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A patient reports, 'My brain is tapped by government agents who can trace my whereabouts and listen to my thoughts.' An appropriate nursing response to this information would be:
- A. Your story is very strange and too bizarre for me to believe.'
- B. Tell me why you think your brain is being tapped.'
- C. What was happening in your life just before you began to think your brain was tapped?'
- D. Are you feeling frightened or angry about the government violating your body?'
Correct Answer: C
Rationale: The correct response is C because it focuses on exploring the underlying reasons for the patient's belief, which can help uncover any triggers or stressors leading to the delusion. This approach shows empathy, builds rapport, and encourages the patient to share more about their experiences. Choice A is dismissive and may cause the patient to feel invalidated. Choice B only focuses on the belief itself without delving deeper into the context. Choice D jumps to assumptions about the patient's emotions without addressing the core issue of the delusion. Overall, choice C promotes therapeutic communication and understanding of the patient's perspective.
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Which theorist emphasized the role of social interaction in mental development?
- A. Piaget
- B. Vygotsky
- C. Erikson
- D. Freud
Correct Answer: B
Rationale: Vygotsky (B) emphasized social interaction and the Zone of Proximal Development in mental growth, unlike Piaget (A, cognitive stages), Erikson (C, psychosocial), or Freud (D, psychosexual).
A victim of a sexual assault sits in the emergency department rocking back and forth and repeatedly saying, "I can't believe I've been raped."Â This behavior is characteristic of:
- A. The acute phase reaction.
- B. The angry stage of rape-trauma syndrome.
- C. A delayed reaction to rape-trauma syndrome.
- D. The long-term phase of rape-trauma syndrome.
Correct Answer: A
Rationale: The correct answer is A: The acute phase reaction. This behavior is characteristic of the immediate emotional response following a traumatic event like sexual assault. The victim may exhibit shock, disbelief, and emotional distress. In this scenario, the victim's reaction of disbelief and repetitive statements align with the acute phase reaction. The other options are incorrect because the angry stage (B) and delayed reaction (C) occur later in the trauma response process, while the long-term phase (D) reflects a more prolonged period of adjustment and coping.
A patient being treated for major depression is the CEO of her own business. She has shown significant improvement and is about to be discharged after completing a course of 15 electroconvulsive therapy sessions. She will continue on SSRI medications. The patient has been counseled not to make a major business decision for a month. The rationale for this is that:
- A. SSRIs may cause confusion in susceptible persons.
- B. ECT often causes temporary memory impairment.
- C. Lingering depression makes the patient incompetent.
- D. The patient needs months to readjust to work pressures.
Correct Answer: B
Rationale: The correct answer is B: ECT often causes temporary memory impairment. This is because electroconvulsive therapy (ECT) is known to have side effects, including temporary memory loss and confusion. As the patient has just completed a course of 15 ECT sessions, it is important to allow time for the effects of ECT to subside before making major decisions, especially in a high-pressure role like being a CEO. Choices A and C are incorrect as SSRIs do not typically cause confusion and lingering depression alone does not necessarily make a patient incompetent. Choice D is incorrect as there is no indication that the patient needs months to readjust to work pressures; the primary concern here is the potential memory impairment from ECT.
In planning aftercare for a client with schizophrenia and whose insurance benefits have been exhausted, the nurse who is concerned about overcoming negative symptoms will make provisions for the client to have stimulation, structure, socialization, and support. Which option would best incorporate these factors?
- A. Day hospitalization
- B. Attending a psychosocial club
- C. Living with his elderly mother
- D. Spending free time in the mall
Correct Answer: B
Rationale: The correct answer is B: Attending a psychosocial club. This option best incorporates the necessary factors of stimulation, structure, socialization, and support for the client with schizophrenia.
- Stimulation: Psychosocial clubs offer various activities to engage the client's mind and keep them occupied.
- Structure: These clubs usually have regular schedules and routines, providing the client with a sense of order and predictability.
- Socialization: Interacting with others in the club can help the client improve social skills and combat feelings of isolation.
- Support: Being part of a community in the club can provide emotional support and encouragement for the client.
Incorrect Choices:
- A: Day hospitalization may offer structure and support but may lack the socialization and stimulation provided by a psychosocial club.
- C: Living with his elderly mother may provide support but may not offer the necessary stimulation, structure, and socialization outside of the home environment.
- D: Spending free time in the mall may offer
A patient with borderline personality disorder has been making steady progress but one day gets a phone call from her boyfriend, who breaks off their relationship. Although she has not self-injured in over 2 months, she makes repeated lacerations on her forearm. Which statement about this and most maladaptive behaviors seen in personality disorders is most accurate?
- A. People with personality disorders rarely achieve lasting improvement.
- B. However dysfunctional, most behavior is the person's best effort to cope.
- C. People with personality disorders are at the mercy of others' actions.
- D. What appears to be improvement can be manipulation instead.
Correct Answer: B
Rationale: The correct answer is B: However dysfunctional, most behavior is the person's best effort to cope. In this scenario, the patient's self-injury following the breakup is a maladaptive coping mechanism to deal with emotional distress. Individuals with personality disorders often engage in maladaptive behaviors as a way to cope with overwhelming emotions or stress. This behavior may not be effective or healthy, but it is their attempt to manage their internal struggles.
A: People with personality disorders rarely achieve lasting improvement - This statement is incorrect as individuals with personality disorders can make progress with therapy and support.
C: People with personality disorders are at the mercy of others' actions - This statement is incorrect as individuals with personality disorders have agency over their behaviors, even if they struggle with emotional regulation.
D: What appears to be improvement can be manipulation instead - This statement is incorrect as improvement in behavior should not be automatically attributed to manipulation; it could genuinely reflect progress in coping skills.