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The medical records of a patient diagnosed with schizophrenia state that the patient has cognitive dysfunction. From this statement, the nurse can expect to see evidence of:
- A. anxiety, fear, and agitation.
- B. aggression, anger, hostility, or violence.
- C. blunted or flat affect or inappropriate affective responses.
- D. impaired memory and attention as well as formal thought disorder.
Correct Answer: D
Rationale: The correct answer is D because cognitive dysfunction in schizophrenia typically involves impaired memory, attention, and formal thought disorder. This is due to the underlying neurobiological and neurocognitive deficits associated with the disorder. Choices A, B, and C are incorrect because they primarily align with emotional and affective symptoms commonly seen in schizophrenia, not specifically cognitive dysfunction. Symptoms such as anxiety, fear, agitation, aggression, anger, hostility, violence, blunted affect, or inappropriate affective responses are more related to the emotional and behavioral aspects of schizophrenia, rather than cognitive deficits.
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A man who regularly experiences premature ejaculation tells the nurse, 'I feel like such a failure. It's so awful for both me and my partner.' Select the nurse's most therapeutic response.
- A. I sense you are feeling frustrated and upset.
- B. Tell me more about feeling like a failure.
- C. You are too hard on yourself.
- D. What do you mean by awful?
Correct Answer: A
Rationale: The correct answer is A because it acknowledges the man's emotions of frustration and upset, showing empathy and understanding. This response validates his feelings and opens the door for further discussion. Choice B shifts the focus away from the man's current emotions. Choice C minimizes his feelings and may come across as dismissive. Choice D is too vague and doesn't address the man's emotional state directly. Overall, choice A is the most therapeutic as it validates the man's feelings and encourages him to express more.
Which of the following criteria can be used to define intellectual disabilities?
- A. Significantly below average intellectual functioning
- B. Impairments in adaptive functioning generally
- C. These deficits should be manifest before the age of 18 -years
- D. All of the above
Correct Answer: D
Rationale: Intellectual Disabilities: Defined by below-average intellectual functioning, adaptive impairments, and onset before age 18.
A psychiatric technician mentions to the nurse, 'All these clients with Axis II problems! It makes me wonder how so many mothers could have been such poor parents and messed up their kids so badly!' The response by the nurse that helps put the development of personality disorders into perspective is:
- A. Parenting is the responsibility of fathers, too, so don't blame only mothers.'
- B. Personality disorder is often related to sexual abuse that occurs without parental knowledge.'
- C. There is some evidence to suggest a biologic component to personality disorders.'
- D. Peer interactions may be more important in child development than parental involvement.'
Correct Answer: C
Rationale: Step-by-step rationale for correct answer (C):
1. Personality disorders are complex and have multifactorial causes.
2. Research suggests a biological component to personality disorders, such as genetic predispositions.
3. This understanding helps to shift the blame away from solely poor parenting.
4. It aligns with the biopsychosocial model, which considers biological, psychological, and social factors.
5. This response promotes a holistic view of personality development.
Summary of why other choices are incorrect:
A: Shifts focus to gender roles, which is not directly relevant to the etiology of personality disorders.
B: Narrowly associates personality disorders with sexual abuse, ignoring other contributing factors.
D: Overemphasizes peer interactions over parental influence, which is not supported by extensive research on personality development.
A catatonic patient admitted in a stuporous condition begins to demonstrate increased motor activity. During his assessment, the psychiatrist raises the patient's arm above his head and releases it. The patient maintains the position his arm was placed in, immobile in that position for 15 minutes, moving only when the nurse gently lowers his arm. What symptom is demonstrated by this assessment technique?
- A. Echopraxia
- B. Waxy flexibility
- C. Depersonalization
- D. Thought withdrawal
Correct Answer: B
Rationale: Waxy flexibility involves maintaining a posture imposed by another person, as seen in the patient's arm staying raised. This behavior is indicative of catatonia, a symptom of severe mental illness. Echopraxia involves mimicking movements of others, not maintaining a position. Depersonalization is a feeling of detachment from oneself, not related to physical movements. Thought withdrawal pertains to a symptom in schizophrenia where thoughts are removed by an external force, not related to physical posture.
A child, age 5, was admitted to the children's unit, having been sexually abused by an acquaintance of her family. The child refuses to talk and participate in unit activities, choosing to stay in her room with her stuffed animals. Which therapeutic intervention will best help the child release pent-up feelings about the abuse?
- A. Individual communication with the nurse
- B. Play therapy
- C. Family therapy
- D. Role-play with other children on the unit
Correct Answer: B
Rationale: The correct answer is B: Play therapy. Play therapy is the most suitable therapeutic intervention for a child in this scenario because it allows the child to express their feelings and experiences through play, which is a natural form of communication for children. Through play therapy, the child can act out their experiences using toys and create a safe space to process their emotions without having to verbally communicate. It helps the child release pent-up feelings and trauma in a non-threatening environment.
Summary of other choices:
A: Individual communication with the nurse may not be as effective as play therapy in this case as the child is not yet comfortable verbalizing their feelings.
C: Family therapy may not be appropriate at this stage as the child is not ready to engage with family members about the abuse.
D: Role-play with other children on the unit may not be beneficial as it can potentially trigger more anxiety and discomfort for the abused child.