Nokea
An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention?
- A. Encourage the graduate to use alternative coping mechanisms such as relaxation exercises.
- B. Complete the problem-solving process for the graduate.
- C. Work through the problem-solving process with the graduate.
- D. Encourage the graduate to keep a journal.
Correct Answer: C
Rationale: In situations where a client is experiencing severe anxiety and struggles with independent problem-solving, it is essential for the nurse to work through the problem-solving process together with the client. By doing so, the nurse can provide support and guidance to help the client navigate through their challenges effectively. Choice A is not the most appropriate as just encouraging alternative coping mechanisms may not address the root of the problem. Choice B of completing the problem-solving process for the graduate does not promote independence or skill development. Choice D of encouraging the graduate to keep a journal may be helpful but does not directly address the need for assistance in problem-solving during heightened anxiety.
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In the treatment of a patient with bipolar disorder experiencing a depressive episode, which medication is commonly prescribed?
- A. Valproic acid
- B. Risperidone
- C. Fluoxetine
- D. Lithium
Correct Answer: C
Rationale: The correct answer is C, Fluoxetine. Fluoxetine, a commonly prescribed antidepressant, is used to manage depressive episodes in bipolar disorder. It helps alleviate symptoms of depression by increasing the levels of serotonin in the brain, which can improve mood and reduce feelings of sadness and hopelessness. While mood stabilizers like lithium are often used in bipolar disorder, for depressive episodes, antidepressants like fluoxetine are preferred to address the specific symptoms associated with depression. Valproic acid is a mood stabilizer often used in bipolar disorder to manage manic episodes. Risperidone is an atypical antipsychotic that may be used in bipolar disorder to help control manic episodes or as an adjunctive treatment, but it is not a first-line medication for depressive episodes.
A client with obsessive-compulsive disorder (OCD) is being cared for by a nurse. Which intervention should the nurse include in the plan of care?
- A. Encourage the client to suppress compulsive behaviors.
- B. Set strict limits on the amount of time the client can engage in compulsive behaviors.
- C. Allow the client to perform compulsive behaviors as needed.
- D. Gradually limit the amount of time allotted for compulsive behaviors.
Correct Answer: D
Rationale: In caring for a client with OCD, it is essential to gradually limit the time allotted for compulsive behaviors. This intervention helps the client develop alternative coping mechanisms. Encouraging suppression or setting strict limits on compulsive behaviors can exacerbate the client's anxiety, making it crucial to approach the care plan with a gradual reduction strategy. Allowing the client to perform compulsive behaviors as needed does not promote progress towards managing OCD symptoms and may reinforce maladaptive patterns of 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.
Based on what criteria do most cultures label behavior as mental illness?
- A. Incomprehensibility and cultural relativity
- B. Strength of character and ethics
- C. Goal directedness and high energy
- D. Creativity and good coping skills
Correct Answer: A
Rationale: The correct answer is A: Incomprehensibility and cultural relativity. Incomprehensibility and cultural relativity are the main criteria used across cultures to define behavior as mental illness. When behavior is incomprehensible and significantly deviates from cultural norms, it is more likely to be classified as a mental illness. Choices B, C, and D are incorrect. Strength of character, ethics, goal directedness, high energy, creativity, and good coping skills are typically associated with positive mental health rather than mental illness.
Which of the following are common symptoms of major depressive disorder? Select one that doesn't apply.
- A. Insomnia
- B. Feelings of hopelessness
- C. Increased energy
- D. Difficulty concentrating
Correct Answer: C
Rationale: Common symptoms of major depressive disorder include insomnia, feelings of hopelessness, difficulty concentrating, and appetite changes. While individuals with major depressive disorder often experience fatigue and low energy levels, increased energy is not typically associated with this condition. Therefore, 'Increased energy' is the correct choice that doesn't apply to major depressive disorder. Choices A, B, and D are all commonly seen in individuals with major depressive disorder, making them incorrect answers.