Nokea
A patient tells the nurse, 'My sexual functioning is normal when my partner wears lace. Without it, I'm not interested in sex.' This comment evidences which sexual disorder?
- A. Exhibitionism
- B. Voyeurism
- C. Pedophilia
- D. Fetishism
Correct Answer: D
Rationale: A person with a sexual fetish finds it necessary to have some external object present, in fantasy or in reality, to be sexually satisfied. Exhibitionism refers to exposing one's genitalia publicly. Voyeurism refers to viewing others in intimate situations. Pedophilia refers to the preference for having sexual relations with a child.
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A patient diagnosed with schizophrenia tells the community mental health nurse, 'I threw away my pills because they interfere with God's voice.' The nurse identifies what as the likely cause of the patient's ineffective management of the medication regimen?
- A. Inadequate discharge planning
- B. Poor therapeutic alliance with clinicians
- C. Impaired reasoning secondary to schizophrenia
- D. Dislike of the side effects of antipsychotic medications
Correct Answer: C
Rationale: The patient's ineffective management of the medication regimen is most closely related to impaired reasoning abilities. The patient believes in being an exalted person who hears God's voice, rather than an individual with a serious mental illness who needs medication to control symptoms. Data do not suggest that any of the other factors often relate to medication nonadherence.
The parent of an adult diagnosed with severe and persistent mental illness asks the nurse, 'Why are you making a referral to that vocational rehabilitation program? My child won't ever be able to hold a job.' Which is the nurse's best reply?
- A. We made this referral to maintain eligibility for federal funding.'
- B. Are you concerned that we're trying to make your child too independent?'
- C. If you think the program would be detrimental, we can postpone it for a time.'
- D. Most patients are capable of employment at some level, competitive or supported.'
Correct Answer: D
Rationale: Studies have shown that most patients who complete vocational rehabilitation programs are capable of some level of employment; also, they demonstrate significant improvement in assertiveness and work behaviors, as well as decreased depression, and improved self-esteem and socialization.
An adult says, 'When I was a child, I took medication because I couldn't follow my teachers' directions. I stopped taking it when I was about 13. I still have trouble getting organized, which causes difficulty at my job.' Which disorder is most likely?
- A. Stress intolerance disorder
- B. Generalized anxiety disorder (GAD)
- C. Borderline personality disorder
- D. Adult attention-deficit/hyperactivity disorder (ADHD)
Correct Answer: D
Rationale: Adult ADHD is usually diagnosed in early life and treated until adolescence. Treatment is often stopped because professionals think the disorder resolves itself because the hyperactive impulsive behaviors may diminish; the inattentive and disorganized behaviors tend to persist, however. Stress intolerance disorder is not found in the DSM-5. The scenario description is inconsistent with generalized anxiety disorder and borderline personality disorder.
An adult has been feeling significant tension since losing a home through foreclosure. This person goes to park, feeds the birds, and then impulsively exposes himself to a group of parents and children. Which term applies to this behavior?
- A. Voyeurism
- B. Frotteurism
- C. Exhibitionism
- D. Sexual masochism
Correct Answer: C
Rationale: Exhibitionism is obtaining sexual pleasure from exposing one's genitalia to unsuspecting strangers. Voyeurism refers to obtaining sexual pleasure from observing people who are naked. Frotteurism is associated with obtaining sexual arousal by rubbing one's genitals against an unsuspecting person. Sexual masochism refers to deriving sexual pleasure from being humiliated, beaten, or otherwise made to suffer.
The father of a child diagnosed with schizophrenia says, 'I lost my job, so we have no health insurance.' The mother says, 'I must watch this child all the time. Without supervision, our child becomes violent and destructive.' A sibling says, 'My parents don't pay attention to me.' These comments signify what related stress?
- A. Life-cycle stressors
- B. Psychobiological issues
- C. Family burden of mental illness
- D. Stigma associated with mental illness
Correct Answer: C
Rationale: Family burden refers to the meaning that the experience of living with a person who is mentally ill has for families. The stressors mentioned are not related to live-cycle issues. The stressors described are psychosocial. Stigma refers to shame and ridicule associated with mental illness.