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A patient has disorganized thinking associated with schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain?
- A. Hippocampus
- B. Frontal lobe
- C. Cerebellum
- D. Brainstem
Correct Answer: B
Rationale: The correct answer is B: Frontal lobe. Disorganized thinking in schizophrenia is often associated with executive function deficits, which are primarily controlled by the frontal lobe. This area is responsible for decision-making, problem-solving, and reasoning. Dysfunction here can lead to disorganized thoughts and behaviors. The other choices, such as the hippocampus (A), involved in memory, the cerebellum (C), involved in motor coordination, and the brainstem (D), involved in basic life functions, are less likely to be directly related to disorganized thinking in schizophrenia.
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A nurse assesses four patients between the ages of 70 and 80. Which patient has the highest risk for alcohol abuse? The patient who:
- A. consumes 1 glass of wine nightly with dinner
- B. began drinking alcohol daily after retirement and says, 'A few drinks keep my mind off my arthritis.'
- C. drank socially throughout adult life and continues this pattern, saying 'Ive earned the right to do as I please.'
- D. abused alcohol between the ages of 25 and 40 but now abstains and occasionally attends Alcoholics Anonymous (AA)
Correct Answer: B
Rationale: Alcohol abuse and dependence can develop at any age, and the geriatric population is particularly at risk. Losses, such as retirement, widowhood, and loneliness, are often related. The distracters describe patients with a lower risk for alcohol abuse.
A patient with schizophrenia who admits to auditory hallucinations anxiously tells the nurse, 'The voice is telling me to do things.' Which of the following responses should the nurse make next?
- A. Do you recognize the voice you hear?'
- B. How long has this been happening?'
- C. Does what the voice tells you to do frighten you?'
- D. What is the voice telling you to do?'
Correct Answer: D
Rationale: The correct answer is D: "What is the voice telling you to do?" This response helps the nurse assess the content and potential danger of the hallucinations, guiding further interventions. Option A focuses on recognition, which is less urgent. Option B addresses duration, not immediate safety. Option C inquires about fear but does not directly address the hallucination's content. By asking what the voice commands, the nurse gains crucial insight for risk assessment and safety planning.
The psychiatric-mental health nurse, who is teaching a patient's parents how to use positive reinforcement techniques with the patient, recommends:
- A. agreeing with the child's statements, whether negative or positive, and simply restating the child's statements without other comment
- B. controlling the child's behavior, so there is no chance of negative behavior
- C. removing adverse consequences to produce positive results
- D. rewarding positive behaviors to promote their recurrence
Correct Answer: D
Rationale: Positive reinforcement rewards desired behaviors, increasing their frequency, a core behavioral strategy.
Adolescents often cite barriers for discussing psychosocial issues with their physician. If confidentiality is addressed, which of the following do adolescents NOT cite as a barrier:
- A. Non-judgemental approach of physician
- B. Personal embarrassment towards discussing sensitive topics
- C. Physician seems rushed
- D. Physician did not ask about sensitive topics
Correct Answer: A
Rationale: A non-judgmental approach facilitates discussion and is not a barrier, unlike embarrassment, time constraints, or perceived lack of understanding.
A person diagnosed with a serious mental illness (SMI) living in the community was punched, pushed to the ground, and robbed of 7 during the day on a public street. Which statements about violence and serious mental illness in general are accurate? Select one tha does not apply.
- A. Persons with SMI are more likely to be violent
- B. SMI persons experience higher rates of sexual assault and victimization than others
- C. Impaired judgment and social skills can provoke hostile or assaultive behavior
- D. Lower incomes force SMI persons to live in high-crime areas, increasing risk
Correct Answer: A
Rationale: Mentally ill persons are more likely to be victims of crime than perpetrators of criminal acts. They are often victims of criminal behavior, including sexual crimes, at a higher rate than others. When a mentally ill person commits a crime, it is usually nonviolent. Mental illnesses interfere with employment and are associated with poverty, limiting SMI persons to living in inexpensive areas that also tend to be higher-crime areas. SMI persons may inadvertently provoke others because of poor judgment or socially inappropriate behavior, or they may be victimized because they are perceived as passive, less likely to resist, and less likely to be believed as witnesses.