A frequent finding in clients with Paraphiliac sexual disorders is that they have:
- A. Other covert or overt emotional
- B. Gonadal and pituitary hormone deficiencies
- C. An inadequate physical development of the sex organs
- D. A poor adjustment due to association with society's fringe groups
Correct Answer: A
Rationale: Clients with paraphilic disorders often have coexisting emotional disorders, which may contribute to or result from their condition.
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The nurse manager of a mental health center wants to improve medication adherence among the seriously mentally ill persons treated there. Which interventions are likely to help achieve this goal? Select one tha does not apply
- A. Maintain stable and consistent staff
- B. Increase the length of medication education groups
- C. Stress that without treatment, illnesses will worsen
- D. Prescribe drugs in smaller but more frequent dosages
Correct Answer: A
Rationale: Trust in ones providers is a key factor in treatment adherence, and mentally ill persons can sometimes take a very long time to develop such trust; therefore, interventions which stabilize staffing allow patients to have more time with staff to develop these bonds. Ready access to prescribers allows medicine-related concerns to be addressed quickly, reducing obstacles to adherence such as side effects or ineffective dosages. Medication costs can be obstacles to adherence as well. Many SMI patients have anosognosia and do not adhere to treatment because they believe they are not ill, so telling them nonadherence will worsen an illness they do not believe they have is unlikely to be helpful. Increasing medication education is helpful only when the cause of nonadherence is a knowledge deficit. Other issues that reduce adherence, particularly anosognosia and side effects, are seldom helped by longer medication education. Requiring medication adherence to participate in other programs is coercive and unethical. Smaller, more frequent doses do not reduce side effects and make the regimen more difficult for the patient to remember.
A patient who has been taking fluoxetine (Prozac) 60 mg daily for the past 6 months tells the nurse at the medication follow-up clinic that he is considering stopping the Prozac. He states his mood is fine, and now that he is living normally, his wife is concerned that he has no sex drive. Which response would be best?
- A. Without the medicine the depression will likely return; you and your wife will need to adjust to the sexual side effects.
- B. If we switch your medication time to the morning, the sexual side effects will be worn off in time for evening sexual activity.
- C. The problem is not likely due to the medicine. Often the depression itself, even after it improves, continues to dampen sex drive.
- D. Without an antidepressant, the depression is more likely to reoccur, but there are other medications that do not interfere so much with sex.
Correct Answer: D
Rationale: Step-by-step rationale for why answer D is correct:
1. Correctly acknowledges the patient's concern about sexual side effects.
2. Highlights the importance of managing depression to prevent recurrence.
3. Offers a solution by mentioning alternative medications with less impact on sex drive.
4. Empowers the patient by providing information and options for treatment.
5. Addresses both the patient's current situation and long-term mental health needs.
Summary of why other choices are incorrect:
A: Overlooks the patient's valid concern about sexual side effects and lacks a proactive solution.
B: Focuses on timing of medication without addressing the underlying issue of sexual side effects.
C: Dismisses the patient's concern and fails to provide a solution or alternative options.
Sensory experiences that occur in the absence of a stimulus are called
- A. illusions
- B. hallucinations
- C. delusions
- D. affect episodes
Correct Answer: B
Rationale: Hallucinations are perceptions without stimuli, distinct from illusions (misinterpretations).
A patient, aged 82 years, has Alzheimer's disease. She lives with her daughter's family and goes to a day care facility on weekdays. The nurse at the day care center noticed the patient was unkempt and had multiple bruises. When the daughter arrived to pick her up, the nurse discussed her observations. The daughter became defensive and said that her mother was very difficult to manage. She stated, "My mother is not my mother anymore. She is confused, and she wanders all night. We have to watch her constantly. Last night I fell asleep, and she fell down the stairs. Sometimes I just cannot bear to care for her."Â Which nursing diagnosis would be most important to address for this patient?
- A. Risk for injury related to impaired cognition, judgment, and coordination and lack of caregiver supervision
- B. Nonadherence related to confusion and disorientation, as evidenced by lack of cooperation
- C. Anxiety related to increasing disorientation, as evidenced by the patient wandering at night
- D. Impaired verbal communication related to brain impairment, as evidenced by the patient's confusion
Correct Answer: A
Rationale: The correct answer is A: Risk for injury related to impaired cognition, judgment, and coordination and lack of caregiver supervision. The rationale is that the patient's Alzheimer's disease has led to impaired cognitive function, making her at risk for injury due to wandering and falls. The daughter's lack of supervision and inability to manage the patient's needs further exacerbate this risk. Choices B, C, and D are incorrect because they do not directly address the immediate safety concern of the patient being at risk for injury. Nonadherence, anxiety, and impaired communication are important issues but do not take precedence over the patient's safety in this context.
A delusion is defined as seeing something that is not real
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: A delusion is a fixed false belief, not a perception (hallucination involves seeing/hearing something not real).
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