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A nurse at a behavioral health clinic sees an unfamiliar psychiatric diagnosis on a patient's insurance form. Which resource should the nurse consult to discern the criteria used to establish this diagnosis?
- A. A psychiatric nursing textbook
- B. NANDA International (NANDA-I)
- C. A behavioral health reference manual
- D. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Correct Answer: D
Rationale: The DSM-5 gives the criteria used to diagnose each mental disorder. The NANDA-I focuses on nursing diagnoses. A psychiatric nursing textbook or behavioral health reference manual may not contain diagnostic criteria.
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A patient is admitted to the psychiatric hospital. Which assessment finding best indicates that the patient has a mental illness? The patient:
- A. describes coping and relaxation strategies used when feeling anxious.
- B. describes mood as consistently sad, discouraged, and hopeless.
- C. can perform tasks attempted within the limits of own abilities.
- D. reports occasional problems with insomnia.
Correct Answer: B
Rationale: A patient who reports having a consistently negative mood is describing a mood alteration that affects the ability to function optimistically. The incorrect options describe mentally healthy behaviors and common problems that do not indicate mental illness.
A nurse wants to find a description of diagnostic criteria for a person diagnosed with schizophrenia. Which resource should the nurse consult?
- A. U.S. Department of Health and Human Services
- B. Journal of the American Psychiatric Association
- C. North American Nursing Diagnosis Association International (NANDA-I)
- D. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Correct Answer: D
Rationale: The DSM-5 identifies diagnostic criteria for psychiatric diagnoses. The other sources have useful information but are not the best resources for finding a description of the diagnostic criteria for a psychiatric disorder.
A nurse must assess several new patients at a community mental health center. Conclusions concerning current functioning should be made on the basis of what factor?
- A. The degree of conformity of the individual to society's norms.
- B. The degree to which an individual appears logical and rational.
- C. A continuum from mentally healthy to mentally unhealthy.
- D. The rate of their intellectual and emotional growth.
Correct Answer: C
Rationale: Because mental health and mental illness are relative concepts, assessment of functioning is made by using a continuum. Mental health is not based on conformity; some mentally healthy individuals do not conform to society's norms. Most individuals occasionally display illogical or irrational thinking. The rate of intellectual and emotional growth is not the most useful criterion to assess mental health or mental illness.
In the majority culture of the United States, which individual is at greatest risk to be incorrectly labeled mentally ill?
- A. Person who is usually pessimistic but strives to meet personal goals.
- B. Wealthy person who gives $20 bills to needy individuals in the community.
- C. Person with an optimistic viewpoint about getting his or her own needs met.
- D. Person who expresses strong beliefs about the existence of alien abductions.
Correct Answer: D
Rationale: Possessing and expressing unpopular or unsubstantiated beliefs often suggests an individual is mentally unstable. In this situation, cultural norms vary, making it more difficult to make an accurate DSM-5 diagnosis. The individuals described in the other options are less likely to be labeled as mentally ill.
The partner of a patient diagnosed with schizophrenia says, 'I don't understand why childhood experiences have anything to do with this disabling illness.' Which nurse's response will best help the partner understand this condition?
- A. Psychological stress is actually at the root of most mental disorders.
- B. We now know that all mental illnesses are the result of genetic factors.
- C. It must be frustrating for you that your spouse is sick so much of the time.
- D. Research has shown schizophrenia has a biological rather than psychological origin.
Correct Answer: D
Rationale: Many of the most prevalent and disabling mental disorders have been found to have strong biological influences. Helping the partner understand the importance of his or her role as a caregiver is also important. Empathy is important but does not increase the spouse's level of knowledge about the cause of the patient's condition. Not all mental illnesses are the result of genetic factors. Psychological stress is not at the root of most mental disorders.