not internal developmental changes. Option D focuses on internal conflicts, but a maturational crisis is distinct as it directly relates to developmental stages.

Correct Answer: A

Rationale: The correct answer is A because abruptly stopping lithium in bipolar patients can lead to a rapid recurrence of manic or hypomanic symptoms due to destabilization of mood regulation. This is known as rebound mania. Choice B is incorrect because discontinuing lithium can have significant effects. Choice C is incorrect as discontinuation may not necessarily lead to severe depression. Choice D is incorrect as lithium discontinuation is not associated with the development of schizophrenia.

Correct Answer: B

Rationale: The correct answer is B: A defense mechanism where unacceptable impulses are substituted with constructive activities. Sublimation involves channeling negative or unacceptable emotions into productive or socially acceptable behaviors. This process allows individuals to express their feelings in a healthy and constructive manner. Choice A (meeting the needs of others) relates to altruism, not sublimation. Choice C (constantly denying disturbing feelings) describes repression, not sublimation. Choice D (transferring emotions to a nonthreatening object) is more aligned with displacement, not sublimation.