A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. The client occasionally curses or calls another client a 'jerk' without provocation. The nurse asks the client how he is feeling, and he responds, 'Everybody picks on me. They frobitz me.' The best response for the nurse to make would be:
- A. That's really too bad.'
- B. Who do you mean when you say 'everybody'?'
- C. What difference does frobitzing make?'
- D. Why do they frobitz?'
Correct Answer: B
Rationale: The correct answer is B: "Who do you mean when you say 'everybody'?"
Rationale:
1. Clarifying the client's statement helps to understand his perception.
2. Asking specifically about 'everybody' encourages the client to express his feelings and thoughts.
3. It promotes therapeutic communication by showing empathy and active listening.
Incorrect choices:
A: "That's really too bad." - This response does not address the client's specific concerns or promote further exploration.
C: "What difference does frobitzing make?" - This response is dismissive and lacks empathy or understanding of the client's experience.
D: "Why do they frobitz?" - This response is confrontational and may come across as accusatory, potentially shutting down communication.
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Bacteria, such as E. Coli, in our water can come from
- A. Factory run-off
- B. Car exhaust
- C. Human and animal feces
- D. Littering
Correct Answer: C
Rationale: E. Coli primarily originates from fecal contamination by humans or animals, making it a common water pollutant.
In planning aftercare for a client with schizophrenia and whose insurance benefits have been exhausted, the nurse who is concerned about overcoming negative symptoms will make provisions for the client to have stimulation, structure, socialization, and support. Which option would best incorporate these factors?
- A. Day hospitalization
- B. Attending a psychosocial club
- C. Living with his elderly mother
- D. Spending free time in the mall
Correct Answer: B
Rationale: The correct answer is B: Attending a psychosocial club. This option best incorporates the necessary factors of stimulation, structure, socialization, and support for the client with schizophrenia.
- Stimulation: Psychosocial clubs offer various activities to engage the client's mind and keep them occupied.
- Structure: These clubs usually have regular schedules and routines, providing the client with a sense of order and predictability.
- Socialization: Interacting with others in the club can help the client improve social skills and combat feelings of isolation.
- Support: Being part of a community in the club can provide emotional support and encouragement for the client.
Incorrect Choices:
- A: Day hospitalization may offer structure and support but may lack the socialization and stimulation provided by a psychosocial club.
- C: Living with his elderly mother may provide support but may not offer the necessary stimulation, structure, and socialization outside of the home environment.
- D: Spending free time in the mall may offer
A person diagnosed with a serious mental illness (SMI) living in the community was punched, pushed to the ground, and robbed of 7 during the day on a public street. Which statements about violence and serious mental illness in general are accurate? Select one tha does not apply.
- A. Persons with SMI are more likely to be violent
- B. SMI persons experience higher rates of sexual assault and victimization than others
- C. Impaired judgment and social skills can provoke hostile or assaultive behavior
- D. Lower incomes force SMI persons to live in high-crime areas, increasing risk
Correct Answer: A
Rationale: Mentally ill persons are more likely to be victims of crime than perpetrators of criminal acts. They are often victims of criminal behavior, including sexual crimes, at a higher rate than others. When a mentally ill person commits a crime, it is usually nonviolent. Mental illnesses interfere with employment and are associated with poverty, limiting SMI persons to living in inexpensive areas that also tend to be higher-crime areas. SMI persons may inadvertently provoke others because of poor judgment or socially inappropriate behavior, or they may be victimized because they are perceived as passive, less likely to resist, and less likely to be believed as witnesses.
A teacher comes to the mental health clinic saying a co-worker recently confronted her about behaviors that are annoying to other co-workers. She is now experiencing moderate to severe levels of anxiety. The co-worker told the patient that others find her very difficult because she is a perfectionist and micromanages the tasks of others on the teaching team, always demanding that things should be done according to her plans. The co-worker mentioned that the patient made everyone feel as though everything they tried was inadequate, and they feel frustrated and angry. The patient states she likes her co-workers and only wanted to help them be successful. The nurse realizes the patient's behaviors are most consistent with:
- A. obsessive-compulsive personality disorder.
- B. narcissistic personality disorder.
- C. histrionic personality disorder.
- D. schizoid personality disorder.
Correct Answer: A
Rationale: The correct answer is A: obsessive-compulsive personality disorder. This is because the patient's behaviors of being a perfectionist, micromanaging tasks, demanding things be done according to her plans, and making others feel inadequate align with the diagnostic criteria for obsessive-compulsive personality disorder. Individuals with this disorder are preoccupied with orderliness, perfectionism, and control.
Choice B: narcissistic personality disorder, is incorrect because the patient's behaviors are not characterized by a sense of grandiosity, a lack of empathy, or a need for admiration, which are hallmark features of narcissistic personality disorder.
Choice C: histrionic personality disorder, is incorrect as individuals with this disorder typically display attention-seeking behavior, emotional instability, and excessive emotionality, none of which are evident in the patient's presentation.
Choice D: schizoid personality disorder, is incorrect as individuals with this disorder tend to be socially detached, have limited emotional expression, and prefer solitary activities, which do not align with the
Which statement by the nurse indicates a good understanding of postpartum blues?
- A. You need to get involved with taking care of this baby.
- B. You are lucky to have a healthy baby. The patient in the next room would give anything to be in your place.
- C. You look tired. Why dont you rest for a bit and I will come back later to start some teaching.
- D. I will call the social worker to check into alternate caregiving for the new baby.
Correct Answer: C
Rationale: This response (C) indicates understanding that postpartum blues is transient and that time and rest are major healers. The other responses (A, B, D) are judgmental or inappropriate.
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