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When planning inpatient psychotherapeutic activities for a patient who has antisocial personality disorder, the psychiatric-mental health nurse:
- A. focuses on group, rather than individual, therapy
- B. provides a permissive atmosphere, so the patient feels a sense of control
- C. provides an organized, structured environment
- D. recognizes that the disorder is characterized by social withdrawal
Correct Answer: C
Rationale: A structured environment sets clear boundaries, countering manipulative tendencies common in antisocial personality disorder.
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During a treatment team meeting, the point is made that a client with schizophrenia has recovered from the acute psychosis but continues to demonstrate apathy, avolition, and blunted affect. The nurse who relates these symptoms to serotonin (SHT2) excess will suggest that the client receive:
- A. Haloperidol (Haldol)
- B. Chlorpromazine (Thorazine)
- C. Olanzapine (Zyprexa)
- D. Phenelzine (NardiI)
Correct Answer: C
Rationale: Rationale: Olanzapine (Zyprexa) is the correct choice because it is an atypical antipsychotic that targets serotonin receptors, particularly 5-HT2 receptors known to be involved in negative symptoms of schizophrenia like apathy, avolition, and blunted affect. Olanzapine's mechanism of action helps alleviate these symptoms by modulating serotonin levels in the brain.
Incorrect Choices:
A: Haloperidol and B: Chlorpromazine are typical antipsychotics that primarily target dopamine receptors and are less effective in treating negative symptoms associated with schizophrenia.
D: Phenelzine is a monoamine oxidase inhibitor used to treat depression and anxiety disorders, not schizophrenia symptoms related to serotonin excess.
When told that he is scheduled to interview a patient with narcissistic personality disorder, the nurse can anticipate the assessment findings will include the following:
- A. charm, drama, seductiveness, and admiration seeking.
- B. preoccupation with minute details and perfectionism.
- C. difficulty being alone, indecisiveness, and submissiveness.
- D. grandiosity, self-importance, and a sense of entitlement.
Correct Answer: D
Rationale: The correct answer is D. In narcissistic personality disorder, individuals exhibit grandiosity, self-importance, and a sense of entitlement. This is a key feature of the disorder where individuals have an inflated sense of their own importance and require excessive admiration. This behavior is often accompanied by a lack of empathy and exploitation of others.
Choice A (charm, drama, seductiveness, and admiration seeking) is more characteristic of histrionic personality disorder.
Choice B (preoccupation with minute details and perfectionism) is more characteristic of obsessive-compulsive personality disorder.
Choice C (difficulty being alone, indecisiveness, and submissiveness) does not align with the typical presentation of narcissistic personality disorder.
A nurse observes a patient who is sitting alone in a room put hands over both ears and vigorously shake her head as though saying, 'No.' Later the patient cries and mutters, 'You don't know what you're talking about! Leave me alone.' What assessment should the nurse attempt to validate?
- A. The patient is seeking the attention of staff.
- B. The patient is inappropriately expressing emotion.
- C. The patient is experiencing auditory hallucinations.
- D. The patient is displaying negative symptoms of schizophrenia.
Correct Answer: C
Rationale: The correct answer is C: The patient is experiencing auditory hallucinations. The patient's behavior of covering both ears and shaking her head as if responding to voices, along with muttering and crying, suggests a sensory perception that is not based on external stimuli. This aligns with the characteristic symptoms of auditory hallucinations, which are common in conditions like schizophrenia.
Choice A is incorrect because the patient's behavior is not necessarily seeking attention but rather responding to internal stimuli. Choice B is incorrect as the patient's emotional expression seems to be a result of the auditory hallucinations rather than being inappropriate. Choice D is incorrect as negative symptoms of schizophrenia typically involve a decrease or absence of normal functions, which is not clearly demonstrated in this scenario.
What is an appropriate goal for a nurse working with a patient with anorexia nervosa?
- A. The patient will gain weight rapidly to restore nutritional balance.
- B. The patient will express satisfaction with their body image by the end of treatment.
- C. The patient will eat three meals daily and demonstrate healthy eating behaviors.
- D. The patient will be able to resume normal physical activities without fatigue.
Correct Answer: C
Rationale: The correct answer is C because setting a goal for the patient to eat three meals daily and demonstrate healthy eating behaviors is a more realistic and achievable target for someone with anorexia nervosa. This goal focuses on establishing regular eating habits and promoting a healthy relationship with food, which are crucial in the treatment of anorexia nervosa. Choices A and D are incorrect as rapid weight gain and resuming normal physical activities may not be safe or sustainable goals for someone with anorexia nervosa. Choice B is also incorrect because body image satisfaction is a complex issue that may not be directly addressed solely through treatment for anorexia nervosa.
A nursing colleague says, 'This patient was admitted claiming to have been raped by her boyfriend, but just look at the sexy clothes she's wearing.' Which response reflects an understanding of the most likely source of the colleague's comment?
- A. Have you ever cared for other sexual assault victims?'
- B. Your sister was raped when she was in college, wasn't she?'
- C. You have three unmarried brothers about the patient's age, don't you?'
- D. Do you think that wearing sexy clothes caused her to be sexually assaulted?'
Correct Answer: D
Rationale: The correct answer is D because it addresses the underlying misconception that a person's clothing choices can justify or provoke sexual assault. By asking if the colleague believes the victim's clothing caused the assault, it challenges victim-blaming and highlights the importance of understanding consent and boundaries.
Option A does not directly address the colleague's potentially victim-blaming statement. Option B brings up the colleague's personal experience, which is irrelevant and may not effectively challenge the problematic comment. Option C makes assumptions about the colleague's personal life, which is not relevant to the situation at hand.