James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for the day shift and anxiously reports, 'Last night, demons came to my room and tried to rape me.' Which response would be most therapeutic?
- A. There are no such things as demons. What you saw were hallucinations.
- B. It is not possible for anyone to enter your room at night. You are safe here.
- C. You seem very upset. Please tell me more about what you experienced last night.
- D. That must have been very frightening, but we'll check on you at night and you'll be safe.
Correct Answer: C
Rationale: Response C is the most therapeutic as it shows empathy and encourages the patient to express their feelings and share more about their experience. By actively listening and inviting the patient to talk, the nurse creates a supportive environment that can help the patient feel heard and understood, which is essential in building trust and rapport in therapeutic communication with individuals experiencing schizophrenia.
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Which assessment question asked by the nurse demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder? Select one that doesn't apply.
- A. Do rules apply to you?
- B. What do you do to manage anxiety?
- C. Do you have a history of disordered eating?
- D. Do you think that you drink too much?
Correct Answer: A
Rationale: Questions about anxiety management, disordered eating, and alcohol use are relevant to identifying comorbid conditions with major depressive disorder, but the question 'Do rules apply to you?' does not directly address common comorbid mental health conditions associated with major depressive disorder.
When using therapeutic communication with a withdrawn patient who has major depression, an effective method of managing the silence is to:
- A. Engage in a quiet meditation
- B. Ask simple questions even if the patient will not answer
- C. Use the technique of making observations
- D. Simply sit quietly and leave when the patient falls asleep
Correct Answer: C
Rationale: Using the technique of making observations is an effective method of managing silence when communicating with a withdrawn patient who has major depression. This approach can encourage the patient to engage and feel understood without the pressure to respond, fostering a therapeutic connection and helping the patient open up at their own pace.
When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:
- A. Medications provided are ineffective.
- B. Nurses are trying to control their minds.
- C. The medications will make them sick.
- D. They are not actually ill.
Correct Answer: D
Rationale: Anosognosia is a lack of insight that affects patients with schizophrenia, leading them to deny or lack awareness of their illness. This lack of awareness often results in patients refusing medication because they genuinely believe they are not ill and do not need treatment. It is crucial for healthcare providers to approach such situations with understanding and empathy, recognizing the impact of anosognosia on treatment adherence.
A nurse is reviewing prescriptions for a patient with major depression at the county clinic. Since the patient has a mild intellectual disability, the nurse would question which classification of antidepressant drugs:
- A. Selective serotonin reuptake inhibitors
- B. Monoamine oxidase inhibitors
- C. Serotonin and norepinephrine reuptake inhibitors
- D. All of the above
Correct Answer: B
Rationale: Monoamine oxidase inhibitors are less suitable for patients with intellectual disabilities due to the need for dietary restrictions and close monitoring. These restrictions can be challenging for patients with mild intellectual disabilities to follow, making this drug class a concern for this patient population.
Which intervention focuses on managing a common characteristic of major depressive disorder associated with the older population?
- A. Conducting routine suicide screenings at a senior center.
- B. Identifying depression as a natural, but treatable outcome of aging.
- C. Identifying males as at a greater risk for developing depression.
- D. Stressing that most individuals experience only a single episode of major depression in a lifetime.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.