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When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:
- A. Medications provided are ineffective.
- B. Nurses are trying to control their minds.
- C. The medications will make them sick.
- D. They are not actually ill.
Correct Answer: D
Rationale: The correct answer is D: They are not actually ill. Anosognosia is a symptom of schizophrenia where patients lack awareness of their illness. This leads them to deny their condition and refuse treatment. Choice A is incorrect as it assumes patients are aware of the medication's effectiveness. Choice B is incorrect as it introduces a paranoid belief not related to anosognosia. Choice C is incorrect as it focuses on physical side effects, not denial of illness.
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A client with obsessive-compulsive disorder (OCD) repeatedly checks to see if the door is locked and asks for reassurance that it is locked. What is the most appropriate intervention by the RN to address this behavior?
- A. Set a specific limit on the number of times the client can check the door.
- B. Help the client find an alternative activity to perform.
- C. Provide consistent reassurance that the door is locked.
- D. Ignore the checking behavior and focus on other behaviors.
Correct Answer: A
Rationale: The correct answer is A: Set a specific limit on the number of times the client can check the door. This intervention helps establish boundaries and structure for the client, which can assist in reducing compulsive behaviors. By setting a specific limit, the client is encouraged to gradually decrease the checking behavior and learn to cope with the anxiety associated with uncertainty. This approach promotes independence and empowerment for the client.
Choice B is incorrect because finding an alternative activity does not directly address the obsessive checking behavior. Choice C is incorrect as providing consistent reassurance reinforces the compulsive behavior. Choice D is incorrect because ignoring the behavior does not actively address or help decrease the compulsive checking.
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: The correct answer is D: She should experience a reduction in hallucinations. First-generation antipsychotic medications are primarily used to target positive symptoms of schizophrenia, such as hallucinations. These medications work by blocking dopamine receptors in the brain, which can help reduce hallucinations. Providing this information to the patient is crucial for managing expectations and understanding the potential benefits of the prescribed medication.
Choices A, B, and C are incorrect because first-generation antipsychotics do not specifically address memory problems, depressive episodes, or social interactions. While some side effects of the medication may impact these areas, the primary focus is on reducing hallucinations and other positive symptoms of schizophrenia. It is important for the nurse to provide accurate information to the patient to ensure effective treatment and management of their condition.
Child protective services have removed 10-year-old Christopher from his parents’ home due to neglect. Christopher reveals to the nurse that he considers the woman next door his 'nice' mom, that he loves school, and gets above average grades. The strongest explanation of this response is:
- A. Temperament
- B. Genetic factors
- C. Resilience
- D. Paradoxical effects of neglect
Correct Answer: C
Rationale: The correct answer is C: Resilience. This is because Christopher's ability to form a positive relationship with the woman next door, his love for school, and above-average grades despite experiencing neglect indicate his resilience. Resilience refers to the capacity to adapt positively in the face of adversity. Christopher's behavior shows his ability to thrive despite challenging circumstances, emphasizing his resilience. Choices A, B, and D do not fully capture Christopher's ability to overcome adversity. Temperament (A) refers to inherent personality traits, genetic factors (B) focus on biological influences, and paradoxical effects of neglect (D) do not directly address Christopher's ability to cope and thrive.
Therapeutic communication is the foundation of a patient-centered interview. Which of the following techniques is not considered therapeutic?
- A. Restating
- B. Encouraging description of perception
- C. Summarizing
- D. Asking 'why' questions
Correct Answer: D
Rationale: As a tutor, the correct answer is D. Asking 'why' questions is not considered a therapeutic communication technique as it can come off as confrontational or judgmental, potentially making the patient feel defensive or pressured to justify their feelings. Therapeutic communication aims to create a safe and supportive environment for patients to express themselves openly without feeling judged. Restating, encouraging description of perceptions, and summarizing are all therapeutic techniques that help patients feel heard and understood, fostering trust and empathy in the patient-provider relationship.
Which factors tend to increase the difficulty of diagnosing young children who demonstrate behaviors associated with mental illness? Select all that apply.
- A. Limited language skills
- B. Level of cognitive development
- C. Level of emotional development
- D. Parental denial that a problem exists
Correct Answer: B
Rationale: The correct answer is B: Level of cognitive development. Diagnosing mental illness in young children is challenging due to their limited ability to express their thoughts and emotions. Their cognitive development affects their capacity to understand and communicate symptoms, making it harder to assess their mental health accurately. Limited language skills (A) and emotional development (C) can also contribute to the difficulty of diagnosis, but cognitive development plays a more significant role. Parental denial (D) may hinder seeking help but is not a factor that directly impacts the diagnostic process in the child.