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In the majority culture of the United States, which individual is at greatest risk to be incorrectly labeled mentally ill?
- A. Person who is usually pessimistic but strives to meet personal goals.
- B. Wealthy person who gives $20 bills to needy individuals in the community.
- C. Person with an optimistic viewpoint about getting his or her own needs met.
- D. Person who expresses strong beliefs about the existence of alien abductions.
Correct Answer: D
Rationale: Possessing and expressing unpopular or unsubstantiated beliefs often suggests an individual is mentally unstable. In this situation, cultural norms vary, making it more difficult to make an accurate DSM-5 diagnosis. The individuals described in the other options are less likely to be labeled as mentally ill.
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A participant at a community education conference asks, 'What is the most prevalent type of mental disorder in the United States?' What is the nurse's best response?
- A. Why do you ask?
- B. Schizophrenia
- C. Affective disorders
- D. Anxiety disorders
Correct Answer: D
Rationale: The prevalence for schizophrenia is 1.1% per year. The prevalence of all affective disorders (e.g., depression, dysthymic disorder, bipolar) is 9.5%. The prevalence of anxiety disorders is 18.1%.
A critical care nurse asks a psychiatric nurse about the difference between a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and a nursing diagnosis. What is the psychiatric nurse's best response?
- A. No functional difference exists between the two diagnoses. Both serve to identify a human deviance.
- B. The DSM-5 diagnosis disregards culture, whereas the nursing diagnosis includes cultural variables.
- C. The DSM-5 diagnosis profiles present distress or disability, whereas a nursing diagnosis considers past and present responses to actual mental health problems.
- D. The DSM-5 diagnosis influences the medical treatment; the nursing diagnosis offers a framework to identify interventions for problems a patient has or may experience.
Correct Answer: D
Rationale: The medical diagnosis, defined according to the DSM-5, is concerned with the patient's disease state, causes, and cures, whereas the nursing diagnosis focuses on the patient's response to stress and possible caring interventions. Both the DSM-5 and a nursing diagnosis consider culture. Nursing diagnoses also consider potential problems.
Which statements most clearly reflect the stigma of mental illness?
- A. Many mental illnesses are hereditary.
- B. Mental illness can be evidence of a brain disorder.
- C. People claim mental illness, so they can qualify for disability.
- D. If people with mental illness went to church, they would be fine.
- E. Mental illness is a result of the breakdown of the American family.
Correct Answer: C,D,E
Rationale: Stigma is represented by judgmental remarks that discount the reality and validity of mental illness. Many mental illnesses are genetically transmitted. Neuroimaging can show changes associated with some mental illnesses.
A patient in the emergency department reports, 'I hear voices saying someone is stalking me. They want to kill me because I found the cure for cancer. I will stab anyone that threatens me.' Which aspects of mental health have the greatest immediate concern to a nurse?
- A. Happiness
- B. Appraisal of reality
- C. Control over behavior
- D. Effectiveness in work
- E. Healthy self-concept
Correct Answer: B,C,E
Rationale: The aspects of mental health of greatest concern are the patient's appraisal of and control over behavior. The patient's appraisal of reality is inaccurate, and auditory hallucinations are evident, as well as delusions of persecution and grandeur. In addition, the patient's control over behavior is tenuous, as evidenced by the plan to 'stab' anyone who seems threatening. A healthy self-concept is lacking. Data are not present to suggest that the other aspects of mental health (happiness and effectiveness in work) are of immediate concern.
Which basic intervention should a psychiatric mental health nurse plan to provide for a patient diagnosed with a mood disorder?
- A. Sharing clinical expertise to enhance patient treatment
- B. Performing individual or group psychotherapy for the patient
- C. Using appropriate diagnostic tests to monitor patient condition
- D. Conducting stress reduction and health maintenance classes
Correct Answer: D
Rationale: Conducting stress reduction and health maintenance classes is the basic intervention that should be performed by a psychiatric mental health nurse. These classes will provide individualized guidance to patients to prevent or reduce mental illness and improve mental health. Community screenings and stress management classes are examples of health maintenance classes. The other options are advanced practice interventions.