Nokea
An adult has been feeling significant tension since losing a home through foreclosure. This person goes to park, feeds the birds, and then impulsively exposes himself to a group of parents and children. Which term applies to this behavior?
- A. Voyeurism
- B. Frotteurism
- C. Exhibitionism
- D. Sexual masochism
Correct Answer: C
Rationale: Exhibitionism is obtaining sexual pleasure from exposing one's genitalia to unsuspecting strangers. Voyeurism refers to obtaining sexual pleasure from observing people who are naked. Frotteurism is associated with obtaining sexual arousal by rubbing one's genitals against an unsuspecting person. Sexual masochism refers to deriving sexual pleasure from being humiliated, beaten, or otherwise made to suffer.
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A patient diagnosed with severe and persistent mental illness who recently moved to a homeless shelter says, 'My life is out of control. I'm like a leaf at the mercy of the wind.' The nurse formulates the diagnosis Powerlessness. Outcomes will focus on which goal?
- A. Instilling hope
- B. Controlling anxiety
- C. Planning social activities
- D. Developing personal autonomy
Correct Answer: D
Rationale: Powerlessness is associated with feeling unable to control events in one's life. It is often associated with low self-esteem. The goal is to increase one's sense of autonomy. The scenario does not indicate hopelessness or anxiety. Socialization is not the primary need.
A patient says, 'I often make careless mistakes and have trouble staying focused. Sometimes it's hard to listen to what someone is saying. I have problems putting things in the right order and often lose equipment.' Which problem should the nurse document?
- A. Inattention
- B. Impulsivity
- C. Hyperactivity
- D. Social impairment
Correct Answer: A
Rationale: Inattention refers to the failure to stay focused. A number of the other problems are the result of failure to pay attention, which contributes to problems with organization. Impulsivity refers to acting without thinking through the consequences. Hyperactivity refers to excessive motor activity. Social impairment refers to the failure to use appropriate social skills.
The father of a child diagnosed with schizophrenia says, 'I lost my job, so we have no health insurance.' The mother says, 'I must watch this child all the time. Without supervision, our child becomes violent and destructive.' A sibling says, 'My parents don't pay attention to me.' These comments signify what related stress?
- A. Life-cycle stressors
- B. Psychobiological issues
- C. Family burden of mental illness
- D. Stigma associated with mental illness
Correct Answer: C
Rationale: Family burden refers to the meaning that the experience of living with a person who is mentally ill has for families. The stressors mentioned are not related to live-cycle issues. The stressors described are psychosocial. Stigma refers to shame and ridicule associated with mental illness.
Which economic factors are most critical to the success of discharge planning for a patient diagnosed with severe and persistent mental illness?
- A. Access to housing
- B. Individual psychotherapy
- C. Income to meet basic needs
- D. Availability of health insurance
- E. Ongoing interdisciplinary evaluation
Correct Answer: A,C,D
Rationale: The success of discharge planning requires careful attention to the patient's economic status. Access to housing is the first priority of the seriously mentally ill, and lack of income and health insurance is a barrier to effective treatment and rehabilitation. Although important aspects of ongoing care of the seriously mentally ill patient, ongoing interdisciplinary evaluation and individual psychotherapy are not economic factors.
A homeless patient diagnosed with severe and persistent mental illness became suspicious and delusional. The patient was given depot antipsychotic medication and housing was arranged at a local shelter. After 2 weeks, which statement by the patient indicates significant improvement?
- A. I am feeling safe and comfortable here. Nobody bothers me.'
- B. They will not let me drink. They have many rules in the shelter.'
- C. Those guys are always watching me. I think someone stole my shoes.'
- D. That shot made my arm sore. I'm not going to take any more of them.'
Correct Answer: A
Rationale: Evaluation of a patient's progress is made based on patient satisfaction with the new health status and the health care team's estimation of improvement. For a formerly delusional patient to admit to feeling comfortable and free of being 'bothered' by others denotes an improvement in the patient's condition. The other options suggest that the patient is in danger of relapse.