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A school nurse is assessing a female high school student who is overly concerned about her appearance. The client's mother states, 'That's not something to be stressed about!' Which is the most appropriate nursing response?
- A. Teenagers! They don't know a thing about real stress.
- B. Stress occurs only when there is a loss.
- C. When you are in poor physical condition, you can't experience psychological well-being.
- D. Stress can be psychological. A threat to self-esteem may result in high stress levels.
Correct Answer: D
Rationale: The correct answer is D. Stress can manifest as physical or psychological. A perceived threat to self-esteem can be as stressful as a physiological change. Choice A is dismissive of the teenager's concerns and does not address the issue professionally. Choice B is incorrect as stress can result from various factors, not just loss. Choice C oversimplifies the relationship between physical condition and psychological well-being, neglecting the impact of mental stressors on overall health.
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During an intake assessment, a healthcare professional asks both physiological and psychosocial questions. The client angrily responds, 'I'm here for my heart, not my head problems.' What is the healthcare professional's best response?
- A. It's just a routine part of our assessment. All clients are asked these same questions.
- B. Why are you concerned about these types of questions?
- C. Psychological factors, like excessive stress, have been found to affect medical conditions.
- D. We can skip these questions, if you like. It isn't imperative that we complete this section.
Correct Answer: C
Rationale: The healthcare professional should educate the client on the negative effects of excessive stress on medical conditions. Understanding the interconnectedness of physical and mental health is crucial for providing holistic care. Choice A is incorrect because it doesn't address the importance of psychosocial aspects. Choice B is wrong as it doesn't provide relevant information about the impact of psychological factors on health. Choice D is incorrect because skipping questions would lead to an incomplete assessment, potentially missing crucial information affecting the client's overall health outcomes.
A healthcare professional is conducting education on anxiety and stress management. Which of the following should be identified as the most important initial step in learning how to manage anxiety?
- A. Diagnostic blood tests
- B. Awareness of factors creating stress
- C. Relaxation exercises
- D. Identifying support systems
Correct Answer: B
Rationale: The correct answer is B: Awareness of factors creating stress. In managing anxiety, the first crucial step is recognizing and being aware of the factors that contribute to stress. Without this awareness, it becomes challenging to effectively address and manage anxiety. Diagnostic blood tests are not typically the initial step in managing anxiety; they may be used to rule out other medical conditions but are not the primary focus. While relaxation exercises can be helpful in managing anxiety, understanding the root causes of stress takes precedence. Identifying support systems is important but comes after recognizing the stress factors to develop a comprehensive management plan.
When under stress, a client routinely uses an excessive amount of alcohol. Finding her drunk, her husband yells at her about the chronic alcohol abuse. Which reaction should the nurse recognize as the use of the defense mechanism of denial?
- A. Hiding liquor bottles in a closet
- B. Yelling at their son for slouching in his chair
- C. Burning dinner on purpose
- D. Saying to the spouse, 'I don't drink too much!'
Correct Answer: D
Rationale: The nurse should recognize the client's statement 'I don't drink too much!' as the use of the defense mechanism of denial. This response indicates the client's refusal to acknowledge the reality of excessive alcohol consumption, which is a key characteristic of denial. By denying the problem, the client avoids facing the negative consequences and feelings associated with their alcohol abuse. Choices A, B, and C do not exhibit denial but rather represent different defense mechanisms. Hiding liquor bottles in a closet might indicate the defense mechanism of concealment, yelling at their son for slouching in his chair could reflect displacement, and burning dinner on purpose might suggest passive-aggressive behavior.
How do psychiatrists determine which diagnosis to give a patient?
- A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
- B. Hospital policy dictates how psychiatrists diagnose mental disorders.
- C. Psychiatrists assess the patient and identify diagnoses based on the patient's unhealthy responses and contributing factors.
- D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.
Correct Answer: A
Rationale: The correct answer is A. Psychiatrists use the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association (APA) to determine diagnoses. The DSM-5 provides standardized criteria for the classification of mental disorders, ensuring accurate and reliable diagnosis and treatment. Choices B and D are inaccurate as hospital policy does not dictate psychiatric diagnoses, and the American Medical Association is not responsible for psychiatric diagnostic criteria. Choice C describes a more general approach to assessment and does not specifically address the standardized criteria used in psychiatric diagnosis.
During an assessment of a client with suspected substance use disorder, which of the following findings should the nurse expect? Select one that doesn't apply.
- A. Feelings of hopelessness
- B. Increased tolerance to the substance
- C. Withdrawal symptoms when not using the substance
- D. Unsuccessful attempts to cut down or control use
Correct Answer: A
Rationale: In clients with substance use disorder, common findings include increased tolerance to the substance, withdrawal symptoms when not using it, and unsuccessful attempts to cut down or control use. Feelings of hopelessness are not typically a direct manifestation of substance use disorder. Instead, feelings of hopelessness may be associated with other mental health conditions or situational factors. Therefore, the correct answer is A. Choices B, C, and D are all expected findings in clients with substance use disorder.