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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.
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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 critical care nurse asks a psychiatric nurse about the difference between a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and a nursing diagnosis. What is the psychiatric nurse's best response?
- A. No functional difference exists between the two diagnoses. Both serve to identify a human deviance.
- B. The DSM-5 diagnosis disregards culture, whereas the nursing diagnosis includes cultural variables.
- C. The DSM-5 diagnosis profiles present distress or disability, whereas a nursing diagnosis considers past and present responses to actual mental health problems.
- D. The DSM-5 diagnosis influences the medical treatment; the nursing diagnosis offers a framework to identify interventions for problems a patient has or may experience.
Correct Answer: D
Rationale: The medical diagnosis, defined according to the DSM-5, is concerned with the patient's disease state, causes, and cures, whereas the nursing diagnosis focuses on the patient's response to stress and possible caring interventions. Both the DSM-5 and a nursing diagnosis consider culture. Nursing diagnoses also consider potential problems.
An 86 year old, previously healthy and independent, falls after an episode of vertigo. Which statement made by this patient best demonstrates resilience?
- A. I knew this would happen eventually.
- B. Attending my weekly water aerobics class is too risky.
- C. I don't need that silly walker to get around by myself.
- D. Maybe some physical therapy will help me with my balance.
Correct Answer: D
Rationale: Resiliency is the ability to recover from or adjust to misfortune and change. The correct response indicates that the patient is hopeful and thinking positively about ways to adapt to the vertigo. Saying 'I knew this would happen eventually' and discontinuing healthy activities suggest a hopeless perspective on the health change. Refusing to use a walker indicates denial.
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.
A patient tells a nurse, 'I have psychiatric problems and am in and out of hospitals all the time. Not one of my friends or relatives has these problems.' What is the nurse's best response?
- A. Comparing yourself with others has no real advantages.
- B. Why do you blame yourself for having a psychiatric illness?
- C. Mental illness affects 50% of the adult population in any given year.
- D. Are you are concerned that others don't experience the same challenges as you.
Correct Answer: D
Rationale: Mental illness affects many people at various times in their lives. No class, culture, or creed is immune to the challenges of mental illness. The correct response also demonstrates the use of reflection, a therapeutic communication technique. It is not true that mental illness affects 50% of the population in any given year. Asking patients if they blame themselves is an example of probing.