Which assessment finding best supports dissociative fugue?
- A. The patient states that he cannot remember important information about himself.
- B. The patient is found to be wandering in a park and cannot remember his name or where he lives.
- C. The patient reports feeling as if she is outside her body and observing herself from a distance.
- D. The patient has a sudden onset of symptoms after experiencing a traumatic event.
Correct Answer: B
Rationale: The key feature of dissociative fugue is sudden, unexpected travel away from home during which the individual may not be able to recall their identity or past events. Choice B best reflects this by describing a scenario where the patient is found wandering in a park and unable to remember their name or residence, which aligns with the characteristic dissociative amnesia seen in dissociative fugue. Choices A, C, and D do not directly support dissociative fugue. Choice A refers more to general dissociative amnesia, Choice C describes depersonalization/derealization disorder, and Choice D suggests acute stress reaction rather than dissociative fugue.
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What is the most appropriate nursing diagnosis for a patient with agoraphobia who reports not having left their house in months?
- A. Social isolation
- B. Ineffective coping
- C. Risk for injury
- D. Impaired social interaction
Correct Answer: A
Rationale: The nursing diagnosis 'Social isolation' is most appropriate for a patient with agoraphobia who has not left their house in months. Agoraphobia often leads to the avoidance of situations or places perceived as unsafe, resulting in social isolation. This diagnosis reflects the patient's limited social interactions and confinement to the home environment, which can impact their overall well-being and mental health. The other options are not as relevant in this scenario: 'Ineffective coping' does not directly address the social withdrawal aspect, 'Risk for injury' is not the primary concern presented, and 'Impaired social interaction' does not capture the extent of isolation described.
Which intervention should a healthcare professional implement to help a patient with social anxiety disorder?
- A. Encourage participation in group therapy sessions.
- B. Suggest practicing relaxation techniques during social interactions.
- C. Advise the patient to avoid social situations that cause anxiety.
- D. Teach the patient cognitive restructuring techniques.
Correct Answer: D
Rationale: Teaching cognitive restructuring techniques is an effective intervention for patients with social anxiety disorder. This approach helps individuals challenge and change their negative thought patterns, leading to improved coping mechanisms in social situations. Choice A, encouraging participation in group therapy sessions, may be overwhelming for individuals with social anxiety. Choice B, suggesting relaxation techniques, may offer short-term relief but does not address the underlying cognitive distortions. Choice C, advising avoidance of social situations, reinforces avoidance behaviors and does not promote long-term improvement in managing social anxiety.
Which behavior is most characteristic of agoraphobia?
- A. Avoiding crowded places and public transportation
- B. Excessively washing hands to prevent contamination
- C. Experiencing unexpected panic attacks
- D. Having a fear of gaining weight
Correct Answer: A
Rationale: Agoraphobia is characterized by the avoidance of situations where escape might be difficult or help unavailable in the event of a panic attack. Avoiding crowded places and public transportation aligns with this fear of being in situations where escape might be challenging, making choice A the most characteristic behavior of agoraphobia. Choices B, C, and D do not directly relate to the core feature of agoraphobia, which is the avoidance of situations perceived as difficult to escape from.
What is the most effective initial intervention for a patient experiencing a panic attack?
- A. Encourage the patient to discuss their feelings.
- B. Provide a quiet environment and stay with the patient.
- C. Administer prescribed medication immediately.
- D. Teach the patient relaxation techniques.
Correct Answer: B
Rationale: During a panic attack, the most effective initial intervention is to provide a quiet environment and stay with the patient. This approach can help the patient feel safe and supported, which may help reduce the intensity and duration of the panic attack. Encouraging the patient to discuss their feelings may not be helpful during the acute phase of a panic attack as it can be overwhelming. Administering prescribed medication immediately is not typically the first-line intervention for panic attacks. Teaching relaxation techniques is beneficial in the long term but may not be the most effective immediate intervention during a panic attack.
What is the most appropriate intervention for a patient experiencing severe anxiety?
- A. Encourage the patient to talk about their anxiety.
- B. Teach the patient deep breathing exercises.
- C. Remain with the patient and provide a calm presence.
- D. Suggest the patient engage in physical activity.
Correct Answer: C
Rationale: When a patient is experiencing severe anxiety, remaining with the patient and providing a calm presence is the most appropriate intervention. This approach can help the patient feel supported and safe, which can help in reducing their anxiety levels. Encouraging the patient to talk about their anxiety may not be suitable during a severe anxiety episode, as it can potentially escalate their distress. Teaching deep breathing exercises can be helpful, but in cases of severe anxiety, the patient may find it challenging to focus on such techniques. Suggesting physical activity may not be suitable as the patient might not be in a state to engage in such activities when experiencing severe anxiety.