Nokea
How is severe and persistent mental best characterized?
- A. Mental illness with longer than 2 weeks' duration.
- B. Major ongoing mental illness marked by significant functional impairments.
- C. Mental illness accompanied by physical impairment and severe social problems.
- D. Major mental illness that cannot be treated to prevent deterioration of cognitive and social abilities.
Correct Answer: B
Rationale: Severe mental illness' has replaced the phrase 'chronic mental illness.' Global impairments in function are evident, including social skills. Physical impairments may or may not be present. Severe mental illness can be treated, but remissions and exacerbations are part of the course of the illness. The distractors fail to effectively address the issue of functional impairment.
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The manager of a health club put a hidden camera in the women's locker room and videotaped women as they showered and dressed. Which sexual dysfunction is evident?
- A. Frotteurism
- B. Exhibitionism
- C. Pedophilia
- D. Voyeurism
Correct Answer: D
Rationale: Voyeurism is the viewing of others in intimate situations such as undressing, bathing, or having sexual relations. Voyeurs are often called 'peeping Toms.' Frotteurism is touching or rubbing against a nonconsenting person to achieve sexual gratification. Exhibitionists are interested in exposing their genitals to others. Pedophiles seek sexual contact with prepubescent children.
The treatment team believes medication will help a patient diagnosed with adult attention-deficit/hyperactivity disorder (ADHD). Which class of medications does the nurse expect will be prescribed?
- A. Benzodiazepines
- B. Stimulants
- C. Antipsychotics
- D. Anxiolytics
Correct Answer: B
Rationale: Stimulants, such as methylphenidate and amphetamines, provide the basis for treatment of both adult and childhood ADHD. They are the most commonly used medications; therefore, the nurse could expect the health care provider to prescribe a drug in this class. None of the other drugs listed as options have proved useful in the treatment of ADHD.
A 37 year old is involuntarily committed to outpatient treatment after sexually molesting a 12-year-old child. The patient says, 'That girl looked like she was 19 years old.' Which defense mechanism is this patient using?
- A. Denial
- B. Identification
- C. Displacement
- D. Rationalization
Correct Answer: D
Rationale: Rationalization is used to justify upsetting behaviors by creating reasons that would allow the individual to believe that the behaviors were warranted or appropriate. The patient is rationalizing molestation of a minor. Denial is used to avoid dealing with the problems and responsibilities related to one's behaviors. Identification is incorporating the image of an emulated person and then acting, thinking, and feeling like that person. Displacement is the discharge of pent-up feelings onto something or someone else in the environment that is less threatening than the original source of the feelings.
For patients diagnosed with severe and persistent mental illness, what is the major advantage of case management?
- A. Modification of traditional psychotherapy
- B. Efficient access and use of resources
- C. Focus on social skills training and self-esteem building
- D. Bringing groups of patients together to discuss common problems
Correct Answer: B
Rationale: The case manager not only provides entrance into the system of care, but he or she also coordinates the multiple referrals that so often confuse the patient who is severely and persistently mentally ill and the patient's family. Case management promotes the efficient use of services. The other options are lesser advantages or may be irrelevant.
Which statements most clearly indicate that the speaker views mental illness with stigma?
- A. Everyone is a little bit crazy.'
- B. If people with mental illness would go to church, their problems would be solved with faith.'
- C. Many mental illnesses are genetically transmitted. It is no one's fault that the illness occurs.'
- D. Anyone can have a mental illness. War or natural disasters can be too stressful for healthy people.'
- E. People with mental illness are lazy. They expect the government to take care of everything they need.'
Correct Answer: A,B,E
Rationale: Statements that trivialize mental illness ('Everyone is a little bit crazy'), suggest simplistic solutions ('go to church'), or stereotype individuals as lazy reflect stigmatizing attitudes. The other statements acknowledge the biological and situational factors of mental illness without judgment, indicating a lack of stigma.