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A patient receives a court order for commitment. Which of the following best exemplifies the concept of `least restrictive environment?
- A. Involuntary commitment to an outpatient community mental health center
- B. Medication administration for sedation so the patient cannot get out of bed
- C. Placing the patient in a locked padded room in response to threats of self-harm
- D. Allowing the patient to make the decision about whether treatment is necessary
Correct Answer: A
Rationale: The correct answer is A because involuntary commitment to an outpatient community mental health center provides treatment while allowing the patient to remain in the community and maintain some level of freedom. This option aligns with the principle of the least restrictive environment by balancing the patient's need for treatment with their rights and autonomy.
Option B is incorrect as sedating a patient to prevent them from getting out of bed is overly restrictive and limits their freedom unnecessarily. Option C is also incorrect as placing a patient in a locked padded room is highly restrictive and does not promote autonomy or community integration. Option D is incorrect because allowing the patient to decide on treatment, while important, may not always align with their best interests in cases of severe mental illness requiring involuntary commitment for safety and treatment.
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A nursing instructor is describing the DSM-IV-TR to a group of nursing students. Which of the following would the instructor include as the primary purpose of this classification?
- A. Provide a commonly understood diagnostic category for clinical practice.
- B. Describe treatment modalities for psychiatric disorders and mental illnesses.
- C. Identify various etiologies for mental disorders based on family histories.
- D. Provide optimal outcomes for treatment for individuals with mental illnesses.
Correct Answer: A
Rationale: The correct answer is A: Provide a commonly understood diagnostic category for clinical practice. The primary purpose of the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) is to establish a standardized system for classifying mental disorders to aid clinicians in diagnosis and treatment. It provides a common language and criteria for mental health professionals to communicate effectively and ensure consistency in diagnosis.
Choice B is incorrect because the DSM-IV-TR focuses on diagnostic criteria rather than treatment modalities. Choice C is incorrect as the DSM-IV-TR does not primarily focus on identifying etiologies but rather on classification. Choice D is incorrect as the manual does not provide specific outcomes for treatment but rather aids in diagnosing mental disorders.
A psychiatric-mental health nurse working in a Veteran’s Administration Medical Center is meeting with a military wife who is an Asian American. The woman is to be joining a support group for wives of veterans who have posttraumatic stress syndrome. When asking her to describe her husband’s mental health problems, which response would the nurse most likely expect?
- A. `Oh, he may seem depressed, but it is just a vitamin deficiency. It runs in his family.
- B. `I know the war messed his mind up. He’ll never be the same.
- C. `Sometimes he hallucinates that he is back in Vietnam.
- D. `He just stays to himself; he never talks to me about what is bothering him.
Correct Answer: D
Rationale: The correct answer is D because it indicates potential symptoms of posttraumatic stress syndrome (PTSD), such as avoidance of discussing traumatic events and social withdrawal. This response suggests the husband may be experiencing emotional distress and difficulty communicating about his problems. Choices A, B, and C do not specifically address the key features of PTSD and may indicate misunderstandings or oversimplifications of mental health issues. Choice A attributes symptoms to a vitamin deficiency, which is not typically associated with PTSD. Choice B implies a permanent and hopeless outlook on the husband's mental health, which may not be accurate. Choice C mentions hallucinations, which are not a common symptom of PTSD but rather may be associated with other psychiatric conditions.
A nursing instructor is preparing a class discussion on the topic of self-determinism. Which of the following would the instructor expect to include? Select all that apply.
- A. Personal autonomy as a key value
- B. Choices based on pleasing others
- C. Activities reflect personal goals
- D. Right to refuse treatment
Correct Answer: A
Rationale: The correct answer is A: Personal autonomy as a key value. Personal autonomy is a fundamental aspect of self-determinism, giving individuals the freedom to make their own choices. This aligns with the concept of self-determinism, where individuals have the right to act in accordance with their own values and goals. Choices based on pleasing others (B) contradict self-determinism as they prioritize external influences over personal autonomy. Activities reflecting personal goals (C) are more in line with self-determinism, but they do not encompass the broader concept of personal autonomy. The right to refuse treatment (D) is an important aspect of autonomy but is specific to healthcare decisions, not the comprehensive concept of self-determinism.
A group of nursing students are reviewing the various theories that form the basis for psychiatric-mental health nursing. The students demonstrate understanding of these theories when they identify which theorist as addressing female development? Select all that apply.
- A. Maslow
- B. Gilligan
- C. Bandura
- D. Miller
Correct Answer: B
Rationale: The correct answer is B: Gilligan. Carol Gilligan is known for her work on female development, particularly in contrast to the male-focused theories of development by theorists like Kohlberg. Gilligan emphasized the importance of relationships, care, and compassion in moral development, which are often more central to female experiences. Maslow's hierarchy of needs (A) is a general theory of motivation, not specific to female development. Bandura (C) is known for social learning theory, which applies to all genders. Miller (D) is not a theorist associated with female development. In this context, Gilligan stands out as the theorist most directly addressing female development.
A nurse had developed a plan of care for a patient with depression. Which nursing diagnosis would reflect the social domain?
- A. Imbalanced Nutrition, Less Than Body Requirements related to lack of appetite.
- B. Powerlessness related to feelings of lack of control over the situation.
- C. Ineffective Role Performance related to inability to participate as family provider
- D. Risk for Suicide related to depressed mood and feelings of oneself as a failure
Correct Answer: C
Rationale: The correct answer is C: Ineffective Role Performance related to inability to participate as family provider. This nursing diagnosis reflects the social domain because it focuses on the patient's inability to fulfill their role as a family provider due to depression, which impacts their social functioning. This diagnosis addresses the patient's social interactions, relationships, and roles within the family unit.
Explanation:
1. Imbalanced Nutrition (A) is related to physical health and nutrition, not the social domain.
2. Powerlessness (B) is related to feelings of lack of control, not specifically tied to social interactions or roles.
3. Risk for Suicide (D) is related to the patient's safety and mental health, not directly addressing social functioning.
In summary, choice C is the correct answer as it specifically addresses the patient's social domain by focusing on their role within the family unit, while the other choices are more related to physical health, mental health, and personal feelings.