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A patient is admitted to the psychiatric hospital. Which assessment finding best indicates that the patient has a mental illness? The patient:
- A. describes coping and relaxation strategies used when feeling anxious.
- B. describes mood as consistently sad, discouraged, and hopeless.
- C. can perform tasks attempted within the limits of own abilities.
- D. reports occasional problems with insomnia.
Correct Answer: B
Rationale: A patient who reports having a consistently negative mood is describing a mood alteration that affects the ability to function optimistically. The incorrect options describe mentally healthy behaviors and common problems that do not indicate mental illness.
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In the majority culture of the United States, which individual is at greatest risk to be incorrectly labeled mentally ill?
- A. Person who is usually pessimistic but strives to meet personal goals.
- B. Wealthy person who gives $20 bills to needy individuals in the community.
- C. Person with an optimistic viewpoint about getting his or her own needs met.
- D. Person who expresses strong beliefs about the existence of alien abductions.
Correct Answer: D
Rationale: Possessing and expressing unpopular or unsubstantiated beliefs often suggests an individual is mentally unstable. In this situation, cultural norms vary, making it more difficult to make an accurate DSM-5 diagnosis. The individuals described in the other options are less likely to be labeled as mentally ill.
A patient tells a nurse, 'I have psychiatric problems and am in and out of hospitals all the time. Not one of my friends or relatives has these problems.' What is the nurse's best response?
- A. Comparing yourself with others has no real advantages.
- B. Why do you blame yourself for having a psychiatric illness?
- C. Mental illness affects 50% of the adult population in any given year.
- D. Are you are concerned that others don't experience the same challenges as you.
Correct Answer: D
Rationale: Mental illness affects many people at various times in their lives. No class, culture, or creed is immune to the challenges of mental illness. The correct response also demonstrates the use of reflection, a therapeutic communication technique. It is not true that mental illness affects 50% of the population in any given year. Asking patients if they blame themselves is an example of probing.
A participant at a community education conference asks, 'What is the most prevalent type of mental disorder in the United States?' What is the nurse's best response?
- A. Why do you ask?
- B. Schizophrenia
- C. Affective disorders
- D. Anxiety disorders
Correct Answer: D
Rationale: The prevalence for schizophrenia is 1.1% per year. The prevalence of all affective disorders (e.g., depression, dysthymic disorder, bipolar) is 9.5%. The prevalence of anxiety disorders is 18.1%.
A nurse wants to find a description of diagnostic criteria for a person diagnosed with schizophrenia. Which resource should the nurse consult?
- A. U.S. Department of Health and Human Services
- B. Journal of the American Psychiatric Association
- C. North American Nursing Diagnosis Association International (NANDA-I)
- D. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Correct Answer: D
Rationale: The DSM-5 identifies diagnostic criteria for psychiatric diagnoses. The other sources have useful information but are not the best resources for finding a description of the diagnostic criteria for a psychiatric disorder.
A nurse must assess several new patients at a community mental health center. Conclusions concerning current functioning should be made on the basis of what factor?
- A. The degree of conformity of the individual to society's norms.
- B. The degree to which an individual appears logical and rational.
- C. A continuum from mentally healthy to mentally unhealthy.
- D. The rate of their intellectual and emotional growth.
Correct Answer: C
Rationale: Because mental health and mental illness are relative concepts, assessment of functioning is made by using a continuum. Mental health is not based on conformity; some mentally healthy individuals do not conform to society's norms. Most individuals occasionally display illogical or irrational thinking. The rate of intellectual and emotional growth is not the most useful criterion to assess mental health or mental illness.