A patient is being educated about the difference between mental health and mental illness. Which statement by the patient reflects an accurate understanding of mental health?
- A. Mental health is the absence of any stressors.
- B. Mental health is successful adaptation to stressors in the internal and external environment.
- C. Mental health is incongruence between thoughts, feelings, and behavior.
- D. Mental health is a diagnostic category in the DSM-5.
Correct Answer: B
Rationale: The correct answer is B. Mental health is defined as the successful adaptation to stressors in the internal and external environment. This includes having thoughts, feelings, and behaviors that are age-appropriate and congruent with cultural and societal norms. Mental health is not solely the absence of stressors or incongruence between thoughts, feelings, and behavior, nor is it a specific diagnostic category in the DSM-5. Choice A is incorrect because mental health is not just the absence of stressors but the ability to adapt to them. Choice C is wrong as mental health involves congruence, not incongruence, between thoughts, feelings, and behaviors. Choice D is inaccurate as mental health is a broader concept than a specific diagnostic category in the DSM-5.
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A client diagnosed with schizophrenia is prescribed an antipsychotic medication. Which of the following side effects should the nurse monitor for? Select one that doesn't apply.
- A. Tardive dyskinesia
- B. Muscle tension
- C. Orthostatic hypotension
- D. Hyperglycemia
Correct Answer: B
Rationale: Side effects of antipsychotic medications commonly include tardive dyskinesia, orthostatic hypotension, and hyperglycemia. Muscle tension is not typically associated with antipsychotic medication use. Tardive dyskinesia is characterized by involuntary movements, orthostatic hypotension refers to a drop in blood pressure upon standing, and hyperglycemia indicates high blood sugar levels. Monitoring these side effects is crucial for early detection and management, but muscle tension is not a typical side effect of antipsychotic medications.
A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data?
- A. The client is experiencing severe distress and is at risk for physical and psychological illness.
- B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness.
- C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports.
- D. The client may view these losses as challenges and perceive them as opportunities.
Correct Answer: C
Rationale: The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500 or more, indicates high stress in a client's life. However, susceptibility to stress-related physical or psychological illness cannot be accurately estimated without considering the individual's coping resources and available support systems. Positive coping mechanisms and strong social support can mitigate the risk of stress-related illnesses even in the face of significant life changes and losses. Choice A is incorrect because it makes a definitive statement about the client's state without considering individual coping mechanisms and support. Choice B is incorrect because a score of 110 does not necessarily mean no threat of stress-related illness, as individual factors play a crucial role. Choice D is incorrect as it assumes a positive outlook without acknowledging the potential impact of the experienced losses on stress levels.
Which symptom should a healthcare provider identify as typical of the fight-or-flight response?
- A. Pupil dilation
- B. Increased heart rate
- C. Decreased salivation
- D. Decreased peristalsis
Correct Answer: B
Rationale: The correct answer is B: Increased heart rate. During the fight-or-flight response, the sympathetic nervous system is activated, causing the release of epinephrine. This hormone triggers an increase in heart rate to supply more blood to the muscles for a rapid response. Pupil dilation occurs to enhance vision in preparation for quick reactions. On the other hand, salivation and peristalsis decrease as the body prioritizes functions necessary for immediate action rather than digestion-related activities. Therefore, choices A, C, and D are incorrect as they do not align with the typical physiological changes associated with the fight-or-flight response.
In evaluating a client's response to stress, what would indicate a secondary appraisal of the stressful event?
- A. When the individual judges the event to be benign
- B. When the individual judges the event to be irrelevant
- C. When the individual judges the resources and skills needed to deal with the event
- D. When the individual judges the event to be pleasurable
Correct Answer: C
Rationale: A secondary appraisal occurs when an individual evaluates the resources and skills required to cope with a stressful event. This type of appraisal focuses on the person's perceived ability to manage the situation. In contrast, choices A, B, and D do not involve the assessment of resources and skills. Choice A relates to a benign judgment of the event, choice B to an irrelevant judgment, and choice D to a pleasurable judgment, which are aspects of primary rather than secondary appraisals.
Which of the following symptoms should a healthcare provider expect to assess in a client diagnosed with generalized anxiety disorder (GAD)? Select one that doesn't apply.
- A. Excessive worry
- B. Muscle tension
- C. Increased energy
- D. Restlessness
Correct Answer: C
Rationale: Symptoms of generalized anxiety disorder include excessive worry, muscle tension, restlessness, and irritability. Increased energy is not typically associated with GAD; clients often experience fatigue instead. This heightened energy level is more commonly seen in conditions like mania or hypomania, rather than in GAD. Therefore, the correct answer is 'Increased energy.' Choices A, B, and D are all symptoms commonly observed in individuals with generalized anxiety disorder.