A patient's sibling says, My brother has a mental illness, but ...

[mrsjacobs44]

A patient's sibling says, My brother has a mental illness, but the doctor ordered a functional magnetic resonance image (fMRI) test. That test is too expensive and will just increase the hospital bill. Select the nurse's best responses.
 
  Select all that apply.
 
  a. Sometimes there are physical causes for psychiatric symptoms. This test will help us understand whether that is the situation.
  b. Some mental illnesses are evident on fMRIs. This test will give information to help us plan the best care for your brother.
  c. Tell me more about what kinds of tests your brother's health insurance plan covers.
  d. It sounds like you do not truly believe your brother had a mental illness.
  e. It would be better for you to discuss your concerns with the doctor.

Question 2

A nurse prepares to administer a second-generation antipsychotic medication to a patient diagnosed with schizophrenia. Additional monitoring for adverse effects will be most important if the patient has which co-morbid health problems?
 
  Select all that apply.
 
  a. Parkinson's disease
  b. Grave's disease
  c. Hyperlipidemia
  d. Osteoarthritis
  e. Diabetes

[mcabuhat]

Answer to Question 1

ANS: A, B
The correct responses provide information to the sibling. Modern imaging techniques are important tools in assessing molecular changes in mental disease and marking the receptor sites of drug action, which can help in treatment planning. Psychiatric symptoms can be caused by anatomical or physiologic abnormalities. There is no evidence of denial in the sibling's comment. The nurse can answer this question rather than referring it to the physician. It would be inappropriate to discuss finances with the patient's sibling.

Answer to Question 2

ANS: A, C, E
Antipsychotic medications may produce weight gain, which would complicate care of a patient with diabetes, and increase serum triglycerides, which would complicate care of a patient with hyperlipidemia. Parkinson's disease involves changes in transmission of dopamine and acetylcholine, so these drugs would also complicate care of this patient. Osteoarthritis and Grave's disease should have no synergistic effect with this medication.

[mrsjacobs44]

Thanks for the timely response, appreciate it

[kishoreddi]

Excellent