Nokea
The most widely used system of psychological classification today is
- A. the Freudian Psychoanalytic System (FPS)
- B. found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
- C. the system designed by Emil Kraepelin and Eugen Bleuler
- D. to be found in the Federal Uniform Code of Psychopathology (UCP)
Correct Answer: B
Rationale: The DSM-IV (now DSM-5) is the standard diagnostic system globally used in psychology.
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A patient has a maladaptive response to eating regulation. Findings include the following: height, 5 feet 3 inches; current weight, 80 pounds with weight loss of 30% of body weight over the past 3 months; T, 96.6m F; BP, 68/40; P, 40; R, 20; poor skin turgor; lanugo; amenorrhea of 6 months' duration; admits to restricting intake to 350 calories daily; is a vegetarian; dissatisfied with eating pattern as evidenced by patient statement, 'I need to lose another 10 pounds to be at ideal weight'; diagnostic testing reveals serum potassium of 2.9 mEq/L and urine specific gravity of 1.028. Which of the following would be the highest priority nursing diagnosis for this patient?
- A. Imbalanced nutrition, less than body requirements.
- B. Disturbed body image.
- C. Deficient fluid volume.
- D. Powerlessness.
Correct Answer: C
Rationale: The correct answer is C: Deficient fluid volume. The patient is displaying signs of severe malnutrition and dehydration, as evidenced by significant weight loss, low blood pressure, low heart rate, and poor skin turgor. The low serum potassium and high urine specific gravity indicate dehydration. Addressing fluid volume deficiency is the top priority to stabilize the patient's condition and prevent further complications like electrolyte imbalances and organ damage. Choices A and B are important but secondary to addressing the immediate threat of dehydration. Choice D is not the priority as the patient's primary concern is physiological rather than psychological.
Mood disorders are those in which the person may
- A. experience severe depression and threaten suicide
- B. exhibit symptoms suggesting physical disease or injury but for which there is no identifiable cause
- C. exhibit behavior that is the result of an organic brain pathology
- D. experience delusions and hallucinations
Correct Answer: A
Rationale: Mood disorders, like depression, feature extreme emotional states, including suicidal ideation.
A 79-year-old white male tells a nurse, 'I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing.' The nurse should analyze this comment as:
- A. normal pessimism of the elderly
- B. evidence of risks for suicide
- C. a call for sympathy
- D. normal grieving
Correct Answer: B
Rationale: The patient describes loss of significant others, economic security, and health. He describes mood alteration and voices the thought that he has little to live for. Combined with his age, sex, and single status, each is a risk factor for suicide. Elderly white males have the highest risk for completed suicide.
A person diagnosed with a serious mental illness enters a shelter for the homeless. Which intervention should be the nurses initial priority?
- A. Find supported employment
- B. Develop a trusting relationship
- C. Administer prescribed medication
- D. Teach appropriate health care practices
Correct Answer: B
Rationale: Basic psychosocial needs do not change because a person is homeless. The first step in caring for health care needs is establishing rapport. Once a trusting relationship is established, the nurse pursues other interventions.
A 72-year-old client with dementia, who resides in a long-term care facility, frequently goes to her room and cries because she misses her children. This client could benefit most from which intervention?
- A. Life review
- B. Doll therapy
- C. Comfort touch
- D. Audio presence therapy
Correct Answer: D
Rationale: The correct answer is D, Audio presence therapy. This intervention involves playing recordings of loved ones' voices to provide comfort and emotional support. For a client with dementia missing her children, hearing their voices can help reduce feelings of loneliness and provide a sense of connection. Life review (A) may not directly address the client's current emotional needs. Doll therapy (B) and comfort touch (C) may provide some comfort but may not be as effective as directly hearing the voices of her children through audio presence therapy (D).