Nokea
Confidentiality should be discussed with all adolescents and parents before the consult. Confidentiality may be breached in all situations below EXCEPT:
- A. Disclosure of sexual abuse
- B. Disclosure of drug abuse
- C. Disclosure of suicidality
- D. Disclosure of dropping grades
Correct Answer: D
Rationale: Confidentiality can be breached for safety concerns (abuse, drug use, suicidality), but dropping grades is not a direct threat to safety or health, so it does not warrant breaching confidentiality.
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A student nurse visiting a senior center says, 'Its depressing to see these old people. They are weak and frail. I doubt any of them can engage in a discussion.' The student is expressing:
- A. reality
- B. ageism
- C. empathy
- D. vulnerability
Correct Answer: B
Rationale: Ageism is a bias against older people because of their age. None of the other options applies to the ideas expressed by the student.
A psychiatric clinical nurse specialist uses cognitive therapy with a patient with anorexia nervosa. Which statement by the nurse supports this type of therapy?
- A. What are your feelings about not eating foods you prepare?
- B. You seem to feel much better about yourself when you eat something.
- C. It must be difficult to talk about private matters to someone you just met.
- D. Being thin doesn't seem to solve problems. You're thin now but still unhappy.
Correct Answer: D
Rationale: The correct answer is D because it reflects a key principle of cognitive therapy, which is challenging distorted thoughts and beliefs. In this statement, the nurse is helping the patient recognize that being thin has not resolved their underlying unhappiness. This challenges the patient's belief that thinness equals happiness, promoting insight and cognitive restructuring.
A: This statement focuses on emotions related to food and preparation, not directly challenging distorted thoughts.
B: This statement focuses on self-esteem related to eating, not directly challenging distorted thoughts.
C: This statement addresses the difficulty of sharing personal information, not directly challenging distorted thoughts.
Mood disorders are those in which the person may
- A. experience severe depression and threaten suicide
- B. exhibit symptoms suggesting physical disease or injury but for which there is no identifiable cause
- C. exhibit behavior that is the result of an organic brain pathology
- D. experience delusions and hallucinations
Correct Answer: A
Rationale: Mood disorders, like depression, feature extreme emotional states, including suicidal ideation.
A patient diagnosed with schizophrenia has difficulty completing tasks and seems forgetful and disinterested in unit activities. A nurse can best select successful strategies by understanding that these behaviors are due to:
- A. a lack of self-esteem.
- B. manipulative tendencies.
- C. shyness and embarrassment.
- D. problems in cognitive functioning.
Correct Answer: D
Rationale: The correct answer is D: problems in cognitive functioning. In schizophrenia, cognitive deficits are common, leading to difficulties in completing tasks, forgetfulness, and lack of interest. Understanding this helps the nurse select appropriate strategies, such as breaking tasks into smaller steps. Choice A (lack of self-esteem) is incorrect as cognitive deficits in schizophrenia are not solely related to self-esteem. Choice B (manipulative tendencies) is incorrect as these behaviors are not indicative of manipulation. Choice C (shyness and embarrassment) is incorrect as cognitive deficits in schizophrenia go beyond social anxiety.
A patient with schizophrenia has received typical (first-generation) antipsychotics for a year. His hallucinations are less intrusive, but he remains apathetic, has poverty of thought, cannot work, and is socially isolated. To address these symptoms, the nurse might consult the prescribing health care provider to suggest a change to:
- A. Haloperidol (Haldol).
- B. Olanzapine (Zyprexa).
- C. Diphenhydramine (Benadryl).
- D. Chlorpromazine (Thorazine).
Correct Answer: B
Rationale: The correct answer is B: Olanzapine (Zyprexa). Olanzapine is an atypical (second-generation) antipsychotic that has been shown to effectively target negative symptoms of schizophrenia, such as apathy, poverty of thought, and social isolation. It also helps with mood stabilization and cognitive function, which can improve the patient's ability to work and engage in social interactions.
Choice A: Haloperidol (Haldol) is a typical (first-generation) antipsychotic like the current medication, which is less effective in treating negative symptoms and can potentially worsen them.
Choice C: Diphenhydramine (Benadryl) is an antihistamine and not indicated for treating schizophrenia symptoms.
Choice D: Chlorpromazine (Thorazine) is another typical (first-generation) antipsychotic, similar to the current medication, and may not adequately address the negative symptoms the patient is experiencing.