Health Care Utilization by Age Group

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A client with schizophrenia is medication compliant and has well-controlled symptoms. He has, however, never been successful in holding a job because of poor social skills and lack of understanding of basic job skills. The nurse case manager should consider referring the client:

  • A. To a day hospital program
  • B. For psychosocial rehabilitation
  • C. For cognitive therapy
  • D. To assertiveness training
Correct Answer: B

Rationale: The correct answer is B: For psychosocial rehabilitation. This option is the best choice as it focuses on improving the client's social skills and job-related abilities through structured programs. Psychosocial rehabilitation helps individuals with mental health conditions develop the necessary skills for successful integration into the community, including job skills training and social skill development. Referring the client to a day hospital program (A) may not address the specific needs related to job skills and social skills. Cognitive therapy (C) primarily focuses on addressing cognitive distortions and may not directly target the client's social and job-related deficits. Assertiveness training (D) may be helpful, but it may not address the broader range of skills needed for successful job placement and retention.

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A patient with acute mania dances atop a pool table, waves a cue in one hand, and says, "I'll throw the pool balls if anyone comes near me." The nurse's first intervention is to:

  • A. Tell the patient
  • B. ""We are taking you to seclusion.""
  • C. Remove the patient from the pool table.
  • D. Clear the room of all other patients.
Correct Answer: B

Rationale: The correct answer is B because taking the patient to seclusion ensures safety for both the patient and others. This intervention controls the immediate risk of harm from the patient's unpredictable behavior. Telling the patient (choice A) may escalate the situation. Removing the patient from the pool table (choice C) may not address the underlying threat. Clearing the room of all other patients (choice D) is not the priority; ensuring immediate safety is paramount in this scenario.

Which measure is critical to achieving desired outcomes in the nurse-client relationship? The nurse:

  • A. develops trust in the client.
  • B. uses autodiagnosis.
  • C. relies on the client liking the nurse rather than limit-setting to achieve structure.
  • D. analyzes the relationships among biologic, familial, and sociocultural factors that contributed to the client's disorder.
Correct Answer: B

Rationale: The correct answer is B: uses autodiagnosis. Autodiagnosis is critical in the nurse-client relationship as it involves self-awareness and reflection by the nurse to understand their own biases, emotions, and reactions. This self-awareness allows the nurse to effectively manage their responses, maintain professionalism, and provide quality care to the client. By being aware of their own thoughts and feelings, nurses can better empathize with the client, build trust, and communicate effectively. This approach helps prevent potential conflicts and misunderstandings, leading to better outcomes in the nurse-client relationship.

Summary:
A: Developing trust in the client is important but not the most critical measure.
C: Relying on the client liking the nurse is not professional and may compromise boundaries.
D: Analyzing biologic, familial, and sociocultural factors is important but not as critical as self-awareness through autodiagnosis.

The nurse is explaining to the family of a patient diagnosed with schizophrenia that the disorder is considered to have neurobiological origins. When the patient's mother asks, 'What part of the brain is dysfunctional?' the nurse should reply, 'Research has implicated the:

  • A. medulla and cortex.'
  • B. cerebellum and cerebrum.'
  • C. hypothalamus and medulla.'
  • D. prefrontal and limbic cortices.'
Correct Answer: D

Rationale: The correct answer is D: prefrontal and limbic cortices. The prefrontal cortex is involved in decision-making, problem-solving, and social behavior, functions that are often impaired in schizophrenia. The limbic cortex is responsible for emotions and memory, both of which are affected in schizophrenia. Research has shown abnormalities in these brain regions in individuals with schizophrenia, supporting the neurobiological origins of the disorder. Choices A, B, and C are incorrect as they do not specifically address the brain regions known to be involved in schizophrenia.

A disorder that interrupts normal sleep patterns and is characterized by repeated, brief jerks of the arms and legs that occur every 20 to 60 seconds during the beginning of sleep is called:

  • A. Insomnia.
  • B. Narcolepsy.
  • C. Hypersomnia.
  • D. None of the above.
Correct Answer: D

Rationale: The correct answer is D: None of the above. The disorder described in the question is Periodic Limb Movement Disorder (PLMD), not any of the options provided. PLMD involves involuntary movements during sleep, which are different from the symptoms of insomnia, narcolepsy, or hypersomnia. Insomnia is difficulty falling or staying asleep, narcolepsy is a neurological disorder characterized by excessive daytime sleepiness, and hypersomnia is excessive daytime sleepiness despite getting enough sleep. Therefore, the correct answer is D as none of the provided options accurately describe the specific disorder mentioned in the question.

A history reveals that a patient virtually stopped eating 5 months ago and lost 25% of body weight. The nurse says, 'Describe what you think about your present weight and how you look.' Which response would be most consistent with anorexia nervosa?

  • A. I'm fat and ugly.'
  • B. What I think about myself is my business.'
  • C. I'm grossly underweight, but I cover it well.'
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A. This response is most consistent with anorexia nervosa because it reflects a distorted body image common in individuals with this condition. Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image, leading to extreme weight loss and restrictive eating habits. Choice B suggests a lack of insight or denial, which is not typical of anorexia nervosa. Choice C acknowledges being underweight but does not reflect the negative body image associated with anorexia nervosa. Choice D is incorrect as option A aligns with the characteristic body image distortion seen in anorexia nervosa.

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