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Maggie, a child in protective custody, is found to have an imaginary friend, Holly. Her foster family shares this information with the nurse. The nurse teaches the family members about children who have suffered trauma and knows her teaching was effective when the foster mother states:
- A. I understand that imaginary friends are abnormal.
- B. I understand that imaginary friends are a maladaptive behavior.
- C. I understand that imaginary friends are a coping mechanism.
- D. I understand that we should tell the child that imaginary friends are unacceptable.
Correct Answer: C
Rationale: Imaginary friends can serve as a coping mechanism for children, especially those who have experienced trauma. They can provide comfort and a sense of control in challenging situations. Acknowledging and supporting the child's imaginary friend can be beneficial in their emotional healing and development.
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You have been working closely with a patient for the past month. Today he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic?
- A. A new psychiatrist is a chance to start fresh; I'm sure it will go well for you.
- B. You say you look forward to the meeting, but you appear anxious or unhappy.
- C. I notice that you frowned and avoided eye contact just now. Don't you feel well?
- D. I get the impression you don't really want to see your psychiatrist-can you tell me why?
Correct Answer: B
Rationale: Choice B is the most therapeutic response as it acknowledges the discrepancy between the patient's verbal statement and nonverbal cues. By addressing both the patient's expressed anticipation and the conflicting nonverbal cues of frowning and avoiding eye contact, the responder demonstrates attentiveness to the patient's emotional state and encourages further exploration of underlying feelings. This approach fosters open communication and helps the patient feel understood and supported.
A female patient diagnosed with schizophrenia has been prescribed a first-generation antipsychotic medication. What information should the nurse provide to the patient regarding her signs and symptoms?
- A. Her memory problems will likely decrease.
- B. Depressive episodes should be less severe.
- C. She will probably enjoy social interactions more.
- D. She should experience a reduction in hallucinations.
Correct Answer: D
Rationale: First-generation antipsychotic medications are effective in reducing hallucinations in patients with schizophrenia. These medications primarily target positive symptoms such as hallucinations and delusions. Therefore, the nurse should inform the patient that she should experience a reduction in hallucinations with the prescribed first-generation antipsychotic medication.
Which intervention is particularly well chosen for addressing a population at high risk for developing schizophrenia?
- A. Screening a group of males aged 15 to 25 for early symptoms.
- B. Forming a support group for females aged 25 to 35 with substance use issues.
- C. Providing coping skills information to a group aged 45 to 55.
- D. Educating parents of developmentally delayed 5- to 6-year-olds on early intervention importance.
Correct Answer: A
Rationale: Screening males aged 15 to 25 for early symptoms of schizophrenia is a well-chosen intervention as this age group is at a higher risk for developing the condition. Early identification can lead to timely treatment and better outcomes, making this intervention particularly effective in addressing the population at risk for schizophrenia.
Tammy, a 28-year-old with major depressive disorder and bulimia nervosa, is ready for discharge from the county hospital after 2 weeks of inpatient therapy. Tammy is taking citalopram (Celexa) and reports that it has made her feel more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider?
- A. Fluoxetine (Prozac)
- B. Isocarboxazid (Marplan)
- C. Amitriptyline
- D. Duloxetine (Cymbalta)
Correct Answer: A
Rationale: Fluoxetine (Prozac) is a suitable alternative antidepressant for Tammy due to its approval for the treatment of bulimia nervosa. It belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressants, similar to citalopram, which Tammy is already taking. Fluoxetine has shown efficacy in treating bulimia nervosa and can be a beneficial choice for individuals with this condition.
The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer, 'locking up' other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:
- A. The need to dominate others
- B. Inventing traumatic events
- C. A need to develop close relationships
- D. A potential symptom of traumatization
Correct Answer: D
Rationale: The behavior of an 8-year-old boy playacting as a police officer and 'locking up' other children to the point of scaring them is likely a symptom of traumatization. Children may reenact traumatic experiences through play, and acting out aggressive or controlling roles can be a sign of underlying trauma. This behavior should be further assessed and addressed with appropriate support and intervention to help the child process and cope with any potential trauma.