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Why is the DSM-5 useful in the practice of psychiatric nursing?
- A. It guides the nurse in making accurate and reliable medical diagnoses.
- B. It represents progress toward a more holistic view of mind and body.
- C. It provides a framework for interdisciplinary communication.
- D. It provides a template for nursing care plans.
Correct Answer: A
Rationale: The DSM-5 is a crucial tool in psychiatric nursing as it guides nurses in making accurate and reliable medical diagnoses of mental health conditions. Using the DSM-5 ensures that diagnoses are standardized, improving the quality and precision of care for clients. While the DSM-5 also supports a holistic view, interdisciplinary communication, and care plan development, its primary role in psychiatric nursing is to assist clinicians in diagnosing mental health conditions accurately.
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When assessing a client diagnosed with major depressive disorder who states, 'I feel like I can't go on,' which of the following actions should the nurse take first?
- A. Administer a prescribed antidepressant medication.
- B. Ask the client if they have a plan to commit suicide.
- C. Encourage the client to attend a support group.
- D. Contact the client's family to provide support.
Correct Answer: B
Rationale: The priority action for the nurse is to assess the client's risk for suicide. By asking if the client has a plan to commit suicide, the nurse can determine the immediate safety of the client and take appropriate interventions to prevent harm. Administering antidepressant medication is not the first action to take in this situation as assessing the client's safety is the priority. Encouraging the client to attend a support group or contacting the client's family, although beneficial, are not immediate actions to ensure the client's safety in a crisis situation.
Which of the following are potential side effects of electroconvulsive therapy (ECT)? Select one that does not apply.
- A. Short-term memory loss
- B. Headache
- C. Confusion
- D. Tardive dyskinesia
Correct Answer: D
Rationale: Potential side effects of ECT include short-term memory loss, headache, confusion, and nausea. Tardive dyskinesia is not a side effect of ECT; it is associated with long-term use of antipsychotic medications, particularly antipsychotics that block dopamine receptors over time. ECT is primarily used for severe depression, bipolar disorder, and certain psychotic disorders. The other choices, short-term memory loss, headache, and confusion, are known side effects of ECT and are usually short-term and manageable.
How do psychiatrists determine which diagnosis to give a patient?
- A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
- B. Hospital policy dictates how psychiatrists diagnose mental disorders.
- C. Psychiatrists assess the patient and identify diagnoses based on the patient's symptoms and contributing factors.
- D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.
Correct Answer: A
Rationale: Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to determine which diagnosis to give a patient. The DSM-5 is a comprehensive manual published by the American Psychiatric Association (APA) that outlines specific criteria for diagnosing mental disorders. It aims to ensure accurate and consistent diagnosis and treatment. Choices B and D provide inaccurate information. Hospital policy does not dictate psychiatric diagnoses, and the American Medical Association does not provide diagnostic labels for mental disorders. Choice C, although mentioning the assessment of patients, does not highlight the specific criteria and guidelines provided by the DSM-5 that psychiatrists use to assign diagnoses.
A client with generalized anxiety disorder (GAD) is being discharged. Which of the following instructions should the nurse include in the discharge teaching? Select one that does not apply.
- A. Practice relaxation techniques daily
- B. Avoid caffeine and alcohol
- C. Engage in regular physical activity
- D. Use benzodiazepines as the first line of treatment
Correct Answer: D
Rationale: When discharging a client with GAD, it is important to provide instructions that promote holistic well-being and support without exacerbating the condition. Practicing relaxation techniques daily, avoiding caffeine and alcohol, and engaging in regular physical activity can help manage anxiety symptoms effectively. These strategies focus on self-care and healthy lifestyle choices. Seeking support from friends and family also plays a crucial role in maintaining mental health. However, using benzodiazepines as the first line of treatment is not recommended due to their potential for dependence and other associated risks. Non-pharmacological interventions and therapy are usually preferred as initial approaches in managing GAD. Therefore, the option 'D: Use benzodiazepines as the first line of treatment' is incorrect and should not be included in the discharge teaching for a client with GAD.
Which of the following are characteristics of borderline personality disorder? Select one that does not apply.
- A. Intense fear of abandonment
- B. Unstable relationships
- C. Impulsivity
- D. Grandiosity
Correct Answer: D
Rationale: Borderline personality disorder is characterized by an intense fear of abandonment, unstable relationships, impulsivity, and chronic feelings of emptiness. Grandiosity, which involves an exaggerated sense of self-importance and superiority, is more commonly associated with narcissistic personality disorder rather than borderline personality disorder. Therefore, the correct answer is D.