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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.
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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%.
Which belief by a nurse supports the highest degree of patient advocacy during a multidisciplinary patient care planning session?
- A. All mental illnesses are culturally determined.
- B. Schizophrenia and bipolar disorder are cross-cultural disorders.
- C. Symptoms of mental disorders are constant from culture to culture.
- D. Some symptoms of mental disorders may reflect a person's cultural patterns.
Correct Answer: D
Rationale: A nurse who understands that a patient's symptoms are influenced by culture will be able to advocate for the patient to a greater degree than a nurse who believes that culture is of little relevance. All mental illnesses are not culturally determined. Schizophrenia and bipolar disorder are cross-cultural disorders, but this understanding has little relevance to patient advocacy. Symptoms of mental disorders change from culture to culture.
A 40-year-old adult living with parents' states, 'I'm happy but I don't socialize much. My work is routine. When new things come up, my boss explains them a few times to make sure I understand. At home, my parents make decisions for me, and I go along with them.' A nurse should identify interventions to improve which patient characteristic?
- A. Self-concept
- B. Overall happiness
- C. Appraisal of reality
- D. Control over behavior
Correct Answer: A
Rationale: The patient feels the need for multiple explanations of new tasks at work and, despite being 40 years of age, allows both parents to make all decisions. These behaviors indicate a poorly developed self-concept. Although the patient reports being happy, the subsequent comments refute that self-appraisal. The patient's comments do not indicate that he/she is out of touch with reality. The patient's needs are broader than control over own behavior.
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.
An 86 year old, previously healthy and independent, falls after an episode of vertigo. Which statement made by this patient best demonstrates resilience?
- A. I knew this would happen eventually.
- B. Attending my weekly water aerobics class is too risky.
- C. I don't need that silly walker to get around by myself.
- D. Maybe some physical therapy will help me with my balance.
Correct Answer: D
Rationale: Resiliency is the ability to recover from or adjust to misfortune and change. The correct response indicates that the patient is hopeful and thinking positively about ways to adapt to the vertigo. Saying 'I knew this would happen eventually' and discontinuing healthy activities suggest a hopeless perspective on the health change. Refusing to use a walker indicates denial.