After taking an antidepressant for about a week, a patient reports constipation and blurred vision, with no improvement in mood. The psychiatric-mental health nurse informs the patient,:
- A. It takes approximately two to four weeks for depression to lessen, and side effects usually diminish over time'
- B. Stop the medication immediately and contact your primary care physician'
- C. You should contact your doctor. The doctor may need to change your medication'
- D. You should schedule an appointment with your ophthalmologist'
Correct Answer: A
Rationale: Antidepressants require 2-4 weeks for therapeutic effect, and early side effects often subside, making this the most reassuring response.
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The nurse has recently set limits for a patient with borderline personality disorder. The patient tells the nurse, 'You used to care about me. I thought you were wonderful. Now I can see I was mistaken. You're hateful.' Which phenomenon is represented by this response?
- A. Splitting
- B. Denial
- C. Reaction formation
- D. Projection
Correct Answer: A
Rationale: The correct answer is A: Splitting. Splitting is a defense mechanism commonly seen in individuals with borderline personality disorder where they perceive others as either all good or all bad. In this scenario, the patient's sudden shift from viewing the nurse as wonderful to hateful demonstrates splitting. The patient is unable to integrate both positive and negative aspects of the nurse's behavior, leading to extreme and polarized perceptions.
Choice B: Denial involves refusing to accept reality to protect oneself from uncomfortable truths, which is not demonstrated in this response.
Choice C: Reaction formation is a defense mechanism where an individual behaves in a way that is opposite to their true feelings, which is not evident in the patient's response.
Choice D: Projection involves attributing one's own unacceptable thoughts or feelings onto someone else, which is not the case in this scenario.
Health Services for disabilities in children and youth:
- A. Are provided by HPB and the Child Development Programmes only
- B. Are inclusive and equitable
- C. Are well-integrated with social services
- D. Ought to include caregiver support and be familycentred
Correct Answer: D
Rationale: Health services should be family-centered and include caregiver support, reflecting best practices in disability care.
Some eating habits that seem to contribute to the incidence of cardiovascular disease are
- A. A diet that is high in fat
- B. A diet that is low in vegetables
- C. A diet that is low in fruits
- D. All of the above
Correct Answer: D
Rationale: High-fat, low-vegetable, and low-fruit diets all contribute to cardiovascular disease by increasing cholesterol and reducing nutrients.
A patient diagnosed with schizophrenia tells the community mental health nurse, 'I threw away my pills because they interfere with Gods voice.' The nurse identifies the etiology of the patients ineffective management of the medication regime as:
- A. inadequate discharge planning
- B. poor therapeutic alliance with clinicians
- C. dislike of antipsychotic medication side effects
- D. impaired reasoning secondary to the schizophrenia
Correct Answer: D
Rationale: The patients ineffective management of the medication regime is most closely related to impaired reasoning. The patient believes in being an exalted personage who hears Gods voice, rather than an individual with a serious mental disorder who needs medication to control symptoms. Data do not suggest any of the other factors often related to medication nonadherence.
A patient who has been physically abused says, 'When I called the police, I just wanted my spouse to stop shoving me around and kicking me. I didn't want anyone to get in trouble. It's easy to get angry with me because I spend too much money.' Which nursing intervention would be most therapeutic for this patient?
- A. You feel your spouse was justified in the abuse because you overspent?'
- B. Tell your spouse that if this happens again, I'll report it to the police.'
- C. Your spouse abuses you when you overspend. So you think it will stop if you stop spending money?'
- D. I can understand that you don't want to press charges, but your spouse needs help controlling anger.'
Correct Answer: A
Rationale: The correct answer is A because it focuses on therapeutic communication by reflecting the patient's feelings and thoughts back to them without judgment. By repeating the patient's words, the nurse shows empathy and understanding, which can help build trust and rapport. Choices B and D may escalate the situation and go against the patient's wishes, potentially causing further harm. Choice C assumes a causal relationship between overspending and abuse, which is not appropriate and may blame the victim. Overall, choice A promotes a non-judgmental and supportive environment, which is crucial in addressing issues of abuse.
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