Nokea
Statistical approaches to abnormality define as 'abnormal' those who
- A. show evidence of loss of contact with reality
- B. are unhappy, withdrawn, and depressed
- C. deviate from typical or average patterns of behavior
- D. are disabled by anxiety
Correct Answer: C
Rationale: Statistical definitions label behavior abnormal if it deviates significantly from the norm, regardless of specific symptoms.
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A patient was admitted to the mental health unit after arguing with co-workers and threatening to kill them. He is diagnosed with paranoid schizophrenia. On the unit he is aloof and suspicious. He mentioned that two physicians he saw talking were plotting to kill him. On the basis of data gathered at this point, which two primary nursing diagnoses should the nurse consider?
- A. Disturbed thought processes and Risk for other-directed violence
- B. Spiritual distress and Social isolation
- C. Risk for loneliness and Knowledge deficit
- D. Disturbed personal identity and Nonadherence
Correct Answer: A
Rationale: The correct answer is A: Disturbed thought processes and Risk for other-directed violence.
1. Disturbed thought processes: The patient's delusions (believing physicians are plotting to kill him) indicate disorganized thinking, a hallmark of paranoid schizophrenia.
2. Risk for other-directed violence: The patient's threatening behavior towards co-workers suggests a potential for violence towards others.
Incorrect choices:
B: Spiritual distress and Social isolation - Not directly related to the patient's current symptoms of paranoid delusions and threat of violence.
C: Risk for loneliness and Knowledge deficit - The patient's issues are more severe than loneliness or knowledge deficit.
D: Disturbed personal identity and Nonadherence - While these issues may be relevant in schizophrenia, they are not the primary concerns presented in this scenario.
An unusual state called 'waxy flexibility' is sometimes observed in schizophrenia
- A. borderline
- B. disorganized
- C. catatonic
- D. paranoid
Correct Answer: C
Rationale: Waxy flexibility, a motor symptom, is unique to catatonic schizophrenia.
A 17-year-old client who has anorexia nervosa states she believes she will have fewer problems in college and will be more popular if she continues to lose weight. What nursing intervention would be useful at this time?
- A. Assisting the client to identify the problems causing her concern.
- B. Determining what she hopes to gain from the behavior.
- C. Explaining that her chances for becoming ill from losing weight are high.
- D. Having a physical report sent to college officials indicating her condition.
Correct Answer: A
Rationale: The correct answer is A because it focuses on assisting the client to identify the problems causing her concern. By helping the client explore the underlying issues driving her desire to lose weight, the nurse can address the root cause of her behavior. This intervention promotes self-awareness and insight, enabling the client to better understand her motivations and make informed choices.
Option B is incorrect because while determining what the client hopes to gain from the behavior is important, it does not directly address the immediate concern of identifying underlying problems.
Option C is incorrect because simply explaining the risks of becoming ill may not effectively address the client's belief that losing weight will lead to fewer problems and increased popularity.
Option D is incorrect because sending a physical report to college officials without the client's consent may violate confidentiality and trust, and it does not address the client's psychological needs.
A community health nurse visits an elderly person whose spouse died 6 months ago. Two vodka bottles are in the trash. When the nurse asks about alcohol use, this person says, 'I get lonely and drink a little to help me forget.' Select the nurses most therapeutic intervention.
- A. Assess whether this patient is drinking and driving
- B. Advise the person not to drink alone because the risks for injury increase
- C. Teach the person about risks for alcoholism and suggest other coping strategies
- D. Arrange for the person to attend an Alcoholics Anonymous meeting for older adults
Correct Answer: D
Rationale: This person needs help with alcohol abuse as well as social involvement. An AA meeting for older adults will provide an opportunity for peer bonding as well as strategies for coping with stress without abusing alcohol. The distracters will not be therapeutic in this instance.
Which measure is advisable to take, considering that individuals with dramatic erratic personality disorders often have the ability to evade limits and manipulate others?
- A. Plan frequent client-centered staff meetings.
- B. Practice take-down and restraint procedures.
- C. Institute written or taped change-of-shift reports.
- D. Rotate staff assignments so no one is responsible for the client for a prolonged period of days.
Correct Answer: A
Rationale: The correct answer is A: Plan frequent client-centered staff meetings. This measure is advisable as it promotes open communication, collaboration, and consistency in care. By holding regular meetings, staff can discuss concerns, share observations, and develop strategies to effectively manage individuals with erratic personality disorders. This approach helps in setting clear boundaries, identifying manipulative behaviors, and ensuring a unified team response.
Summary:
- Choice B: Practice take-down and restraint procedures is incorrect as it focuses on physical control rather than preventive strategies.
- Choice C: Institute written or taped change-of-shift reports is incorrect as it lacks real-time communication and immediate response to potential issues.
- Choice D: Rotate staff assignments so no one is responsible for the client for a prolonged period of days is incorrect as it may disrupt continuity of care and hinder the establishment of trust and rapport.