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The father of a child diagnosed with schizophrenia says, 'I lost my job, so we have no health insurance.' The mother says, 'I must watch this child all the time. Without supervision, our child becomes violent and destructive.' A sibling says, 'My parents don't pay attention to me.' These comments signify what related stress?
- A. Life-cycle stressors
- B. Psychobiological issues
- C. Family burden of mental illness
- D. Stigma associated with mental illness
Correct Answer: C
Rationale: Family burden refers to the meaning that the experience of living with a person who is mentally ill has for families. The stressors mentioned are not related to live-cycle issues. The stressors described are psychosocial. Stigma refers to shame and ridicule associated with mental illness.
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An adult diagnosed with attention-deficit/hyperactivity disorder (ADHD) says, 'I've always been stupid. I never had friends when I was a child. My parents often punished me because I made mistakes. Now, I can't keep a job.' The nurse managing care should consider suggesting what intervention?
- A. Aversive therapy to extinguish negative behaviors.
- B. Cognitive therapy to help address internalized beliefs.
- C. Group therapy to allow comparison of feelings with others.
- D. Vocational counseling to identify needed occupational skills.
Correct Answer: B
Rationale: Cognitive therapy and knowledge of ADHD will make it possible for the patient to reframe the past and present in a more positive and realistic light and to challenge internalized false beliefs about self this improving self-image. Aversive therapy would not be useful for the patient. Group therapy may be valuable later to allow for the testing of new coping behaviors in a safe environment. Vocational counseling can help the patient explore suitable career options while pursuing treatment.
An adult has been feeling significant tension since losing a home through foreclosure. This person goes to park, feeds the birds, and then impulsively exposes himself to a group of parents and children. Which term applies to this behavior?
- A. Voyeurism
- B. Frotteurism
- C. Exhibitionism
- D. Sexual masochism
Correct Answer: C
Rationale: Exhibitionism is obtaining sexual pleasure from exposing one's genitalia to unsuspecting strangers. Voyeurism refers to obtaining sexual pleasure from observing people who are naked. Frotteurism is associated with obtaining sexual arousal by rubbing one's genitals against an unsuspecting person. Sexual masochism refers to deriving sexual pleasure from being humiliated, beaten, or otherwise made to suffer.
A nurse prepares for an initial interview with a patient with suspected adult attention-deficit/hyperactivity disorder (ADHD). Questions should be focused to elicit information about which problem?
- A. Headaches
- B. Inattention
- C. Sexual impulses
- D. Trichotillomania
Correct Answer: B
Rationale: Inattention usually persists from childhood into adult ADHD, although hyperactivity, impulsivity, and social impairments may also be present. Headaches would not be expected. Sexual impulses may be affected by adult ADHD, but this area is assessed later. Trichotillomania refers to pulling out one's hair as a tension-relieving behavior.
Health maintenance and promotion efforts for patients diagnosed with severe mental illness should include education about the importance of what regular intervention?
- A. Home safety inspections
- B. Monitoring of self-care abilities
- C. Screening for cancer, hypertension, and diabetes
- D. Determination of adequacy of a patient's support system
Correct Answer: C
Rationale: Individuals diagnosed with severe and persistent mental illness have an increased prevalence of medical disorders. Patients should be taught the importance of regular visits to a primary care physician for screening for these illnesses. Home safety inspections are more often suggested for patients with physical impairments. Caregivers and family members usually evaluate self-care abilities, rather than the patient. Assessment of a patient's support system is not usually considered part of health promotion and maintenance.
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.