Nokea
A nurse and social worker co-lead a reminiscence group for eight old-old and centenarian adults. Which activity is appropriate to include in the group?
- A. Mild aerobic exercise
- B. Singing a song from World War II
- C. Discussing national leadership during the Vietnam War
- D. Identifying the most troubling story in today's newspaper
Correct Answer: B
Rationale: The correct answer is B: Singing a song from World War II. This activity is appropriate because reminiscence therapy involves recalling past memories to enhance well-being in older adults. Singing a song from that era can help trigger positive emotions and memories for the participants.
A: Mild aerobic exercise may not be suitable for all participants due to physical limitations.
C: Discussing national leadership during the Vietnam War might evoke negative emotions or political disagreements.
D: Identifying the most troubling story in today's newspaper could lead to distress and is not conducive to the therapeutic nature of reminiscence therapy.
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A person diagnosed with a serious mental illness (SMI) living in the community was punched, pushed to the ground, and robbed of 7 during the day on a public street. Which statements about violence and serious mental illness in general are accurate? Select one tha does not apply.
- A. Persons with SMI are more likely to be violent
- B. SMI persons experience higher rates of sexual assault and victimization than others
- C. Impaired judgment and social skills can provoke hostile or assaultive behavior
- D. Lower incomes force SMI persons to live in high-crime areas, increasing risk
Correct Answer: A
Rationale: Mentally ill persons are more likely to be victims of crime than perpetrators of criminal acts. They are often victims of criminal behavior, including sexual crimes, at a higher rate than others. When a mentally ill person commits a crime, it is usually nonviolent. Mental illnesses interfere with employment and are associated with poverty, limiting SMI persons to living in inexpensive areas that also tend to be higher-crime areas. SMI persons may inadvertently provoke others because of poor judgment or socially inappropriate behavior, or they may be victimized because they are perceived as passive, less likely to resist, and less likely to be believed as witnesses.
A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. The client occasionally curses or calls another client a 'jerk' without provocation. The nurse asks the client how he is feeling, and he responds, 'Everybody picks on me. They frobitz me.' The best response for the nurse to make would be:
- A. That's really too bad.'
- B. Who do you mean when you say 'everybody'?'
- C. What difference does frobitzing make?'
- D. Why do they frobitz?'
Correct Answer: B
Rationale: The correct answer is B: "Who do you mean when you say 'everybody'?"
Rationale:
1. Clarifying the client's statement helps to understand his perception.
2. Asking specifically about 'everybody' encourages the client to express his feelings and thoughts.
3. It promotes therapeutic communication by showing empathy and active listening.
Incorrect choices:
A: "That's really too bad." - This response does not address the client's specific concerns or promote further exploration.
C: "What difference does frobitzing make?" - This response is dismissive and lacks empathy or understanding of the client's experience.
D: "Why do they frobitz?" - This response is confrontational and may come across as accusatory, potentially shutting down communication.
A researcher seeking an organic basis for schizophrenia would be well-advised to investigate the role of
- A. amphetamines and amphetamine receptors
- B. adrenaline and noradrenaline
- C. histamine and antihistamine
- D. dopamine and dopamine receptors
Correct Answer: D
Rationale: Dopamine dysregulation, particularly via receptors, is a primary organic focus in schizophrenia research.
The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating. He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. This information most likely suggests:
- A. medication nonadherence.
- B. a need for psychoeducation.
- C. the chronic nature of his illness.
- D. relapse of his schizophrenia.
Correct Answer: D
Rationale: The correct answer is D: relapse of his schizophrenia. The patient's symptoms of feeling tense, difficulty concentrating, poor sleep, and delusional beliefs about creatures at work indicate a worsening of his psychotic symptoms. This suggests a relapse of schizophrenia, a chronic mental illness characterized by periods of stability and exacerbation of symptoms. The patient's previous stability for a year makes medication nonadherence less likely. While psychoeducation may be beneficial, the patient's current symptoms require more immediate intervention for relapse management. The information provided does not directly indicate the chronic nature of his illness, but rather an acute exacerbation. Therefore, D is the most appropriate choice based on the presented symptoms and clinical understanding of schizophrenia.
After a person was abducted and raped at gunpoint by an unknown assailant, which assessment finding best indicates the acute phase of the rape-trauma syndrome?
- A. Decreased motor activity
- B. Confusion and disbelief
- C. Flashbacks and dreams
- D. Fears and phobias
Correct Answer: B
Rationale: The correct answer is B: Confusion and disbelief. During the acute phase of rape-trauma syndrome, the victim may experience feelings of confusion and disbelief as they try to process the traumatic event. This initial reaction is a common response to such a severe and violating experience. The victim may struggle to comprehend what has happened to them, leading to feelings of shock and disbelief. This phase is characterized by emotional numbing, disorientation, and difficulty in making decisions.
Decreased motor activity (Choice A) is not specific to the acute phase of rape-trauma syndrome and can be a general response to trauma. Flashbacks and dreams (Choice C) are more commonly associated with the intrusion phase of the syndrome, which occurs after the acute phase. Fears and phobias (Choice D) may develop later in the reorganization phase of the syndrome as the victim tries to cope with the aftermath of the trauma.