Nokea
A nurse cares for a patient diagnosed with paraphilia. The nurse expects the health care provider may prescribe which type of medication to reduce paraphilic behaviors?
- A. Stimulants
- B. Erectile dysfunction medication
- C. Atypical antipsychotic medication
- D. Mood stabilizer
Correct Answer: D
Rationale: Pharmacological treatment typically involves medications that reduce impulsive or compulsive behavior, such as antidepressants, naltrexone, antipsychotics, mood stabilizers, or medications that interfere with the production of sexual hormones in order to reduce sexual urges. The other medications are not indicated for this disorder.
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For patients diagnosed with severe and persistent mental illness, what is the major advantage of case management?
- A. Modification of traditional psychotherapy
- B. Efficient access and use of resources
- C. Focus on social skills training and self-esteem building
- D. Bringing groups of patients together to discuss common problems
Correct Answer: B
Rationale: The case manager not only provides entrance into the system of care, but he or she also coordinates the multiple referrals that so often confuse the patient who is severely and persistently mentally ill and the patient's family. Case management promotes the efficient use of services. The other options are lesser advantages or may be irrelevant.
Which economic factors are most critical to the success of discharge planning for a patient diagnosed with severe and persistent mental illness?
- A. Access to housing
- B. Individual psychotherapy
- C. Income to meet basic needs
- D. Availability of health insurance
- E. Ongoing interdisciplinary evaluation
Correct Answer: A,C,D
Rationale: The success of discharge planning requires careful attention to the patient's economic status. Access to housing is the first priority of the seriously mentally ill, and lack of income and health insurance is a barrier to effective treatment and rehabilitation. Although important aspects of ongoing care of the seriously mentally ill patient, ongoing interdisciplinary evaluation and individual psychotherapy are not economic factors.
The treatment team believes medication will help a patient diagnosed with adult attention-deficit/hyperactivity disorder (ADHD). Which class of medications does the nurse expect will be prescribed?
- A. Benzodiazepines
- B. Stimulants
- C. Antipsychotics
- D. Anxiolytics
Correct Answer: B
Rationale: Stimulants, such as methylphenidate and amphetamines, provide the basis for treatment of both adult and childhood ADHD. They are the most commonly used medications; therefore, the nurse could expect the health care provider to prescribe a drug in this class. None of the other drugs listed as options have proved useful in the treatment of ADHD.
An adult says, 'When I was a child, I took medication because I couldn't follow my teachers' directions. I stopped taking it when I was about 13. I still have trouble getting organized, which causes difficulty at my job.' Which disorder is most likely?
- A. Stress intolerance disorder
- B. Generalized anxiety disorder (GAD)
- C. Borderline personality disorder
- D. Adult attention-deficit/hyperactivity disorder (ADHD)
Correct Answer: D
Rationale: Adult ADHD is usually diagnosed in early life and treated until adolescence. Treatment is often stopped because professionals think the disorder resolves itself because the hyperactive impulsive behaviors may diminish; the inattentive and disorganized behaviors tend to persist, however. Stress intolerance disorder is not found in the DSM-5. The scenario description is inconsistent with generalized anxiety disorder and borderline personality disorder.
How is severe and persistent mental best characterized?
- A. Mental illness with longer than 2 weeks' duration.
- B. Major ongoing mental illness marked by significant functional impairments.
- C. Mental illness accompanied by physical impairment and severe social problems.
- D. Major mental illness that cannot be treated to prevent deterioration of cognitive and social abilities.
Correct Answer: B
Rationale: Severe mental illness' has replaced the phrase 'chronic mental illness.' Global impairments in function are evident, including social skills. Physical impairments may or may not be present. Severe mental illness can be treated, but remissions and exacerbations are part of the course of the illness. The distractors fail to effectively address the issue of functional impairment.