Nokea
A client who has multiple sclerosis is admitted to the hospital with increasingly frequent and severe exacerbations. One day, the client's partner confides to the nurse, 'Life is getting very hard and depressing, and I am upset with myself for thinking about a nursing home.' After listening to the partner's concerns, which response would the nurse make?
- A. Joining a support group of people who are coping with this situation may be helpful.'
- B. You may be able to decrease your feelings of guilt by seeking counseling.'
- C. It would be helpful if you became involved in volunteer work at this time.'
- D. I recognize it's hard to deal with, but try to remember that this, too, shall pass.'
Correct Answer: A
Rationale: Joining a support group of individuals facing similar circumstances can provide valuable support and the opportunity to share experiences, making it the most appropriate response. The response suggesting counseling to decrease feelings of guilt is premature because the partner did not directly express guilt and it may not be the most immediate need. Suggesting involvement in volunteer work at this time fails to address the partner's current emotional distress and may come across as dismissive. Offering false reassurance by stating 'this, too, shall pass' does not validate the partner's feelings and minimizes the seriousness of their concerns.
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Which consideration is the most accurate when applying the principles of mental health?
- A. Emotionally ill individuals may initially reject psychological support from family or others.
- B. People with emotional illnesses may experience challenges in problem-solving.
- C. Mental illness is not solely characterized by signs and symptoms of socially inappropriate behavior.
- D. Emotional health is promoted when there is a sense of mastery of self and the environment.
Correct Answer: D
Rationale: Emotional health is enhanced when an individual feels a sense of control over themselves and their surroundings, fostering security, reducing anxiety, and promoting optimal functioning. While some emotionally ill individuals may reject help initially, many are in distress and acknowledge the need for psychological support. Some seek care based on positive past experiences or the attention received. Additionally, individuals with excellent cognitive function may face challenges in problem-solving due to emotional or psychological barriers. Not all individuals with mental illness exhibit socially inappropriate behavior; it is a misconception that mental illness is solely characterized by such signs and symptoms. Therefore, the most accurate consideration among the choices is that emotional health thrives when there is a feeling of mastery over oneself and the environment.
For which condition would electroconvulsive therapy (ECT) be used?
- A. Severe clinical depression
- B. Substance abuse disorders
- C. Antisocial personality disorder
- D. Psychosis occurring in schizophrenia
Correct Answer: A
Rationale: Electroconvulsive therapy (ECT) is indicated for severe clinical depression, especially in cases where clients do not respond well to psychotropic medications or require immediate intervention due to the severity of their depression. ECT is not typically used as a primary treatment for substance abuse disorders, antisocial personality disorder, or psychosis occurring in schizophrenia. While ECT is an effective intervention for severe depression, it is important to consider individual client needs and response to other treatment options before resorting to ECT.
Which therapeutic approach would indicate the client is receiving desensitization therapy?
- A. Imagery
- B. Modeling
- C. Role playing
- D. Assertiveness training
Correct Answer: A
Rationale: The correct answer is 'Imagery.' Imagery is a therapeutic approach used in desensitization therapy. It helps in facilitating positive self-talk and involves the client initiating and controlling mental pictures to correct faulty cognitions. Modeling, role-playing, and assertiveness training are effective general behavioral approaches but are not specific to desensitization therapy.
Which behavior indicates that the client has learned the most effective method to cope with anger?
- A. Goes for a long jog
- B. Talks about the anger
- C. Goes outside and screams
- D. Focuses on cause of anger
Correct Answer: B
Rationale: The correct answer is 'Talks about the anger.' This response indicates that the client has learned a positive coping method, as discussing angry feelings is a healthier way of dealing with anger. Talking about anger allows for expression and communication, leading to a better understanding of the emotions involved. Going for a long jog or screaming outside may provide temporary relief, but they do not address the root cause or help in processing the emotions effectively. Focusing solely on the cause of anger without expressing feelings may lead to increased frustration and escalation of anger, rather than promoting constructive coping mechanisms.
Which implemented strategies would not be effective in preventing post-traumatic stress in the nursing staff?
- A. Providing breaks to the staff whenever needed
- B. Encouraging the staff to work for more than 12 hours per day
- C. Encouraging the staff to encourage and support their coworkers
- D. Asking the staff and managers to talk about their feelings with each other
Correct Answer: B
Rationale: To prevent post-traumatic stress in the nursing staff, it is crucial to avoid overworking them. Encouraging staff to work for more than 12 hours per day can lead to burnout and increased stress levels, thus exacerbating post-traumatic stress. Providing breaks whenever needed is essential to ensure rest and rejuvenation during demanding shifts. Encouraging staff to support and uplift their coworkers can create a positive work environment, fostering resilience against stress. Additionally, promoting open communication by asking staff and managers to discuss their feelings can facilitate emotional processing and mutual support, ultimately reducing the risk of post-traumatic stress.