Nokea
A nurse prepares a plan of care for a patient diagnosed with adult attention-deficit/hyperactivity disorder (ADHD). Which intervention should be included?
- A. Remind the patient of priorities and deadlines.
- B. Teach work-related skills such as basic computer literacy.
- C. Establish penalties for failing to organize and prioritize tasks.
- D. Give encouragement and strategies for managing and organizing.
Correct Answer: D
Rationale: The nurse's major responsibilities lie with encouraging the patient to learn and use necessary skills, assisting the patient to stay on task. The nurse is not an ever-present taskmaster or disciplinarian. The nurse does not teach work-related skills; vocational staff members assume those types of tasks.
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A nurse counsels a patient diagnosed with serious and persistent mental illness. The patient lives at home with family. Which resource could the nurse suggest assisting the patient and family to cope with the stigma of mental illness as well as provide support and education?
- A. American Psychiatric Association (APA)
- B. National Alliance on Mental Illness (NAMI)
- C. Community Mental Health Centers (CMHCs)
- D. Programs of Assertive Community Treatment (PACT)
Correct Answer: B
Rationale: Stigma represents the bias and prejudice commonly held regarding mental illness. NAMI actively seeks to dispel misconceptions about mental illness. The organization also offers patient and family support and education about living with mental illness. Community Mental Health Centers (CMHCs) are government agencies that provide outpatient services to persons diagnosed with SPMI. The APA is the professional organization of psychiatrists. Programs of Assertive Community Treatment (PACT) use a treatment team approach to improve symptom management and quality of life for persons diagnosed with SPMI.
A patient diagnosed with severe and persistent mental illness lives in a homeless shelter. The priority nursing diagnosis for this patient is Powerlessness. Which intervention should be included in the plan of care?
- A. Encourage mutual goal setting.
- B. Verbally communicate empathy.
- C. Reinforce participation in activities.
- D. Demonstrate an accepting attitude.
Correct Answer: A
Rationale: Mutual goal setting is an intervention designed to promote feelings of personal autonomy and dispel feelings of powerlessness. Although it might be easier and faster for the nurse to establish a plan and outcomes, this action contributes to the patient's sense of powerlessness. Involving the patient in decision making empowers the patient and reduces feelings of powerlessness.
A patient diagnosed with severe and persistent mental illness who recently moved to a homeless shelter says, 'My life is out of control. I'm like a leaf at the mercy of the wind.' The nurse formulates the diagnosis Powerlessness. Outcomes will focus on which goal?
- A. Instilling hope
- B. Controlling anxiety
- C. Planning social activities
- D. Developing personal autonomy
Correct Answer: D
Rationale: Powerlessness is associated with feeling unable to control events in one's life. It is often associated with low self-esteem. The goal is to increase one's sense of autonomy. The scenario does not indicate hopelessness or anxiety. Socialization is not the primary need.
Health maintenance and promotion efforts for patients diagnosed with severe mental illness should include education about the importance of what regular intervention?
- A. Home safety inspections
- B. Monitoring of self-care abilities
- C. Screening for cancer, hypertension, and diabetes
- D. Determination of adequacy of a patient's support system
Correct Answer: C
Rationale: Individuals diagnosed with severe and persistent mental illness have an increased prevalence of medical disorders. Patients should be taught the importance of regular visits to a primary care physician for screening for these illnesses. Home safety inspections are more often suggested for patients with physical impairments. Caregivers and family members usually evaluate self-care abilities, rather than the patient. Assessment of a patient's support system is not usually considered part of health promotion and maintenance.
An adult has been feeling significant tension since losing a home through foreclosure. This person goes to park, feeds the birds, and then impulsively exposes himself to a group of parents and children. Which term applies to this behavior?
- A. Voyeurism
- B. Frotteurism
- C. Exhibitionism
- D. Sexual masochism
Correct Answer: C
Rationale: Exhibitionism is obtaining sexual pleasure from exposing one's genitalia to unsuspecting strangers. Voyeurism refers to obtaining sexual pleasure from observing people who are naked. Frotteurism is associated with obtaining sexual arousal by rubbing one's genitals against an unsuspecting person. Sexual masochism refers to deriving sexual pleasure from being humiliated, beaten, or otherwise made to suffer.