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Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, "I don't need to come see you anymore. I have found a therapy app on my phone that I love." How should Carolina respond to this news?
- A. That sounds exciting; would you be willing to visit and show me the app?
- B. At this time, there is no real evidence that the app can replace our therapy.
- C. I am not sure that is a good idea right now; we are so close to progress.
- D. Why would you think that is a better option than meeting with me?
Correct Answer: A
Rationale: Carolina should respond by showing interest in the app, as it can help maintain the therapeutic relationship and provide an opportunity to evaluate the app's effectiveness together. By asking the patient to visit and show the app, Carolina demonstrates openness to exploring new tools that the patient finds helpful, while also ensuring that the patient's well-being remains a priority. This approach fosters communication, allows for a collaborative discussion on how the app fits into the patient's treatment plan, and may potentially address any concerns or misconceptions the patient has about the app replacing traditional therapy.
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After Natasha's husband passed away two months ago, she has been overwhelmed with grief. When Natasha is subsequently diagnosed with major depressive disorder, her daughter, Nadia, makes which true statement?
- A. Depression often begins after a major loss. Losing dad was a major loss.
- B. Bereavement and depression are the same problem.
- C. Mourning is pathological and not normal behavior.
- D. Antidepressant medications will not help this type of depression.
Correct Answer: A
Rationale: It is common for major depressive disorder to be triggered by significant life events, such as the sudden loss of a loved one. Therefore, Nadia's statement that 'Depression often begins after a major loss' is correct. Bereavement and major depressive disorder are related but distinct conditions, and while mourning can be intense, it is generally considered a normal response to loss. Antidepressant medications can be beneficial in treating depression, including cases triggered by a significant loss.
Tomas is a 21-year-old male with a recent diagnosis of schizophrenia. Tomas's nurse recognizes that self-medicating with excessive alcohol is common in this disease and can co-occur along with:
- A. Generally good health despite the mental illness.
- B. An aversion to drinking fluids.
- C. Anxiety and depression.
- D. The ability to express his needs.
Correct Answer: C
Rationale: Individuals with schizophrenia often turn to alcohol as a form of self-medication to manage co-occurring symptoms of anxiety and depression. This coping mechanism can exacerbate the underlying mental health condition and hinder proper treatment. Recognizing and addressing these co-occurring issues are essential in providing holistic care for individuals with schizophrenia.
Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted's wife and his blood tests confirm. To reduce Ted's mania, the psychiatric nurse practitioner recommends:
- A. Clonazepam (Klonopin)
- B. Fluoxetine (Prozac)
- C. Electroconvulsive therapy (ECT)
- D. Lurasidone (Latuda)
Correct Answer: D
Rationale: Lurasidone (Latuda) is an atypical antipsychotic medication commonly used in the treatment of bipolar disorder. It can help manage symptoms of mania by stabilizing mood and reducing the intensity of manic episodes. Given Ted's history of bipolar I disorder and the need to address his manic symptoms, Lurasidone (Latuda) is a suitable recommendation by the psychiatric nurse practitioner to aid in managing Ted's condition effectively.
What principle should guide a nurse's fear about 'saying the wrong thing' to a patient in nurse-patient communication?
- A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
- B. The patient is more interested in talking to you than listening to what you have to say and is not likely to be offended.
- C. Considering the patient's history, there is little chance that the comment will do any actual harm.
- D. Most people with a mental illness have, by necessity, developed a high tolerance for forgiveness.
Correct Answer: A
Rationale: Effective nurse-patient communication is guided by the principle that patients value sincere and respectful interactions. A nurse's well-meaning approach that conveys acceptance, respect, and concern helps establish trust and rapport with patients, even if the nurse is apprehensive about making mistakes. It is essential for the nurse to focus on genuine intent and respect for the patient's situation rather than being consumed by the fear of saying something wrong.
Which therapeutic communication statement might a healthcare professional use when a patient's nursing diagnosis is altered thought processes?
- A. I know you mention hearing voices, but I cannot hear them.
- B. Stop listening to the voices, they are NOT real.
- C. You say you hear voices, what are they telling you?
- D. Please ask the voices to leave you alone for now.
Correct Answer: C
Rationale: Choice C is the most appropriate therapeutic communication statement in this scenario. By asking the patient what the voices are telling them, the healthcare professional encourages the patient to express their thoughts and feelings, aiding in understanding their altered thought processes. This approach can help establish a therapeutic relationship and provide valuable insight into the patient's experiences.