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A woman whose abusive husband was killed in an automobile accident 3 years earlier continues to idealize him and repeatedly talks about their “wonderful relationship.” Which outcome is most appropriate for the patient? Patient will:
- A. Enlist the emotional support of both family and friends.
- B. Keep a daily journal recording memories of time spent with her husband.
- C. Express both positive and negative feelings about her husband and their life together.
- D. Read information on the affects of physical abuse and the support groups available to her.
Correct Answer: C
Rationale: Rationale:
Choice C is correct because it encourages the patient to express both positive and negative feelings about her husband and their relationship. This approach helps the patient process complex emotions and move towards a more realistic view of the past. It promotes emotional healing and growth by allowing the patient to acknowledge and work through conflicting feelings.
Summary of Incorrect Choices:
A: While emotional support is important, simply enlisting the support of family and friends may not address the underlying issues of idealization and unresolved emotions.
B: Keeping a daily journal may reinforce the idealization of the husband and could potentially hinder the patient's progress in coming to terms with the reality of the relationship.
D: Reading about abuse and support groups may provide information, but it does not directly address the patient's need to explore and express her own feelings about her husband and their relationship.
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An elderly couple who lived in the same home for the past 50 years have moved into an
adult retirement center in a nearby town. Changes in lifestyle such as this couple is
experiencing should alert the nurse to the possibility of:
- A. Acute grief
- B. Traumatic grief
- C. Chronic sorrow
- D. Adventitious crisis
Correct Answer: D
Rationale: The correct answer is D: Adventitious crisis. This type of crisis is triggered by external events such as moving to a retirement center after 50 years in the same home. The sudden change in environment can lead to distress and challenges for the elderly couple, causing an adventitious crisis. Acute grief (A) and traumatic grief (B) are typically associated with the loss of a loved one, not a change in lifestyle. Chronic sorrow (C) refers to ongoing grief related to a chronic illness or disability, which is not the case in this scenario.
A teen is grieving the loss of her pet dog. She states to her mother, “I miss my dog so much, but I know that if I start crying, I will never stop.” The teen is expressing a fear of:
- A. Appearing emotionally immature
- B. Embarrassing herself by crying in public
- C. Losing the support of her friends and family.
- D. Losing control over her emotions.
Correct Answer: D
Rationale: The correct answer is D: Losing control over her emotions. The teen's statement indicates a fear of losing control if she starts crying. This fear suggests that she believes crying will lead to an inability to stop, indicating a concern about managing her emotions. This fear of losing control over her emotions aligns with the teen's hesitance to express her grief through tears.
A: Appearing emotionally immature - This choice is incorrect as the teen's statement does not directly suggest a fear of appearing emotionally immature.
B: Embarrassing herself by crying in public - This choice is incorrect as the teen's statement does not mention a fear of embarrassment.
C: Losing the support of her friends and family - This choice is incorrect as the teen's statement does not indicate a fear of losing support from others.
When a patient asks the nurse, “How can jolting me with an electrical shock possibly do me any good?” the answer most reflective of current biologic theory would be:
- A. “ECT produces a change in brain chemistry that results in improved mood.
- B. “ECT provides you with external punishment so you can stop punishing yourself.”
- C. “ECT interrupts brain impulses that are causing hallucinations and delusions.”
- D. ECT shocks the brain into re-establishing normal electrical patterns.”
Correct Answer: A
Rationale: Step 1: Electroconvulsive therapy (ECT) is a treatment for severe depression and other mental health disorders.
Step 2: Current biological theory suggests that ECT produces changes in brain chemistry, specifically neurotransmitters, leading to improved mood.
Step 3: The correct answer (A) aligns with this theory by explaining how ECT impacts brain chemistry to alleviate symptoms.
Step 4: Answer B is incorrect as ECT is not used as punishment but as a therapeutic intervention.
Step 5: Answer C is incorrect as ECT is not primarily used to interrupt brain impulses causing hallucinations and delusions.
Step 6: Answer D is incorrect as ECT does not shock the brain into re-establishing normal electrical patterns but rather affects neurotransmitter levels.
A patient attending group therapy mentions, “In the beginning, I was so sick that everyone had to help me. For the last few days, it’s felt good to be able to give something back to the group.” This statement can be assessed as an example of Yalom’s factor of:
- A. Cohesiveness
- B. Imitative behavior
- C. Altruism
- D. Harmonizing
Correct Answer: C
Rationale: The correct answer is C: Altruism. This statement reflects the concept of altruism in group therapy, as the patient expresses the satisfaction of being able to give back to the group after receiving help in the beginning. Altruism refers to the unselfish concern for the well-being of others. In this case, the patient's experience of feeling good by being able to contribute positively to the group reflects a sense of altruism.
Choices A, B, and D are incorrect:
A: Cohesiveness is the sense of belonging and unity within a group, which is not directly reflected in the patient's statement.
B: Imitative behavior involves mimicking the actions of others, which is not evident in the patient's statement.
D: Harmonizing refers to the process of resolving conflicts and reaching agreement, which is not explicitly mentioned in the patient's statement.
The wife of a patient diagnosed with paranoid schizophrenia asks: “I’ve been told that my husband’s illness is probably related to imbalanced brain chemicals. Can you be more specific?”
- A. Breakdown of dopamine produces LSD, which in large amounts produces psychosis
- B. Decreased amounts of the brain chemical dopamine explain the presence of delusions and hallucinations.
- C. An increase in the brain chemical dopamine explains the presence of delusions and hallucinations.
- D. An increase in the brain chemical dopamine explains the presence of lack of motivation and disordered affect
Correct Answer: C
Rationale: The correct answer is C: An increase in the brain chemical dopamine explains the presence of delusions and hallucinations. In paranoid schizophrenia, there is an overactivity of dopamine receptors in the brain, leading to an excess of dopamine. This excess dopamine is associated with symptoms like delusions and hallucinations. Therefore, an increase in dopamine levels is directly linked to these specific symptoms in individuals with paranoid schizophrenia.
Explanation for why the other choices are incorrect:
A: Breakdown of dopamine producing LSD does not directly relate to the symptoms of paranoid schizophrenia.
B: Decreased amounts of dopamine do not explain the presence of delusions and hallucinations in paranoid schizophrenia; it is the increase in dopamine that is associated with these symptoms.
D: An increase in dopamine is more closely related to delusions and hallucinations rather than lack of motivation and disordered affect in paranoid schizophrenia.