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The goal for a patient is to increase resiliency. Which outcome should a nurse add to the plan of care to be achieved within 3 days?
- A. Patient describes feelings associated with loss and stress.
- B. Patient meet own needs before considering the rights of others.
- C. Patient will identify healthy coping behaviors in response to stressful events.
- D. Patient will allow others to assume responsibility for major areas of own life.
Correct Answer: C
Rationale: The patient's ability to identify healthy coping behaviors indicates adaptive, healthy behavior and demonstrates an increased ability to recover from severe stress. Describing feelings associated with loss and stress does not move the patient toward adaptation. The remaining options are maladaptive behaviors.
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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.
A patient is admitted to the psychiatric hospital. Which assessment finding best indicates that the patient has a mental illness? The patient:
- A. describes coping and relaxation strategies used when feeling anxious.
- B. describes mood as consistently sad, discouraged, and hopeless.
- C. can perform tasks attempted within the limits of own abilities.
- D. reports occasional problems with insomnia.
Correct Answer: B
Rationale: A patient who reports having a consistently negative mood is describing a mood alteration that affects the ability to function optimistically. The incorrect options describe mentally healthy behaviors and common problems that do not indicate mental illness.
The partner of a patient diagnosed with schizophrenia says, 'I don't understand why childhood experiences have anything to do with this disabling illness.' Which nurse's response will best help the partner understand this condition?
- A. Psychological stress is actually at the root of most mental disorders.
- B. We now know that all mental illnesses are the result of genetic factors.
- C. It must be frustrating for you that your spouse is sick so much of the time.
- D. Research has shown schizophrenia has a biological rather than psychological origin.
Correct Answer: D
Rationale: Many of the most prevalent and disabling mental disorders have been found to have strong biological influences. Helping the partner understand the importance of his or her role as a caregiver is also important. Empathy is important but does not increase the spouse's level of knowledge about the cause of the patient's condition. Not all mental illnesses are the result of genetic factors. Psychological stress is not at the root of most mental disorders.
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.
A patient's history shows intense and unstable relationships with others. The patient initially idealizes an individual and then devalues the person when the patient's needs are not met. Which aspect of mental health is a problem for this patient?
- A. Effectiveness in work
- B. Communication skills
- C. Productive activities
- D. Maintaining relationships
Correct Answer: D
Rationale: The information provided centers on relationships with others, which are described as intense and unstable. The relationships of mentally healthy individuals are stable, satisfying, and socially integrated. Data are not present to describe work effectiveness, communication skills, or activities.