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A patient is scheduled to attend an occupational therapy group to work on the identified goal of “recognizing and using more effective coping techniques.” What measure can the nurse use to continue to support the patient’s attainment of this goal after he returns to the unit?
- A. Praising him for positive behavioral changes
- B. Avoiding setting limits that would increase his anxiety level
- C. Isolating him from more seriously ill patients
- D. Recommending that he avoid group activities for a while
Correct Answer: A
Rationale: The correct answer is A: Praising him for positive behavioral changes. This measure reinforces the patient's use of effective coping techniques, providing positive feedback and motivation. This positive reinforcement encourages the patient to continue utilizing these strategies.
Choices B, C, and D are incorrect:
B: Avoiding setting limits that would increase his anxiety level - This does not actively support the patient's goal of recognizing and using more effective coping techniques.
C: Isolating him from more seriously ill patients - Isolation does not promote the practice of coping techniques and may hinder the patient's social interaction and progress.
D: Recommending that he avoid group activities for a while - Avoiding group activities contradicts the goal of attending occupational therapy groups and working towards improved coping techniques.
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In response to the nurse’s statement, “Tell me about your family,” the patient became silent and displayed nonverbally that he is uncomfortable. Which statement by the nurse reflects sensitivity to the patient?
- A. “I’m so sorry. I didn’t realize your family was a problem for you.”
- B. “Learning to express negative feelings will assist you in getting well.”
- C. “Perhaps you can talk about your feelings to the physician next time you meet.”
- D. “That seems to be a difficult subject for you. We can discuss when you are
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the patient's discomfort without making assumptions or judgments. By recognizing the difficulty the patient is facing and offering to discuss it when they are ready, the nurse shows empathy and respect for the patient's feelings.
Choice A is incorrect because it assumes the family is a problem for the patient. Choice B is incorrect because it focuses on expressing negative feelings rather than addressing the patient's current discomfort. Choice C is incorrect because it deflects the conversation to the physician without addressing the patient's immediate needs.
A chronically depressed and suicidal client is admitted to a psychiatric unit. The client is scheduled for electroconvulsive therapy (ECT). During the course of ECT, a nurse should recognize the continued need for which critical intervention?
- A. Suicide assessment must continue throughout the ECT course.
- B. Antidepressant medications are contraindicated throughout the ECT course.
- C. Discourage expressions of hopelessness throughout the ECT course.
- D. Encourage a high-caloric diet throughout the ECT course.
Correct Answer: A
Rationale: The correct answer is A because suicide assessment must continue throughout the ECT course to ensure the safety and well-being of the client. During ECT, the client may experience changes in mood and behavior, which could impact their risk of suicide. It is essential for the nurse to monitor and assess the client's suicidal ideation and intent regularly. This ongoing assessment helps in identifying any exacerbation of suicidal thoughts and allows for timely intervention to prevent self-harm.
Choice B is incorrect because antidepressant medications are not necessarily contraindicated throughout the ECT course. In some cases, a client may still require antidepressants in addition to ECT for optimal treatment outcomes.
Choice C is incorrect because it is important to acknowledge and validate the client's feelings of hopelessness rather than discouraging them. By addressing and exploring these feelings, the nurse can provide support and facilitate the client's emotional processing.
Choice D is incorrect because encouraging a high-caloric diet is not directly related to the critical intervention needed during
When differentiating between bereavement symptoms and depression, the nurse will base the formulation on knowledge that in bereavement:
- A. Symptoms remit and exacerbate.
- B. Guilt feelings are overwhelming.
- C. Suicide thoughts are common.
- D. Psychomotor retardation is obvious.
Correct Answer: A
Rationale: The correct answer is A because in bereavement, symptoms of grief and sadness tend to come and go, known as remitting and exacerbating, as the individual processes the loss over time. This is a normal part of the grieving process. On the other hand, in depression, symptoms are persistent and may not improve without intervention. Guilt feelings being overwhelming (B) is common in both bereavement and depression. Suicide thoughts being common (C) can occur in severe depression but are not a distinguishing factor between bereavement and depression. Psychomotor retardation being obvious (D) is a symptom more commonly associated with severe depression rather than bereavement.
The wife of a patient diagnosed with paranoid schizophrenia asks: “I’ve been told that my husband’s illness is probably related to imbalanced brain chemicals. Can you be more specific?”
- A. Breakdown of dopamine produces LSD, which in large amounts produces psychosis
- B. Decreased amounts of the brain chemical dopamine explain the presence of delusions and hallucinations.
- C. An increase in the brain chemical dopamine explains the presence of delusions and hallucinations.
- D. An increase in the brain chemical dopamine explains the presence of lack of motivation and disordered affect
Correct Answer: C
Rationale: The correct answer is C: An increase in the brain chemical dopamine explains the presence of delusions and hallucinations. In paranoid schizophrenia, there is an overactivity of dopamine receptors in the brain, leading to an excess of dopamine. This excess dopamine is associated with symptoms like delusions and hallucinations. Therefore, an increase in dopamine levels is directly linked to these specific symptoms in individuals with paranoid schizophrenia.
Explanation for why the other choices are incorrect:
A: Breakdown of dopamine producing LSD does not directly relate to the symptoms of paranoid schizophrenia.
B: Decreased amounts of dopamine do not explain the presence of delusions and hallucinations in paranoid schizophrenia; it is the increase in dopamine that is associated with these symptoms.
D: An increase in dopamine is more closely related to delusions and hallucinations rather than lack of motivation and disordered affect in paranoid schizophrenia.
Discharge planning begins for an elderly patient hospitalized for 2 weeks diagnosed with major depression. The patient needs ongoing assessment and socialization opportunities as well as education about medication and relapse prevention. The patient lives with a daughter, who works during the week. Select the best referral for this patient.
- A. Behavioral health home care
- B. Partial hospitalization
- C. A skilled nursing facility
- D. A halfway house
Correct Answer: A
Rationale: The correct answer is A: Behavioral health home care. This option provides ongoing assessment, socialization opportunities, and education about medication and relapse prevention, which are all essential for the elderly patient with major depression. Additionally, it allows the patient to stay in their own home environment, promoting comfort and familiarity.
Option B: Partial hospitalization may not provide the ongoing support and socialization opportunities needed for the patient.
Option C: A skilled nursing facility may offer medical care but may not focus on mental health needs or socialization.
Option D: A halfway house is typically for individuals transitioning from addiction treatment and may not address the specific needs of an elderly patient with major depression.