Nokea
Disability is:
- A. More common in low-income region of the world
- B. Found in 16% or 1.3 billion people worldwide
- C. More common in males
- D. Not inclusive of mental health conditions
Correct Answer: B
Rationale: WHO estimates disability affects 16% of the global population (1.3 billion), including mental health conditions.
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The patient on the mental health unit who should be assessed as being at highest risk for directing violent behavior toward others is the patient who has:
- A. Obsessive-compulsive disorder and performs many rituals.
- B. Paranoid delusions of being followed by the Mafia.
- C. Severe depression with feelings of worthlessness and self-loathing.
- D. Completed alcohol withdrawal and is now in a rehabilitation program.
Correct Answer: B
Rationale: The correct answer is B because paranoid delusions of being followed by the Mafia indicate a high level of suspiciousness and potential for harm to others. This patient may act out violently in self-defense or as a reaction to perceived threats. Choice A is incorrect as OCD rituals are typically not associated with violent behavior. Choice C is incorrect as severe depression is more likely to result in self-harm rather than harm towards others. Choice D is incorrect as completed alcohol withdrawal and entering a rehabilitation program do not inherently indicate an increased risk of violent behavior towards others.
The client tells the nurse, 'I thought my psychiatrist was the best doctor in the world. I thought he understood me completely. Now, I hate him! He doesn't understand me at all. He's just dumping me to go on a 2-week vacation.' The nurse assesses the client's description of feelings about the physician as evidence of the use of:
- A. Splitting
- B. Projective identification
- C. Isolation of affect
- D. Dissociation
Correct Answer: A
Rationale: The correct answer is A: Splitting. Splitting is a defense mechanism where a person sees things in extremes of either all good or all bad. In this scenario, the client initially idealizes the psychiatrist as the best doctor, then suddenly devalues and hates him for taking a vacation, indicating a shift from all good to all bad. This extreme change in perception is characteristic of splitting.
B: Projective identification involves projecting one's own feelings onto another person and then identifying with those projected feelings. This choice does not fit the scenario as the client is not projecting their feelings onto the psychiatrist.
C: Isolation of affect refers to the separation of feelings from ideas and events. The client's strong emotions towards the psychiatrist do not demonstrate a lack of emotional expression or detachment from feelings.
D: Dissociation is a defense mechanism where thoughts, feelings, and experiences are separated from conscious awareness. The client's reaction does not suggest a disconnection from reality or consciousness.
The nurse is assisting a victim of spousal abuse to create a plan for escape if it becomes necessary. What components should the plan include? Select all that apply.
- A. A code word to signal children that it is time to leave.
- B. Phone numbers for the nearest shelter and crisis hotline.
- C. Telling the spouse that she has a plan and will leave.
- D. Collecting birth certificates and other essential documents.
Correct Answer: A
Rationale: The correct answer is A: A code word to signal children that it is time to leave. This is crucial for ensuring the safety of the victim and their children without alerting the abuser. Other choices like B, providing phone numbers for shelters, are important but may not always be feasible in an emergency. Choice C, informing the spouse about the plan, can escalate the situation. Choice D, collecting essential documents, is important but may not always be the immediate priority in a dangerous situation. Having a code word ensures a discreet and quick escape if needed.
People with Mania experience strange feelings of grandiosity
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Mania often includes grandiosity, such as believing one has special powers or status.
A patient, who has had three successive spontaneous abortions, reached the twelfth week of pregnancy on the fourth attempt, when she passed a moderate amount of blood with clots per vaginam and complained of intermittent lower abdominal pain. On vaginal examination, the cervical canal admitted one finger readily and bimanual palpation revealed a uterus compatible in size with a pregnancy of only eight weeks duration. The menstrual cycle had been regular (5/28) before this pregnancy and the duration of pregnancy calculated from the first day of the last menstrual period was definitely known. Which one of the following is the most likely diagnosis?
- A. Threatened abortion.
- B. Cervical incompetence.
- C. Incomplete abortion.
- D. Ectopic pregnancy.
Correct Answer: C
Rationale: Bleeding, pain, open cervix, and uterine size smaller than expected (8 weeks vs. 12 weeks) suggest incomplete abortion (C), where some products of conception remain. Threatened abortion (A) has a closed cervix, cervical incompetence (B) lacks bleeding, ectopic (D) has different signs, and missed abortion (E) has no expulsion.