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An 86 year old, previously healthy and independent, falls after an episode of vertigo. Which statement made by this patient best demonstrates resilience?
- A. I knew this would happen eventually.
- B. Attending my weekly water aerobics class is too risky.
- C. I don't need that silly walker to get around by myself.
- D. Maybe some physical therapy will help me with my balance.
Correct Answer: D
Rationale: Resiliency is the ability to recover from or adjust to misfortune and change. The correct response indicates that the patient is hopeful and thinking positively about ways to adapt to the vertigo. Saying 'I knew this would happen eventually' and discontinuing healthy activities suggest a hopeless perspective on the health change. Refusing to use a walker indicates denial.
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A participant at a community education conference asks, 'What is the most prevalent type of mental disorder in the United States?' What is the nurse's best response?
- A. Why do you ask?
- B. Schizophrenia
- C. Affective disorders
- D. Anxiety disorders
Correct Answer: D
Rationale: The prevalence for schizophrenia is 1.1% per year. The prevalence of all affective disorders (e.g., depression, dysthymic disorder, bipolar) is 9.5%. The prevalence of anxiety disorders is 18.1%.
Which belief by a nurse supports the highest degree of patient advocacy during a multidisciplinary patient care planning session?
- A. All mental illnesses are culturally determined.
- B. Schizophrenia and bipolar disorder are cross-cultural disorders.
- C. Symptoms of mental disorders are constant from culture to culture.
- D. Some symptoms of mental disorders may reflect a person's cultural patterns.
Correct Answer: D
Rationale: A nurse who understands that a patient's symptoms are influenced by culture will be able to advocate for the patient to a greater degree than a nurse who believes that culture is of little relevance. All mental illnesses are not culturally determined. Schizophrenia and bipolar disorder are cross-cultural disorders, but this understanding has little relevance to patient advocacy. Symptoms of mental disorders change from culture to culture.
Which statements most clearly reflect the stigma of mental illness?
- A. Many mental illnesses are hereditary.
- B. Mental illness can be evidence of a brain disorder.
- C. People claim mental illness, so they can qualify for disability.
- D. If people with mental illness went to church, they would be fine.
- E. Mental illness is a result of the breakdown of the American family.
Correct Answer: C,D,E
Rationale: Stigma is represented by judgmental remarks that discount the reality and validity of mental illness. Many mental illnesses are genetically transmitted. Neuroimaging can show changes associated with some mental illnesses.
A patient in the emergency department reports, 'I hear voices saying someone is stalking me. They want to kill me because I found the cure for cancer. I will stab anyone that threatens me.' Which aspects of mental health have the greatest immediate concern to a nurse?
- A. Happiness
- B. Appraisal of reality
- C. Control over behavior
- D. Effectiveness in work
- E. Healthy self-concept
Correct Answer: B,C,E
Rationale: The aspects of mental health of greatest concern are the patient's appraisal of and control over behavior. The patient's appraisal of reality is inaccurate, and auditory hallucinations are evident, as well as delusions of persecution and grandeur. In addition, the patient's control over behavior is tenuous, as evidenced by the plan to 'stab' anyone who seems threatening. A healthy self-concept is lacking. Data are not present to suggest that the other aspects of mental health (happiness and effectiveness in work) are of immediate concern.
A patient's history shows intense and unstable relationships with others. The patient initially idealizes an individual and then devalues the person when the patient's needs are not met. Which aspect of mental health is a problem for this patient?
- A. Effectiveness in work
- B. Communication skills
- C. Productive activities
- D. Maintaining relationships
Correct Answer: D
Rationale: The information provided centers on relationships with others, which are described as intense and unstable. The relationships of mentally healthy individuals are stable, satisfying, and socially integrated. Data are not present to describe work effectiveness, communication skills, or activities.