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A patient diagnosed with a serious mental illness lives independently and attends a psychosocial rehabilitation program. The patient presents at the emergency department seeking hospitalization. The patient has no acute symptoms but says, 'I have no money to pay my rent or refill my prescription.' Select the nurses best action.
- A. Involve the patients case manager to provide crisis intervention
- B. Send the patient to a homeless shelter until housing can be arranged
- C. Arrange for a short in-patient admission and begin discharge planning
- D. Explain that one must have active psychiatric symptoms to be admitted
Correct Answer: A
Rationale: Impaired stress tolerance and problem-solving abilities can cause persons with SMI to experience relatively minor stressors as crises. This patient has run out of money, and this has overwhelmed her ability to cope, resulting in a crisis for which crisis intervention would be an appropriate response. Inpatient care is not clinically indicated nor is the patient homeless (although she may fear she is). Telling the patient that she is not symptomatic enough to be admitted may prompt malingering.
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A patient with schizophrenia has been stabilized in the Crisis Center and is about to be discharged. He will be living with his family, but the family knows nothing about the patient's illness, its treatment, or the role they can play in his recovery. Which activity would be most beneficial for the family to attend?
- A. Psychoanalytic group
- B. Psychoeducational group
- C. Individual counseling
- D. Family therapy
Correct Answer: B
Rationale: The correct answer is B: Psychoeducational group. This option is most beneficial as it will provide the family with education about schizophrenia, its treatment, and the role they can play in the patient's recovery. This will help the family better understand the illness, how to support the patient, and how to communicate effectively.
Explanation:
1. Psychoanalytic group (A) focuses on exploring unconscious thoughts and emotions, which may not be as practical or helpful for educating the family about schizophrenia.
2. Individual counseling (C) may not involve the family as a whole and may not provide the necessary education and support for the family unit.
3. Family therapy (D) could be beneficial, but psychoeducational group specifically targets providing knowledge and skills needed to support the patient's recovery, making it the most appropriate choice in this scenario.
A client admitted with delusions, hallucinations, and thought disorder has the admitting diagnosis schizophreniform disorder R/O organic pathology. Based on this information, the nurse can expect that the client will:
- A. Undergo an MRI test
- B. Have psychological testing
- C. Have an immunologic assay performed
- D. Participate in a dexamethasone suppression test
Correct Answer: A
Rationale: Step 1: The client is admitted with symptoms suggestive of a psychotic disorder, specifically schizophreniform disorder.
Step 2: The admitting diagnosis includes ruling out organic pathology, indicating a need to investigate potential physical causes.
Step 3: An MRI test is a non-invasive imaging procedure that can help identify any structural abnormalities in the brain.
Step 4: This test is appropriate in ruling out organic causes of the symptoms presented by the client.
Step 5: Psychological testing (Choice B) is more focused on assessing cognitive and emotional functioning, not ruling out organic pathology.
Step 6: Immunologic assay (Choice C) is used to detect antibodies or antigens in the blood, not typically relevant in this context.
Step 7: Dexamethasone suppression test (Choice D) is used to assess for abnormalities related to cortisol levels in conditions like depression, not specific to ruling out organic pathology in psychotic disorders.
Summary: Choice A is correct because an MRI test is the most relevant
Which of the following is the most effective strategy to prevent relapse in anorexia nervosa?
- A. Focusing solely on weight gain.
- B. Providing a structured meal plan and ongoing emotional support.
- C. Encouraging weight loss to maintain control.
- D. Limiting the patient's exposure to food-related discussions.
Correct Answer: B
Rationale: The correct answer is B because providing a structured meal plan and ongoing emotional support addresses both the physical and psychological aspects of anorexia nervosa. Structured meal plans help establish healthy eating habits, while emotional support addresses underlying triggers and promotes mental well-being. Focusing solely on weight gain (A) neglects the emotional component of the disorder. Encouraging weight loss (C) reinforces harmful behaviors. Limiting food-related discussions (D) does not address the root causes of anorexia nervosa. In summary, B is the most effective strategy as it tackles both the physical and emotional aspects of the disorder.
Which of the following combines the best treatments for postpartum blues?
- A. Antidepressants, sleep, crisis intervention
- B. Rest, support, compassion
- C. Mother-baby bonding session, family education, antidepressants
- D. Analgesics for post-delivery pain, rest, longer hospital stay
Correct Answer: B
Rationale: Antidepressants have no use in postpartum blues (A, C). Rest, support, and compassion (B) are the main interventions for this self-limiting condition, unlike analgesics or extended hospital stays (D).
Which of the following is related to recent attempts to find biochemical explanations for schizophrenia?
- A. schizotaxin
- B. psychotropin
- C. dopamine
- D. diazepam
Correct Answer: C
Rationale: Dopamine excess in the brain is a leading biochemical theory for schizophrenia, supported by antipsychotic efficacy.