Which client should the nurse anticipate to be most receptive to psychiatric treatment?
- A. A Jewish female journalist
- B. A Baptist homeless male
- C. A Catholic black male
- D. A Protestant Swedish business executive
Correct Answer: A
Rationale: The client who is Jewish and female, a journalist, is likely to be more receptive to psychiatric treatment due to cultural factors. In Jewish culture, there is often a high value placed on preventative healthcare, including mental health. Additionally, research suggests that women are more likely than men to seek treatment for mental health issues, making this client more open to psychiatric care. Choice B, a homeless male, might face barriers to accessing and accepting psychiatric treatment due to challenges related to homelessness. Choice C, a Catholic black male, and choice D, a Protestant Swedish business executive, do not provide specific cultural or gender-related factors that would indicate higher receptiveness to psychiatric treatment than the Jewish female journalist.
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A healthcare professional is assessing a client with obsessive-compulsive disorder (OCD). Which of the following findings should the professional expect? Select one that does not apply.
- A. Recurrent, intrusive thoughts
- B. Compulsive behaviors
- C. Delusions of grandeur
- D. Avoidance of situations that trigger obsessions
Correct Answer: C
Rationale: Obsessive-compulsive disorder (OCD) is characterized by recurrent, intrusive thoughts (obsessions), compulsive behaviors, and avoidance of situations that trigger obsessions. Delusions of grandeur, which involve inflated beliefs about one's own importance or abilities, are not typically associated with OCD. Therefore, the presence of delusions of grandeur would not be an expected finding in a client with OCD. Choices A, B, and D are all typical features of OCD and would be expected findings during the assessment of a client with this disorder.
A client with a history of alcohol use disorder is admitted to the hospital for detoxification. Which of the following symptoms should the nurse expect to observe during withdrawal? Select one that doesn't apply.
- A. Tremors
- B. Hallucinations
- C. Diaphoresis
- D. Bradycardia
Correct Answer: D
Rationale: During alcohol withdrawal, symptoms such as tremors, hallucinations, diaphoresis, and seizures are commonly observed. Bradycardia is not typically associated with alcohol withdrawal; instead, tachycardia, an increased heart rate, is more commonly seen. Therefore, bradycardia is the correct answer as it is not an expected symptom during alcohol withdrawal. Tremors, hallucinations, and diaphoresis are all common manifestations of alcohol withdrawal, while bradycardia is not typically seen in this context.
A new psychiatric nurse states, 'This client's use of defense mechanisms should be eliminated.' Which is a correct evaluation of this nurse's statement?
- A. Defense mechanisms can be self-protective responses to stress and need not be eliminated.
- B. Defense mechanisms are a maladaptive attempt by the ego to manage anxiety and should always be eliminated.
- C. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged but not eliminated.
- D. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.
Correct Answer: A
Rationale: The correct evaluation is that defense mechanisms can be self-protective responses to stress and do not necessarily need to be eliminated. These mechanisms help individuals reduce anxiety during times of stress. It is crucial for the nurse to understand that defense mechanisms serve a purpose and can be a normal part of coping. However, if defense mechanisms significantly hinder the client's ability to develop healthy coping skills, they should be addressed and explored. Eliminating defense mechanisms entirely without considering the individual's overall coping strategies can be counterproductive and may lead to increased distress for the client. Choice B is incorrect because not all defense mechanisms are maladaptive; some can be adaptive and helpful. Choice C is incorrect because labeling individuals as having weak ego integrity based on their use of defense mechanisms is stigmatizing and oversimplified. Choice D is incorrect because fostering and encouraging defense mechanisms without differentiation can lead to maladaptive behaviors and reliance on these mechanisms instead of healthier coping strategies.
Which of the following is identified as a psychoneurotic response to severe anxiety as it appears in the DSM-5?
- A. Somatic symptom disorder
- B. Grief responses
- C. Psychosis
- D. Bipolar disorder
Correct Answer: A
Rationale: The correct answer is A: Somatic symptom disorder. Somatic symptom disorder is characterized by preoccupation with physical symptoms for which there is no demonstrable organic pathology. One of the diagnostic criteria is a high level of anxiety about health concerns or illness. In the DSM-5, somatic symptom disorders are classified under the category of somatic symptom and related disorders, which encompass conditions where psychological factors play a significant role in the development, exacerbation, or maintenance of physical symptoms. Choices B, C, and D are incorrect. Grief responses, psychosis, and bipolar disorder are not specifically categorized as psychoneurotic responses to severe anxiety in the DSM-5.
During an assessment of a client with suspected substance use disorder, which of the following findings should the nurse expect? Select one that doesn't apply.
- A. Feelings of hopelessness
- B. Increased tolerance to the substance
- C. Withdrawal symptoms when not using the substance
- D. Unsuccessful attempts to cut down or control use
Correct Answer: A
Rationale: In clients with substance use disorder, common findings include increased tolerance to the substance, withdrawal symptoms when not using it, and unsuccessful attempts to cut down or control use. Feelings of hopelessness are not typically a direct manifestation of substance use disorder. Instead, feelings of hopelessness may be associated with other mental health conditions or situational factors. Therefore, the correct answer is A. Choices B, C, and D are all expected findings in clients with substance use disorder.
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