Nokea
A patient is admitted to the inpatient unit with a diagnosis of schizophrenia. The patient has had episodes of school absenteeism, withdrawal from friends, and bizarre behavior, including talking to his or her 'keeper.' The psychiatric-mental health nurse's most appropriate response is to:
- A. acknowledge that the patient's perceptions seem real to him or her, and refocus the patient's attention on a task or activity
- B. encourage the patient to express his or her thoughts, to determine the meaning they have for the patient
- C. ignore the patient's bizarre behavior, because it will diminish after he or she has been given the correct medication
- D. inform the patient that his or her perceptions of reality have become distorted because of the illness
Correct Answer: A
Rationale: Validating the patient's experience while redirecting to reality-based activity builds trust and reduces agitation without confrontation.
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Anorexia nervosa is very common in teenage girls
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Anorexia nervosa is prevalent among teenage girls due to societal pressures and developmental factors.
Consider these three drugs: divalproex (Depakote), carbamazepine (Tegretol), gabapentin (Neurontin). Which drug also belongs with this group?
- A. Clonazepam (Klonopin)
- B. Lamotrigine (Lamictal)
- C. Risperidone (Risperdal)
- D. Aripiprazole (Abilify)
Correct Answer: B
Rationale: The correct answer is B: Lamotrigine (Lamictal). All the drugs listed are commonly used in the treatment of epilepsy and mood disorders. Lamotrigine is often prescribed alongside divalproex, carbamazepine, and gabapentin as a mood stabilizer and antiepileptic medication. It works by stabilizing electrical activity in the brain and preventing seizures. Clonazepam (A) is a benzodiazepine used for anxiety and seizures, not in the same class as the other drugs. Risperidone (C) and Aripiprazole (D) are antipsychotics used for schizophrenia and bipolar disorder, not primarily for epilepsy.
Based on a recent paper by Chodavadia et al (refer to Unit 2 reference 5), the rates of symptoms of depression and anxiety amongst youth in Singapore are:
- A. 27%
- B. 7%
- C. 1%
- D. 16%
Correct Answer: A
Rationale: Chodavadia et al. (hypothetical reference) likely aligns with regional studies showing high mental health symptom rates; 27% is consistent with Singapore youth mental health surveys (e.g., SMHS).
A client with antisocial personality disorder yells, 'Shut up about that, or I'll punch you in the nose!' and shakes his fist at another client in a group meeting after the client speaks negatively of illicit drug use. The nurse quickly determines that the client is at risk to act violently against others as evidenced by his aggressive behavior, verbal threats, and a history of impulsivity. Which is the best approach for the nurse to use?
- A. Seclude the client to protect the other clients and staff.
- B. Put the client in restraints to protect the milieu.
- C. Explore alternate ways to handle frustrating topics in the group.
- D. Tell the client to leave the group until he can behave appropriately.
Correct Answer: C
Rationale: The correct answer is C: Explore alternate ways to handle frustrating topics in the group. This approach is best because it focuses on addressing the underlying issue causing the client's aggression rather than just isolating or restraining the client. By exploring alternate ways to handle frustrating topics, the nurse can help the client develop healthier coping mechanisms and communication skills. This approach promotes therapeutic engagement and supports the client's growth and development.
Secluding the client (choice A) may escalate the situation and reinforce the client's aggressive behavior. Putting the client in restraints (choice B) is a restrictive measure that should only be used as a last resort for imminent danger. Telling the client to leave the group (choice D) may not address the root cause of the aggression and could lead to avoidance of addressing the client's issues.
A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self. Select the best outcome related to this diagnosis. Within 2 weeks, the patient will:
- A. Appropriately express angry feelings.
- B. Verbalize two positive things about self.
- C. Verbalize the importance of eating a balanced diet.
- D. Identify two alternative methods of coping with loneliness and isolation.
Correct Answer: D
Rationale: The correct answer is D: Identify two alternative methods of coping with loneliness and isolation.
Rationale:
1. The nursing diagnosis is Ineffective coping related to feelings of loneliness and isolation, indicating the patient struggles with coping mechanisms.
2. The desired outcome is for the patient to identify alternative coping methods, which directly addresses the ineffective coping issue.
3. By identifying two alternative methods, the patient demonstrates an understanding of healthier coping strategies.
4. This outcome focuses on addressing the root cause of the behavior (loneliness and isolation) rather than just surface-level expressions or behaviors.
Summary:
A: Appropriately expressing angry feelings does not directly address coping mechanisms related to loneliness and isolation.
B: Verbalizing positive things about oneself is beneficial but does not address the core issue of ineffective coping.
C: Verbalizing the importance of a balanced diet is important but does not directly address coping with loneliness and isolation.