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During assessment, the nurse asks a patient to explain what the following means: 'A penny saved is a penny earned.' The nurse is assessing which of the following?
- A. Affect
- B. Attention
- C. Concentration
- D. Abstract reasoning
Correct Answer: D
Rationale: Interpreting proverbs like 'A penny saved is a penny earned' requires abstract reasoning, the ability to understand and analyze abstract concepts. Affect involves emotional expression, attention is focus, and concentration is sustained mental effort.
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A group of nursing students are reviewing information about counseling interventions. The students demonstrate a need for additional review when they identify counseling interventions as involving which of the following?
- A. Specific, time-limited intervention
- B. Focus on coping improvement
- C. Goal of regaining functional abilities
- D. Prevention of disability
Correct Answer: A
Rationale: Counseling interventions focus on improving coping (B), regaining function (C), and preventing disability (D), but they are not always specific or time-limited (A), as they may be ongoing or flexible. Identifying A as a key feature indicates misunderstanding.
The nurse is assessing a patient?s immediate and short-term memory. Which of the following would be most appropriate?
- A. Questioning the patient about an event that has occurred within the past several months
- B. Giving the patient a simple scenario and having him identify what would be the best response
- C. Giving the patient three words and asking him to recite them now and then in 5 minutes
- D. Asking the patient to tell the nurse the date, time, and current location
Correct Answer: C
Rationale: Testing immediate and short-term memory involves recalling information after a brief delay. Giving three words to recite now and in 5 minutes assesses both immediate recall and short-term memory. Past events test long-term memory, scenarios test judgment, and orientation tests cognitive status.
A patient is engaged in bibliotherapy and begins to express his feelings because he closely associates his experience with that provided by the reading material. The nurse interprets this as which of the following?
- A. Insight
- B. Catharsis
- C. Anxiety reduction
- D. Problem solving
Correct Answer: B
Rationale: Bibliotherapy involves emotional release through relating to reading material. The patient?s expression of feelings indicates catharsis, the release of pent-up emotions. Insight involves understanding, anxiety reduction is a secondary effect, and problem-solving involves action planning.
The nurse is reviewing the assessment data of a patient diagnosed with a mental illness. The patient is to be prescribed medication to treat the illness. The nurse would identify changes in which laboratory values as being the least significant?
- A. Hemoglobin
- B. Alanine aminotransferase (ALT)
- C. Blood urea nitrogen (BUN) level
- D. Serum creatinine
Correct Answer: A
Rationale: Hemoglobin levels, related to oxygen-carrying capacity, are less directly relevant to psychiatric medication management compared to liver function (ALT) and kidney function (BUN, creatinine), which affect drug metabolism and excretion. Abnormal hemoglobin may indicate anemia but is less critical for psychotropic drugs.
Which of the following questions would be most helpful in beginning an initial assessment interview for a patient who has just been admitted to a psychiatric inpatient unit?
- A. Have you had any previous psychiatric admissions?
- B. What brings you into the hospital today?
- C. Have you had any thoughts about trying to harm yourself?
- D. How would you describe your relationship with your spouse?
Correct Answer: B
Rationale: The initial assessment interview aims to establish rapport and understand the patient?s primary reason for admission. Asking 'What brings you into the hospital today?' is open-ended, patient-centered, and elicits the patient?s perception of their problem, setting the stage for further assessment. Previous admissions, suicidal thoughts, and relationships are important but secondary to understanding the current reason for admission.