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A client has been diagnosed with borderline personality disorder. Which behavior is characteristic of this disorder?
- A. Excessive need for attention
- B. Instability in relationships
- C. Fear of abandonment
- D. Lack of interest in activities
Correct Answer: B
Rationale: The correct answer is B: Instability in relationships. Individuals with borderline personality disorder often exhibit instability in their relationships, characterized by intense and unstable interpersonal connections, oscillating between idealization and devaluation. This pattern can lead to frequent conflicts, dramatic emotional shifts, and difficulties maintaining stable relationships. Choices A, C, and D are incorrect. While individuals with borderline personality disorder may also have an excessive need for attention, fear of abandonment, or lack of interest in activities, the hallmark feature defining this disorder is the instability in relationships.
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A client is being treated for obsessive-compulsive disorder (OCD). Which intervention should be included in the care plan?
- A. Discourage the client from performing rituals.
- B. Allow the client to perform rituals in the early stages of treatment.
- C. Encourage the client to focus on their compulsions.
- D. Isolate the client to prevent performance of rituals.
Correct Answer: B
Rationale: Allowing the client to perform rituals in the early stages of treatment is a common therapeutic approach for obsessive-compulsive disorder (OCD). Allowing the client to engage in rituals can help reduce anxiety by providing temporary relief. It is a part of exposure therapy, where the individual is gradually exposed to anxiety-provoking situations. As treatment progresses, the focus shifts to gradually reducing the frequency and intensity of rituals through interventions like exposure and response prevention therapy. Discouraging the client from performing rituals (Choice A) is not recommended as it may increase anxiety and resistance to treatment. Encouraging the client to focus on their compulsions (Choice C) may reinforce the behavior rather than helping to decrease it. Isolating the client (Choice D) is not therapeutic and can lead to feelings of abandonment and worsen symptoms.
During a community education session on mental health, which statement about stigma and mental illness is correct?
- A. Stigma has no impact on treatment outcomes.
- B. Stigma can prevent individuals from seeking treatment.
- C. Stigma is only a problem in developing countries.
- D. Stigma related to mental illness is decreasing significantly worldwide.
Correct Answer: B
Rationale: The correct answer is B: 'Stigma can prevent individuals from seeking treatment.' Stigma surrounding mental illness can create barriers for individuals seeking treatment. It can lead to feelings of shame, fear of judgment, and discrimination, which may deter individuals from accessing the necessary support and care they need. Choices A, C, and D are incorrect. Stigma does have a significant impact on treatment outcomes by discouraging individuals from seeking help, it is not limited to developing countries but is a global issue, and unfortunately, stigma related to mental illness is still prevalent worldwide, although efforts are being made to reduce it.
A client has been prescribed sertraline for depression, and the nurse is providing discharge instructions. Which dietary instruction should the nurse include?
- A. Avoid foods high in sodium.
- B. Avoid foods high in calcium.
- C. Avoid foods high in tyramine.
- D. Avoid foods high in potassium.
Correct Answer: C
Rationale: Clients prescribed sertraline should avoid foods high in tyramine to prevent a hypertensive crisis. Sertraline, an antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class, can interact with tyramine-rich foods, potentially causing a dangerous increase in blood pressure known as a hypertensive crisis. Choices A, B, and D are incorrect because there is no specific dietary restriction related to sodium, calcium, or potassium intake when taking sertraline.
A client with bipolar disorder is prescribed lithium. Which dietary instruction should the nurse provide?
- A. Avoid foods high in potassium.
- B. Increase intake of caffeinated beverages.
- C. Maintain consistent sodium intake.
- D. Follow a low-protein diet.
Correct Answer: C
Rationale: The correct instruction for a client with bipolar disorder prescribed lithium is to maintain consistent sodium intake. Fluctuations in sodium levels can impact lithium levels, potentially leading to toxicity. Therefore, it is crucial to advise the client to keep their sodium intake consistent to ensure the effectiveness and safety of the lithium therapy. Choices A, B, and D are incorrect. Avoiding foods high in potassium is not directly related to lithium therapy. Increasing intake of caffeinated beverages can interfere with the action of lithium. Following a low-protein diet is not a standard recommendation for clients prescribed lithium.
In a client with obsessive-compulsive disorder (OCD) undergoing cognitive-behavioral therapy, which outcome indicates that the therapy is effective?
- A. The client reports a decrease in the frequency of compulsive behaviors.
- B. The client reports a decrease in the intensity of obsessive thoughts.
- C. The client reports an improvement in overall mood.
- D. The client reports an improvement in sleep patterns.
Correct Answer: A
Rationale: In clients with OCD undergoing cognitive-behavioral therapy, a decrease in the frequency of compulsive behaviors is a key indicator of treatment effectiveness. This reduction signifies progress in managing and controlling the compulsions associated with OCD, which is a primary goal of the therapy. Choices B, C, and D may also be positive outcomes of therapy, but the most critical aspect in treating OCD with cognitive-behavioral therapy is targeting and reducing the frequency of compulsive behaviors.