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A novice nurse tells the assigned mentor, 'I admitted a patient today who has several bizarre delusions. I wanted to tell the patient that the ideas and conclusions simply are not logical. What do you think will happen if I do?' Which reply by the mentor is best?
- A. I think you'll give the patient something to think about.'
- B. The patient will probably incorporate you into the delusions as a persecutor.'
- C. Develop trust using empathy and calmness before pointing out discrepancies.'
- D. Initially, it would be better to go along with the patient's thinking to gain cooperation.'
Correct Answer: C
Rationale: Step 1: Establish trust - Developing trust with the patient is crucial in building a therapeutic relationship.
Step 2: Use empathy and calmness - Showing empathy helps the patient feel understood and valued.
Step 3: Point out discrepancies - Once trust is established, gently pointing out discrepancies in a non-confrontational manner can help the patient reflect on their delusions.
Summary: Choice C is the best because it emphasizes the importance of building trust and rapport before addressing the patient's delusions. Choices A, B, and D are incorrect because they do not prioritize the therapeutic relationship or show empathy towards the patient's experiences.
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A patient with the diagnosis of schizophrenia, disorganized type, approaches the nurse and says, "It's beat, it's eat. No room for doom." The nurse can correctly assess this verbalization as:
- A. Neologisms
- B. Clanging
- C. Ideas of reference.
- D. Associative looseness.
Correct Answer: B
Rationale: The correct answer is B: Clanging. Clanging refers to the association of words based on sound rather than meaning. In this case, the patient's verbalization "It's beat, it's eat. No room for doom" demonstrates a pattern of words that rhyme or have similar sounds but lack coherent meaning. This is characteristic of clanging seen in disorganized schizophrenia. Neologisms (A) are newly created words with unique meanings, which is not evident here. Ideas of reference (C) involve misinterpreting unrelated events as being personally significant, which is not demonstrated in the patient's statement. Associative looseness (D) is a thought disorder where ideas are loosely associated, but the patient's statement does not show this specific feature.
When a psychiatric technician questions the nurse about comorbidity of eating disorders, which Axis I disorder would the nurse say is most commonly seen in clients with bulimia and anorexia nervosa?
- A. Anxiety disorders.
- B. Depressive disorders.
- C. Dissociative disorders.
- D. Somatoform disorders.
Correct Answer: B
Rationale: The correct answer is B: Depressive disorders. Depression is commonly seen in clients with bulimia and anorexia nervosa due to the psychological and emotional struggles associated with these eating disorders. Individuals may experience feelings of worthlessness, hopelessness, and sadness, contributing to depressive symptoms. This comorbidity is well-documented in clinical research. Anxiety disorders (Choice A), dissociative disorders (Choice C), and somatoform disorders (Choice D) are less commonly associated with eating disorders compared to depressive disorders, making them incorrect choices in this context.
What is the most effective intervention to address the disturbed body image in patients with anorexia nervosa?
- A. Help the patient engage in self-care routines.
- B. Provide psychotherapy to address the patient's perceptions.
- C. Encourage participation in group activities that require social interaction.
- D. Support the patient in selecting appropriate meals.
Correct Answer: B
Rationale: The correct answer is B because psychotherapy helps address the underlying psychological factors contributing to the disturbed body image in anorexia nervosa. Specifically, cognitive-behavioral therapy can challenge distorted thoughts about body image. Self-care routines (A) may not directly address the root cause. Group activities (C) may not target individual concerns effectively. Supporting meal selection (D) does not address the psychological aspect of body image distortion. In summary, psychotherapy is crucial in addressing the complex psychological issues associated with body image in anorexia nervosa.
A patient with Alzheimer's disease has been determined to have a dressing/grooming self-care deficit. Which intervention(s) would be appropriate for this nursing diagnosis? Select all that apply.
- A. Replace personal clothing with gym clothes that all match each other.
- B. Label the patient's clothing with his name and name of the item.
- C. Provide clothing with elastic waistbands and hook-and-loop closures.
- D. None of the above.
Correct Answer: A
Rationale: Rationale: Option A is correct because replacing personal clothing with matching gym clothes simplifies dressing, reducing confusion for a patient with Alzheimer's. This intervention promotes independence and minimizes frustration. Labeling clothing (Option B) may help in identifying items but does not address the deficit. Clothing with elastic waistbands and closures (Option C) may be helpful but does not directly address the deficit. "None of the above" (Option D) is incorrect as Option A is an appropriate intervention.
A short-term goal for a patient with Alzheimer disease is:
- A. Improved functioning in the least restrictive environment
- B. improved problem solving in activities of daily living
- C. increased self-esteem and improved self-concept
- D. regained sensory perception and cognitive function
Correct Answer: A
Rationale: Promoting function in a safe, least restrictive setting is realistic and achievable given Alzheimer's progressive nature.