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The partner of a patient diagnosed with schizophrenia says, 'I don't understand why childhood experiences have anything to do with this disabling illness.' Which nurse's response will best help the partner understand this condition?
- A. Psychological stress is actually at the root of most mental disorders.
- B. We now know that all mental illnesses are the result of genetic factors.
- C. It must be frustrating for you that your spouse is sick so much of the time.
- D. Research has shown schizophrenia has a biological rather than psychological origin.
Correct Answer: D
Rationale: Many of the most prevalent and disabling mental disorders have been found to have strong biological influences. Helping the partner understand the importance of his or her role as a caregiver is also important. Empathy is important but does not increase the spouse's level of knowledge about the cause of the patient's condition. Not all mental illnesses are the result of genetic factors. Psychological stress is not at the root of most mental disorders.
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A 40-year-old adult living with parents' states, 'I'm happy but I don't socialize much. My work is routine. When new things come up, my boss explains them a few times to make sure I understand. At home, my parents make decisions for me, and I go along with them.' A nurse should identify interventions to improve which patient characteristic?
- A. Self-concept
- B. Overall happiness
- C. Appraisal of reality
- D. Control over behavior
Correct Answer: A
Rationale: The patient feels the need for multiple explanations of new tasks at work and, despite being 40 years of age, allows both parents to make all decisions. These behaviors indicate a poorly developed self-concept. Although the patient reports being happy, the subsequent comments refute that self-appraisal. The patient's comments do not indicate that he/she is out of touch with reality. The patient's needs are broader than control over own behavior.
A nurse at a behavioral health clinic sees an unfamiliar psychiatric diagnosis on a patient's insurance form. Which resource should the nurse consult to discern the criteria used to establish this diagnosis?
- A. A psychiatric nursing textbook
- B. NANDA International (NANDA-I)
- C. A behavioral health reference manual
- D. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Correct Answer: D
Rationale: The DSM-5 gives the criteria used to diagnose each mental disorder. The NANDA-I focuses on nursing diagnoses. A psychiatric nursing textbook or behavioral health reference manual may not contain diagnostic criteria.
A patient tells a nurse, 'I have psychiatric problems and am in and out of hospitals all the time. Not one of my friends or relatives has these problems.' What is the nurse's best response?
- A. Comparing yourself with others has no real advantages.
- B. Why do you blame yourself for having a psychiatric illness?
- C. Mental illness affects 50% of the adult population in any given year.
- D. Are you are concerned that others don't experience the same challenges as you.
Correct Answer: D
Rationale: Mental illness affects many people at various times in their lives. No class, culture, or creed is immune to the challenges of mental illness. The correct response also demonstrates the use of reflection, a therapeutic communication technique. It is not true that mental illness affects 50% of the population in any given year. Asking patients if they blame themselves is an example of probing.
An 86 year old, previously healthy and independent, falls after an episode of vertigo. Which statement made by this patient best demonstrates resilience?
- A. I knew this would happen eventually.
- B. Attending my weekly water aerobics class is too risky.
- C. I don't need that silly walker to get around by myself.
- D. Maybe some physical therapy will help me with my balance.
Correct Answer: D
Rationale: Resiliency is the ability to recover from or adjust to misfortune and change. The correct response indicates that the patient is hopeful and thinking positively about ways to adapt to the vertigo. Saying 'I knew this would happen eventually' and discontinuing healthy activities suggest a hopeless perspective on the health change. Refusing to use a walker indicates denial.
In the majority culture of the United States, which individual is at greatest risk to be incorrectly labeled mentally ill?
- A. Person who is usually pessimistic but strives to meet personal goals.
- B. Wealthy person who gives $20 bills to needy individuals in the community.
- C. Person with an optimistic viewpoint about getting his or her own needs met.
- D. Person who expresses strong beliefs about the existence of alien abductions.
Correct Answer: D
Rationale: Possessing and expressing unpopular or unsubstantiated beliefs often suggests an individual is mentally unstable. In this situation, cultural norms vary, making it more difficult to make an accurate DSM-5 diagnosis. The individuals described in the other options are less likely to be labeled as mentally ill.