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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.
You may also like to solve these questions
Schizophrenia affects approximately _____% of the world's population.
- A. 1
- B. 5
- C. 9
- D. 13
Correct Answer: A
Rationale: The correct answer is A (1%). Schizophrenia affects around 1% of the world's population, according to research. This prevalence rate has been consistently reported across different studies and populations. It is a chronic and severe mental disorder, but it is not as common as other mental health conditions. Choices B, C, and D (5%, 9%, 13%) are incorrect because they overestimate the prevalence of schizophrenia. These percentages are much higher than the actual documented rate, which is closer to 1%.
When a victim of sexual assault is discharged from the emergency department, the nurse should:
- A. Notify the patient's family of the event to ensure support for the patient.
- B. Offer to stay with the patient until stability is regained.
- C. Advise the patient to try not to think about the assault.
- D. Provide referral information verbally and in writing.
Correct Answer: D
Rationale: The correct answer is D because providing referral information verbally and in writing ensures that the victim has access to appropriate resources for follow-up care and support. This step is crucial in helping the victim navigate the emotional and physical aftermath of the assault.
A: Notifying the patient's family without the patient's consent could violate the patient's privacy and autonomy.
B: While offering to stay with the patient shows support, it may not always be feasible and may not address the victim's long-term needs.
C: Advising the patient to try not to think about the assault is dismissive of their trauma and does not provide constructive support.
A consumer at a rehabilitative psychosocial program says to the nurse, 'People are not cleaning up behind themselves in the bathrooms. The building is dirty and cluttered.' How should the nurse respond?
- A. Encourage the consumer to discuss it at a meeting with everyone
- B. Hire a professional cleaning service to clean the restrooms
- C. Address the complaint at the next staff meeting
- D. Tell the consumer, 'Thats not my problem'
Correct Answer: A
Rationale: Consumer-run programs range from informal clubhouses, which offer socialization and recreation, to competitive businesses, such as snack bars or janitorial services, which provide needed services and consumer employment while encouraging independence and building vocational skills. Consumers engage in problem solving under the leadership of staff.
A family has noted the following behaviors in one of their elderly parents: periodic indecisiveness, forgetfulness, mild transient confusion, occasional misperception, distractibility, and occasional unclear thinking. Where on the continuum of cognitive responses would this patient be?
- A. At point 1
- B. At point 2
- C. At point 3
- D. There is insufficient information to make a determination.
Correct Answer: B
Rationale: The correct answer is B: At point 2. This patient's symptoms indicate mild cognitive impairment, which falls between normal age-related decline (point 1) and dementia (point 3). Mild cognitive impairment involves noticeable cognitive changes but does not significantly interfere with daily functioning. Point 1 is too mild for the symptoms described, and point 3 is too severe as the patient's symptoms are not indicative of full-blown dementia. Therefore, the patient is best placed at point 2 on the continuum of cognitive responses.
An elderly woman is brought to the clinic by her daughter. The client states that she has had a cold for several days. Her daughter states that her mother has been confused about when her routine medications are to be taken and that her mother has never experienced confusion about her medications before. Based on this information, it is important that the nurse ask the client whether:
- A. There is a history of mental illness in the family
- B. She has been given a diagnosis of a mental health disorder in the past
- C. She can recall her last visit to a physician
- D. She has taken any over-the-counter medications for her cold
Correct Answer: D
Rationale: The correct answer is D: She has taken any over-the-counter medications for her cold. It is important for the nurse to ask this question because over-the-counter medications can sometimes interact with prescription medications, leading to confusion or other cognitive issues in elderly patients. By identifying any OTC medications the client has taken, the nurse can assess potential drug interactions that may be contributing to the confusion.
Choices A, B, and C are incorrect. History of mental illness in the family or a previous diagnosis of mental health disorder may not directly address the current issue of confusion related to medication management. Asking about the last visit to a physician is also less relevant compared to inquiring about current medication use for a potential cause of confusion.