Nokea
A client has made multiple visits to the clinic. The nurse suspects that the client may be experiencing complex somatic symptom disorder based on which of the following?
- A. Expressions of concern about psychological problems
- B. Indications that parents were always in 'good health'
- C. Reports of the same symptoms repeatedly
- D. Evidence of a need for social support from her friends
Correct Answer: C
Rationale: The correct answer is C: Reports of the same symptoms repeatedly. In complex somatic symptom disorder, individuals often report persistent physical symptoms with no clear medical explanation. By repeatedly reporting the same symptoms, the client demonstrates a key characteristic of this disorder. Choices A, B, and D do not directly align with the diagnostic criteria for complex somatic symptom disorder. Expressions of concern about psychological problems (A) could indicate other mental health conditions. Indications that parents were always in 'good health' (B) and evidence of a need for social support from friends (D) are not specific to complex somatic symptom disorder.
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A staff nurse on a psychiatric unit knows that patients often have trouble sleeping because of their psychiatric conditions. Which of the following would reflect a psychiatric nursing intervention to appropriately address this problem?
- A. Limiting amounts of evening snacks and beverages
- B. Involving patients in a volleyball game immediately before bedtime
- C. Enforcing the rule that all patients be in bed with lights out by 10:30 PM
- D. Encouraging patients to take short naps in the afternoons
Correct Answer: A
Rationale: Correct Answer: A: Limiting amounts of evening snacks and beverages
Rationale:
1. Limiting evening snacks and beverages can help regulate patients' sleep patterns by reducing stimulants that may interfere with sleep.
2. Nutrition plays a role in sleep quality, and avoiding heavy meals close to bedtime can promote better sleep.
3. This intervention addresses a common issue in psychiatric patients without imposing strict rules or physical activity.
4. It focuses on a holistic approach to improving sleep quality by considering dietary factors.
Summary:
B: Involving patients in a volleyball game immediately before bedtime - This choice is incorrect as vigorous physical activity before bedtime can be stimulating and may disrupt sleep.
C: Enforcing the rule that all patients be in bed with lights out by 10:30 PM - This choice is incorrect as it is too rigid and may not address the underlying causes of sleep disturbances.
D: Encouraging patients to take short naps in the afternoons - This choice is incorrect as daytime
A psychiatric-mental health nurse is working with a patient who is being treated for depression. Which patient statement would indicate that her spirituality is intact?
- A. My church friends came to visit me this past Sunday afternoon.'
- B. Nothing will ever be the same again; my life is not worth living.'
- C. I know I am as well off as I can be under the circumstances.'
- D. I know God must be punishing me for all my sins.'
Correct Answer: C
Rationale: The correct answer is C because the patient's statement reflects a sense of acceptance and inner peace despite challenging circumstances, indicating a belief in a higher power or spirituality. This indicates that her spirituality is intact.
Choice A implies social support but does not necessarily indicate spirituality. Choice B expresses hopelessness and suicidal ideation, which are not indicative of intact spirituality. Choice D reflects feelings of guilt and punishment, which do not align with a sense of spiritual well-being.
The nurse is assessing a child's cognitive ability to think logically. The nurse asks the child to count backward from 10 to 0, and the child complies. What cognitive stage is this child in?
- A. sensorimotor
- B. formal operational
- C. concrete operational
- D. preoperational
Correct Answer: C
Rationale: The child counting backward from 10 to 0 demonstrates conservation of numbers and reversibility, characteristics of the concrete operational stage. In this stage, children can engage in logical thought processes, manipulate information mentally, and understand conservation. This ability is typically developed around ages 7 to 11.
A: Sensorimotor stage focuses on sensory experiences and object permanence, typically occurring from birth to age 2.
B: Formal operational stage involves abstract thinking and hypothetical reasoning, usually from age 12 and beyond.
D: Preoperational stage includes egocentrism and lack of conservation, typical for children aged 2 to 7.
Therefore, the child counting backward is in the concrete operational stage due to their ability to think logically and understand conservation.
In the emergency department, the nurse assesses a client who is aggressive and experiencing auditory hallucinations. The client states,"The CIA is plotting to kill me." To which mental health setting would the nurse expect this client to be admitted?
- A. Long-term, inpatient facility.
- B. Day treatment.
- C. Short-term, inpatient, locked unit.
- D. Psychiatric case management.
Correct Answer: C
Rationale: The correct answer is C: Short-term, inpatient, locked unit. This setting is appropriate because the client is exhibiting acute symptoms of aggression and auditory hallucinations, indicating a need for close monitoring and safety precautions in a secure environment. Long-term inpatient facility (choice A) is not suitable for acute episodes. Day treatment (choice B) may not provide the level of supervision needed. Psychiatric case management (choice D) focuses on community-based care, not acute inpatient care. Therefore, choice C is the most appropriate for managing the client's current symptoms.
A person who has been unable to leave home for more than a week because of severe anxiety says, "I know it does not make sense, but I just can't bring myself to leave my apartment alone." Which nursing intervention is appropriate?
- A. Help the person use online video calls to provide interaction with others.
- B. Advise the person to accept the situation and use a companion.
- C. Ask the person to explain why the fear is so disabling.
- D. Teach the person to use positive self-talk techniques.
Correct Answer: D
Rationale: The correct answer is D, teaching the person to use positive self-talk techniques. This intervention is appropriate because it addresses the cognitive aspect of anxiety. By teaching the person to challenge negative thoughts and replace them with positive affirmations, they can gradually overcome their fear and build confidence in leaving the apartment. Online video calls (A) may provide temporary relief but do not address the root cause of the anxiety. Advising the person to use a companion (B) may enable avoidance of the problem rather than actively working on overcoming it. Asking the person to explain their fear (C) may not be helpful if they are already aware that it is irrational. Positive self-talk techniques empower the individual to change their mindset and behavior effectively.