Nokea
The family of a client mentions to the nurse, 'The family therapist talked to us about enmeshment. We're not sure we understood what it meant.' The nurse should base a response on knowledge that an enmeshed family is a unit in which:
- A. individuality is encouraged.
- B. boundaries are poorly defined.
- C. conflict is effectively resolved.
- D. social acceptance is deemed unimportant.
Correct Answer: B
Rationale: The correct answer is B: boundaries are poorly defined. In an enmeshed family, boundaries between family members are blurred, leading to a lack of individual autonomy and independence. Enmeshment can result in difficulties in establishing personal identities and healthy relationships. Choices A, C, and D are incorrect because individuality is not encouraged, conflict is not effectively resolved, and social acceptance is not necessarily deemed unimportant in an enmeshed family dynamic.
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Which of the following is related to recent attempts to find biochemical explanations for schizophrenia?
- A. schizotaxin
- B. psychotropin
- C. dopamine
- D. diazepam
Correct Answer: C
Rationale: Dopamine excess in the brain is a leading biochemical theory for schizophrenia, supported by antipsychotic efficacy.
When undertaking care for a patient with an eating disorder, a nurse should first:
- A. perform a complete patient assessment.
- B. obtain a history from the patient's family.
- C. examine his or her own feelings about weight.
- D. question the patient as to when he or she last ate a meal.
Correct Answer: C
Rationale: The correct answer is C because examining the nurse's own feelings about weight is essential to ensure they have a neutral and non-judgmental attitude towards the patient. This self-awareness helps the nurse avoid projecting biases onto the patient and fosters a therapeutic relationship. Performing a complete patient assessment (A) is important but not the first step. Obtaining a history from the patient's family (B) may be helpful but is not the initial priority. Questioning the patient about their last meal (D) is important but does not address the nurse's own attitudes and biases that could impact care.
A patient diagnosed with a serious mental illness lives independently and attends a psychosocial rehabilitation program. The patient presents at the emergency department seeking hospitalization. The patient has no acute symptoms but says, 'I have no money to pay my rent or refill my prescription.' Select the nurses best action.
- A. Involve the patients case manager to provide crisis intervention
- B. Send the patient to a homeless shelter until housing can be arranged
- C. Arrange for a short in-patient admission and begin discharge planning
- D. Explain that one must have active psychiatric symptoms to be admitted
Correct Answer: A
Rationale: Impaired stress tolerance and problem-solving abilities can cause persons with SMI to experience relatively minor stressors as crises. This patient has run out of money, and this has overwhelmed her ability to cope, resulting in a crisis for which crisis intervention would be an appropriate response. Inpatient care is not clinically indicated nor is the patient homeless (although she may fear she is). Telling the patient that she is not symptomatic enough to be admitted may prompt malingering.
During morning care, the nursing assistant asks a patient with dementia, 'How was your night?' The patient replies, 'It was lovely. My husband and I went out to dinner and to a movie.' The nurse who overhears this should make the assessment that the patient is:
- A. Demonstrating a sense of humor.
- B. Using confabulation.
- C. Perseverating.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Using confabulation. Confabulation is when a person with dementia unknowingly creates fictitious memories to fill in gaps in their memory. In this scenario, the patient's response of going out to dinner and a movie with their husband is not based in reality, indicating confabulation. A: Demonstrating a sense of humor is incorrect because the patient is not intentionally being humorous. C: Perseverating is incorrect as it refers to repeating the same words or phrases, which is not evident in the patient's response. D: None of the above is incorrect as the patient's response aligns with confabulation.
What role does play have in mental development?
- A. Minimal
- B. Develops social skills only
- C. Enhances imagination and reasoning
- D. Physical benefits only
Correct Answer: C
Rationale: Play enhances imagination and reasoning (C), fostering cognitive growth. It's not minimal (A), not just social (B), or only physical (D), per child development research.