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A person who is preoccupied with fears of having a serious disease suffers from
- A. a conversion reaction
- B. hypochondriasis
- C. a traumatic disorder
- D. an obsession
Correct Answer: B
Rationale: Hypochondriasis involves persistent fear of serious illness despite no evidence.
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In an art therapy session, a client with anorexia nervosa was asked to draw a picture of herself. Which drawing would likely depict the client's view of herself?
- A. A tall, slim girl with obvious muscle definition.
- B. A malnourished teenager with thin, lanky extremities.
- C. A grossly obese figure lacking feminine characteristics.
- D. A shapely figure of a model who she admires.
Correct Answer: C
Rationale: The correct answer is C because individuals with anorexia nervosa often have a distorted body image and see themselves as larger than they actually are. Drawing a grossly obese figure lacking feminine characteristics reflects the distorted self-perception common in anorexia nervosa. Choice A is incorrect as it portrays a positive body image. Choice B may be close, but it focuses more on malnourishment rather than distorted body image. Choice D is incorrect as it reflects admiration for a shapely figure, which may not align with the client's self-perception.
The nurse wants to enroll a patient with poor social skills in a training program for patients diagnosed with schizophrenia. Which description accurately describes social skills training?
- A. Patients learn to improve their attention and concentration
- B. Group leaders provide support without challenging patients to change
- C. Complex interpersonal skills are taught by breaking them into simpler behaviors
- D. Patients learn social skills by practicing them in a supported employment setting
Correct Answer: C
Rationale: In social skills training, complex interpersonal skills are taught by breaking them down into component behaviors that are covered in a stepwise fashion. Social skills training is not based in employment settings, although such skills can be addressed as part of supported employment services. The other distracters are less relevant to social skills training.
Sleep terrors usually occur only once a night, during stages 3 and 4 of NREM sleep. They are often accompanied by which physical sign?
- A. Intense stress.
- B. Sexual arousal.
- C. Physical strength.
- D. None of the above.
Correct Answer: D
Rationale: The correct answer is D: None of the above. Sleep terrors are not typically accompanied by intense stress, sexual arousal, or increased physical strength. Sleep terrors are characterized by sudden awakening from sleep with intense fear and a physical reaction, such as screaming or thrashing. These episodes occur during stages 3 and 4 of NREM sleep and are not associated with the physical signs mentioned in the other choices. Therefore, the correct answer is D, as sleep terrors do not necessarily involve any of the physical signs listed in the other options.
An older adult patient who lives with a daughter and attends the Alzheimer day hospital program exhibits bilateral bruising for the second time on both upper outer arms. When the nurse questions the patient about the bruising, the patient starts to cry and pleads, 'Please don't say anything. It's not my daughter's fault. I just bruise easily.' Which intervention reflects the best management of this situation?
- A. Call the daughter to discuss both the bruising and her parent's reaction.
- B. Report the elder abuse, and inform the patient and the daughter of your intention.
- C. Notify the patient's social worker of the bruising after a complete assessment has been completed.
- D. Inform the patient and the daughter of your intention to document the bruising and arrange for appropriate counseling.
Correct Answer: B
Rationale: The correct answer is B: Report the elder abuse and inform the patient and the daughter of your intention. This is the best intervention as it prioritizes the safety and well-being of the older adult. Here's the rationale:
1. The patient's repeated bruising and fear of disclosure indicate potential abuse.
2. Reporting elder abuse is mandatory to ensure protection for the patient.
3. Informing the patient and daughter shows transparency and involves them in the process.
4. It is crucial to address the situation promptly to prevent further harm.
Summary:
A: Calling the daughter may escalate the situation and compromise the patient's safety.
C: Notifying the social worker without addressing the abuse directly may delay necessary action.
D: Counseling may be beneficial, but addressing the abuse is a priority to ensure the patient's safety.
After a person was abducted and raped at gunpoint by an unknown assailant, which assessment finding best indicates the acute phase of the rape-trauma syndrome?
- A. Decreased motor activity
- B. Confusion and disbelief
- C. Flashbacks and dreams
- D. Fears and phobias
Correct Answer: B
Rationale: The correct answer is B: Confusion and disbelief. During the acute phase of rape-trauma syndrome, the victim may experience feelings of confusion and disbelief as they try to process the traumatic event. This initial reaction is a common response to such a severe and violating experience. The victim may struggle to comprehend what has happened to them, leading to feelings of shock and disbelief. This phase is characterized by emotional numbing, disorientation, and difficulty in making decisions.
Decreased motor activity (Choice A) is not specific to the acute phase of rape-trauma syndrome and can be a general response to trauma. Flashbacks and dreams (Choice C) are more commonly associated with the intrusion phase of the syndrome, which occurs after the acute phase. Fears and phobias (Choice D) may develop later in the reorganization phase of the syndrome as the victim tries to cope with the aftermath of the trauma.