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A woman was abducted and raped at gunpoint by an unknown assailant. When found, she was confused and disoriented. The nurse makes the following observations about the client. She is talking rapidly in disjointed phrases, is unable to concentrate, and is indecisive when asked to make simple decisions. The client's level of anxiety can be assessed as
- A. moderate
- B. severe
- C. mild
- D. nonexistent
Correct Answer: B
Rationale: The client's presentation, including rapid and disjointed speech, inability to concentrate, and indecisiveness, are indicative of severe anxiety. These symptoms suggest a high level of distress and impairment in cognitive functioning, which aligns with severe anxiety rather than mild or moderate levels. The traumatic experience of being abducted and raped at gunpoint would likely contribute to such a severe level of anxiety.
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Which factors tend to increase the difficulty of diagnosing young children who demonstrate behaviors associated with mental illness? Select one that does not apply.
- A. Limited language skills
- B. Level of cognitive development
- C. Level of emotional development
- D. Parental denial that a problem exists
Correct Answer: D
Rationale: Diagnosing mental illness in young children can be complex due to their limited language skills, cognitive development, and emotional development. However, parental denial does not directly affect the child's inherent challenges, making it the factor that does not apply to the difficulty of diagnosis.
Which statement made by the nurse demonstrates the best understanding of nonverbal communication?
- A. The patient's verbal and nonverbal communication is often different.
- B. When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response.
- C. If a patient is slumped in the chair, I can be sure he's angry or depressed.
- D. It's easier to understand verbal communication than nonverbal communication.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Substance abuse is often present in individuals diagnosed with bipolar disorder. Laura, a 28-year-old with a bipolar disorder diagnosis, chooses to drink alcohol instead of taking her prescribed medications. The nurse caring for this patient recognizes that:
- A. Anxiety may be present.
- B. Alcohol ingestion is a form of self-medication.
- C. The patient is lacking a sufficient number of neurotransmitters.
- D. The patient is using alcohol as a coping mechanism.
Correct Answer: B
Rationale: Individuals with bipolar disorder may turn to alcohol as a form of self-medication to cope with their symptoms. This behavior is often seen as an attempt to manage mood swings and alleviate distress. It is important for healthcare providers to address and manage substance abuse issues in patients with bipolar disorder to ensure proper treatment and overall well-being.
Therapeutic communication is the foundation of a patient-centered interview. Which of the following techniques is not considered therapeutic?
- A. Restating
- B. Encouraging description of perception
- C. Summarizing
- D. Asking 'why' questions
Correct Answer: D
Rationale: Asking 'why' questions is not considered a therapeutic technique in patient-centered communication as it can make patients feel defensive or judged. 'Why' questions may imply criticism or put the patient on the spot, potentially hindering open and honest communication. Instead, focusing on open-ended questions that encourage patients to express their feelings and thoughts without feeling judged or interrogated is more conducive to therapeutic communication.
Which statement by the patient indicates a need for further teaching regarding the treatment of major depressive disorder?
- A. I have been on this antidepressant for 3 days. I understand that the full effect may take weeks to occur.
- B. I am going to ask my nurse practitioner to discontinue my Prozac today and let me start taking a monoamine oxidase inhibitor tomorrow.
- C. I may ask to have my medication changed to Wellbutrin due to the problems I am having being romantic with my wife.
- D. I realize that there are many antidepressants and it might take a while until we find the one that works best for me.
Correct Answer: B
Rationale: Choice B indicates a need for further teaching because the patient is planning to switch directly from Prozac, an SSRI, to a monoamine oxidase inhibitor (MAOI) without allowing for a washout period. This abrupt switch poses a risk of serotonin syndrome, which can be life-threatening. It is essential to educate the patient about the importance of consulting healthcare providers before changing medications to prevent potential adverse effects.