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The nurse is caring for a client on a behavioral health unit. What would support the theory that mental illness is a psychobiologic disorder?
- A. The client needs supervision in performing self-care.
- B. The client behavior improves with group therapy.
- C. The client has an alteration in neurotransmitter levels.
- D. The client has developed inappropriate interpersonal skills.
Correct Answer: C
Rationale: The nurse is correct to confirm the biologic disorder of an alteration in neurotransmitter levels. The neurotransmitters dopamine, norepinephrine, epinephrine, serotonin, and acetylcholine often are implicated in the psychobiology of mental illness. Evaluating the client's need for personal assistance, behavior improvement with group therapy, and inappropriate interpersonal skills addresses behavior aspects alone.
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The nurse is reviewing ways to foster effective coping skills with a client who has an anxiety disorder. What should the nurse include in the teaching? Select all that apply.
- A. Re-establish priorities and strike a healthy balance between work and play.
- B. Engage in a daily exercise program.
- C. Learn about stress management education and join a support group.
- D. Avoid verbalizing or writing about feelings of anxiety.
- E. Delay stressful tasks as desired.
Correct Answer: A,B,C
Rationale: The nurse should suggest re-establishing priorities and striking a healthy balance between work and play, engaging in a daily exercise program, pursuing stress management education, and joining a support group as ways to foster effective coping skills. The client should be encouraged to clearly state feelings or write about them in a diary if verbalizing dramatic or angry thoughts is difficult. The nurse should also discuss time management techniques such as avoiding procrastination; therefore, delaying stressful tasks as desired would not be included in the teaching.
The nurse is admitting a client into a mental health facility and completing a mental status examination. Which assessment criteria would the nurse document to complete a total score? Select all that apply.
- A. Thought content
- B. Family report
- C. Physical appearance
- D. Attention
- E. History of abuse
- F. Memory
Correct Answer: A,C,D,F
Rationale: A mental status examination is one component of a thorough neurologic examination. It is an array of observations and questions that elicit information about a person's cognitive and mental state. The examination does not document a family report or a past history of physical abuse.
The nurse researcher and committee monitoring are working with in a research study administering study medications to study participants. If the nurse researcher is administering study medications in a double-blind study, who is knowledgeable of the specifics of the medication?
- A. The nurse researcher
- B. The study committee and research nurse
- C. The study committee, research nurse, and client
- D. The study committee
Correct Answer: D
Rationale: The study committee is knowledgeable about the study medications. The nurse researcher and clients are not aware of the components of the medication, being a therapeutic medication or placebo. Thirty percent of the individuals receiving a placebo experience a positive outcome.
The nurse is obtaining a health history from a client with stress-related illnesses. When the nurse asks the client how the client copes with stress, which coping mechanism causes the nurse the most concern?
- A. I play video games for an hour.
- B. I run eight hours per day.
- C. I lift weights after work.
- D. I go out with friends.
Correct Answer: B
Rationale: The nurse is most concerned about the maladaptive coping mechanism of running eight hours per day. Playing video games, exercising or lifting weights, and going out with friends are more positive, beneficial coping mechanisms which, if done appropriately and in moderation, can reduce stress.
The nurse is caring for a client who has recently lost a spouse. Which question asked by the nurse is essential in guarding the client's immune system?
- A. Do you have friends and family to support you?
- B. Do you live alone in a one-story house?
- C. Are you able to prepare nutritious meals?
- D. Are your neighbors able to check on you?
Correct Answer: A
Rationale: When a client has very intense stress, such as the loss of a spouse, stress can lower the number of white blood cells impacting the immune system. There is also a connection between poorer immune function and loneliness. Asking the client about friends and family who are available to provide support is most helpful. Friends and family allow the client to share emotions and immune function improves. The other questions provide helpful data but not as pertinent to the immune system.