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The nurse wants to enroll a patient with poor social skills in a training program for patients diagnosed with schizophrenia. Which description accurately describes social skills training?
- A. Patients learn to improve their attention and concentration
- B. Group leaders provide support without challenging patients to change
- C. Complex interpersonal skills are taught by breaking them into simpler behaviors
- D. Patients learn social skills by practicing them in a supported employment setting
Correct Answer: C
Rationale: In social skills training, complex interpersonal skills are taught by breaking them down into component behaviors that are covered in a stepwise fashion. Social skills training is not based in employment settings, although such skills can be addressed as part of supported employment services. The other distracters are less relevant to social skills training.
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A 75-year-old patient comes to the clinic reporting frequent headaches. As the nurse begins the interaction, which action is most important?
- A. Complete a neurological assessment
- B. Determine whether the patient can hear as the nurse speaks
- C. Suggest that the patient lie down in a darkened room for a few minutes
- D. Administer medication to relieve the patient's pain before continuing the assessment
Correct Answer: B
Rationale: Correct Answer: B. Determine whether the patient can hear as the nurse speaks.
Rationale:
1. Hearing assessment is crucial to ensure patient understanding and communication.
2. Hearing loss may affect compliance with treatment and safety.
3. Identifying hearing deficits early can prevent misunderstandings and improve patient outcomes.
Summary:
- A: While a neurological assessment may be necessary, addressing hearing first is more immediate.
- C: Suggesting rest may help with headache management, but addressing hearing is more critical.
- D: Administering medication is premature without assessing hearing first.
A patient with acute mania approaches the nurse, waves a newspaper, and says, "I want the phone right now. I need to call this store while their sale is going on. I need ten dresses and four pairs of shoes." Select the nurse's best intervention.
- A. Suggest the patient ask a friend do the shopping and bring purchases to the unit.
- B. Invite the patient to sit with the nurse and look at new fashion magazines.
- C. Tell the patient phone use is not allowed until self-control is improved.
- D. Ask whether the patient has enough money to pay for the purchases.
Correct Answer: C
Rationale: The correct answer is C because the patient's behavior is impulsive and reflects poor judgment, which are common symptoms of acute mania. By telling the patient that phone use is not allowed until self-control is improved, the nurse is setting a boundary to prevent further impulsive actions. This intervention prioritizes safety and helps maintain a therapeutic environment.
A: This option does not address the immediate need to manage the patient's impulsive behavior and may put the friend in a potentially risky situation.
B: Inviting the patient to look at fashion magazines does not address the impulsivity and may even reinforce the behavior.
D: Asking about the patient's financial situation is not the most appropriate intervention at this time.
The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating. He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. This information most likely suggests:
- A. medication nonadherence.
- B. a need for psychoeducation.
- C. the chronic nature of his illness.
- D. relapse of his schizophrenia.
Correct Answer: D
Rationale: The correct answer is D: relapse of his schizophrenia. The patient's symptoms of feeling tense, difficulty concentrating, poor sleep, and delusional beliefs about creatures at work indicate a worsening of his psychotic symptoms. This suggests a relapse of schizophrenia, a chronic mental illness characterized by periods of stability and exacerbation of symptoms. The patient's previous stability for a year makes medication nonadherence less likely. While psychoeducation may be beneficial, the patient's current symptoms require more immediate intervention for relapse management. The information provided does not directly indicate the chronic nature of his illness, but rather an acute exacerbation. Therefore, D is the most appropriate choice based on the presented symptoms and clinical understanding of schizophrenia.
In learning disabilities, the name for mathematical disorder is:
- A. Dyspraxia
- B. Dyslexia
- C. Dyscalculia
- D. Dysphasia
Correct Answer: C
Rationale: Mathematics Disorder (Dyscalculia): A specific learning disability characterised by mathematical ability being substantially below norm for chronological age, intelligence, and educational level.
A nurse is planning care for a patient with bulimia nervosa. Which goal should be included in the care plan?
- A. The patient will engage in daily exercise to prevent weight gain.
- B. The patient will maintain a healthy, balanced diet without purging behaviors.
- C. The patient will gain 1-2 pounds per week.
- D. The patient will eliminate binge eating and purging behaviors entirely.
Correct Answer: B
Rationale: Step-by-step rationale:
1. Maintaining a healthy, balanced diet without purging behaviors is crucial for managing bulimia nervosa.
2. This goal promotes physical health and addresses the underlying disordered eating habits.
3. It focuses on establishing sustainable eating patterns to support overall well-being.
4. It helps prevent complications associated with bulimia, such as electrolyte imbalances.
Summary:
- Option A is incorrect as excessive exercise can be a compensatory behavior in eating disorders.
- Option C is incorrect as rapid weight gain is not recommended in the treatment of bulimia.
- Option D is incorrect as complete elimination of binge eating and purging may be unrealistic initially.