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Which information should a nurse include in health teaching for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) and their significant others?
- A. Tendency for genetic transmission
- B. Prevention strategies related to substance abuse
- C. Negative reinforcement strategies to help modify behaviors
- D. Selective serotonin reuptake inhibitors (SSRIs) are usually prescribed for hyperactivity
- E. Cognitive therapy may help resolve internalized negative beliefs about self
Correct Answer: A,B,E
Rationale: Evidence suggests that ADHD has a biological basis. This fact can help adults with the disorder to cope with low self-esteem. Cognitive therapy is helpful in reframing negative beliefs about self. Adults diagnosed with ADHD have a higher incidence of substance abuse problems. Psychostimulant medications, rather than SSRIs, are usually prescribed.
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The manager of a health club put a hidden camera in the women's locker room and videotaped women as they showered and dressed. Which sexual dysfunction is evident?
- A. Frotteurism
- B. Exhibitionism
- C. Pedophilia
- D. Voyeurism
Correct Answer: D
Rationale: Voyeurism is the viewing of others in intimate situations such as undressing, bathing, or having sexual relations. Voyeurs are often called 'peeping Toms.' Frotteurism is touching or rubbing against a nonconsenting person to achieve sexual gratification. Exhibitionists are interested in exposing their genitals to others. Pedophiles seek sexual contact with prepubescent children.
A nurse counsels a patient diagnosed with serious and persistent mental illness. The patient lives at home with family. Which resource could the nurse suggest assisting the patient and family to cope with the stigma of mental illness as well as provide support and education?
- A. American Psychiatric Association (APA)
- B. National Alliance on Mental Illness (NAMI)
- C. Community Mental Health Centers (CMHCs)
- D. Programs of Assertive Community Treatment (PACT)
Correct Answer: B
Rationale: Stigma represents the bias and prejudice commonly held regarding mental illness. NAMI actively seeks to dispel misconceptions about mental illness. The organization also offers patient and family support and education about living with mental illness. Community Mental Health Centers (CMHCs) are government agencies that provide outpatient services to persons diagnosed with SPMI. The APA is the professional organization of psychiatrists. Programs of Assertive Community Treatment (PACT) use a treatment team approach to improve symptom management and quality of life for persons diagnosed with SPMI.
An adult patient tells the case manager, 'I don't have bipolar disorder anymore, so I don't need medicine. After I was in the hospital last year, you helped me get an apartment and disability checks. Now I'm bored and don't have any friends.' Which resources should the nurse suggest for the patient?
- A. Psychoeducation classes
- B. Vocational rehabilitation
- C. Social skills training
- D. Homeless shelter
- E. Crisis intervention
Correct Answer: A,B,C
Rationale: The patient does not understand the illness and the need for adhering to the medication regimen. Psychoeducation for the patient (and family) can address this lack of knowledge. Work gives meaning and purpose to life; vocational rehabilitation can assist with this aspect of care. The patient, who considers himself friendless, could also profit from social skills training to improve the quality of interpersonal relationships. Many patients with severe mental illness have such poor communication skills that others are uncomfortable interacting with them. Interactional skills can be effectively taught by breaking down each skill into small verbal and nonverbal components. The patient presently has a home and does not require the services of a homeless shelter. The nurse case manager functions in the role of crisis stabilizer, so no related referral is needed.
An adult diagnosed with attention-deficit/hyperactivity disorder (ADHD) says, 'I've always been stupid. I never had friends when I was a child. My parents often punished me because I made mistakes. Now, I can't keep a job.' The nurse managing care should consider suggesting what intervention?
- A. Aversive therapy to extinguish negative behaviors.
- B. Cognitive therapy to help address internalized beliefs.
- C. Group therapy to allow comparison of feelings with others.
- D. Vocational counseling to identify needed occupational skills.
Correct Answer: B
Rationale: Cognitive therapy and knowledge of ADHD will make it possible for the patient to reframe the past and present in a more positive and realistic light and to challenge internalized false beliefs about self this improving self-image. Aversive therapy would not be useful for the patient. Group therapy may be valuable later to allow for the testing of new coping behaviors in a safe environment. Vocational counseling can help the patient explore suitable career options while pursuing treatment.
Which nursing action should occur first when preparing to work with a patient who has a problem of sexual functioning?
- A. Acquire knowledge of the patient's sexual roles and preferences.
- B. Develop an understanding of human sexual responses.
- C. Assess the patient's sexual functioning.
- D. Clarify the nurse's own personal values.
Correct Answer: D
Rationale: Before a nurse can be helpful to patients with sexual dysfunction, he or she must be aware of and comfortable with his or her own feelings about sex and sexuality. Nurses must be comfortable with the idea that patients have a right to their own values and must avoid criticism and censure.