Nokea
Which of the following are behaviours that may be associated with adolescent depression?
- A. School refusal
- B. Social withdrawal
- C. Reduced self-care
- D. Maladaptive coping behaviours
Correct Answer: A
Rationale: School refusal is a well-documented behavior associated with adolescent depression; the question implies a single correct answer, though B-D are also relevant.
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A patient with borderline personality disorder has been hospitalized several times after self-injurious behavior and suicide attempts. The patient has entered dialectical behavior therapy on an outpatient basis. During therapy, the advanced practice nurse has been counseling her regarding self-harm behavior management. Today the patient called the nurse and reported 'feeling empty and anxious' and wants to cut herself. Which response would best help in this situation?
- A. Arrange for an emergency admission to a crisis unit.
- B. Arrange for an emergency admission to an inpatient unit.
- C. Assist the patient to identify and choose a coping strategy.
- D. Advise the patient to take an anxiolytic, then go to sleep.
Correct Answer: C
Rationale: The correct response is C: Assist the patient to identify and choose a coping strategy. This choice is the best because it involves helping the patient develop healthy coping mechanisms to manage her distress. This empowers the patient to take control of her emotions and actions in a positive way. Emergency admissions (choices A and B) may not address the underlying issues and could potentially reinforce maladaptive behaviors. Advising medication (choice D) without addressing the emotional distress directly may not provide long-term solutions. In summary, choice C focuses on empowering the patient and addressing the root of the problem, making it the most appropriate response in this scenario.
A nurse would assess for which feature in a patient diagnosed with bulimia nervosa?
- A. Introverted personality traits
- B. Abuse of diuretics and laxatives
- C. Disinterest in sexual activity
- D. Denial of hunger at all times
Correct Answer: B
Rationale: The correct answer is B because abuse of diuretics and laxatives is a common behavior in individuals with bulimia nervosa to control weight. This behavior is known as purging. Choice A is incorrect as personality traits vary among individuals with bulimia nervosa. Choice C is incorrect as disinterest in sexual activity is not a typical feature of this disorder. Choice D is incorrect as individuals with bulimia nervosa often experience episodes of binge eating, indicating they do experience hunger at times.
A patient with schizophrenia has been stabilized in the Crisis Center and is about to be discharged. He will be living with his family, but the family knows nothing about the patient's illness, its treatment, or the role they can play in his recovery. Which activity would be most beneficial for the family to attend?
- A. Psychoanalytic group
- B. Psychoeducational group
- C. Individual counseling
- D. Family therapy
Correct Answer: B
Rationale: The correct answer is B: Psychoeducational group. This option is most beneficial as it will provide the family with education about schizophrenia, its treatment, and the role they can play in the patient's recovery. This will help the family better understand the illness, how to support the patient, and how to communicate effectively.
Explanation:
1. Psychoanalytic group (A) focuses on exploring unconscious thoughts and emotions, which may not be as practical or helpful for educating the family about schizophrenia.
2. Individual counseling (C) may not involve the family as a whole and may not provide the necessary education and support for the family unit.
3. Family therapy (D) could be beneficial, but psychoeducational group specifically targets providing knowledge and skills needed to support the patient's recovery, making it the most appropriate choice in this scenario.
A patient diagnosed with a serious mental illness lives independently and attends a psychosocial rehabilitation program. The patient presents at the emergency department seeking hospitalization. The patient has no acute symptoms but says, 'I have no money to pay my rent or refill my prescription.' Select the nurses best action.
- A. Involve the patients case manager to provide crisis intervention
- B. Send the patient to a homeless shelter until housing can be arranged
- C. Arrange for a short in-patient admission and begin discharge planning
- D. Explain that one must have active psychiatric symptoms to be admitted
Correct Answer: A
Rationale: Impaired stress tolerance and problem-solving abilities can cause persons with SMI to experience relatively minor stressors as crises. This patient has run out of money, and this has overwhelmed her ability to cope, resulting in a crisis for which crisis intervention would be an appropriate response. Inpatient care is not clinically indicated nor is the patient homeless (although she may fear she is). Telling the patient that she is not symptomatic enough to be admitted may prompt malingering.
Assist her in developing an emergency plan, since the pattern of violence is likely to continue.
- A. Developing an emergency plan is crucial in situations of potential violence.
- B. The pattern of violence may decrease over time.
- C. The pattern of violence is unpredictable.
- D. None of the above.
Correct Answer: A
Rationale: Rationale for Choice A:
1. Developing an emergency plan is crucial as it ensures safety during potential violent situations.
2. It empowers the individual to have a plan of action in place to protect themselves.
3. By having an emergency plan, the individual can respond quickly and effectively to ensure their safety.
Summary of Other Choices:
B. The pattern of violence decreasing is uncertain and doesn't address the immediate need for safety.
C. Labeling the pattern of violence as unpredictable doesn't provide a proactive solution for the individual's safety.
D. "None of the above" is incorrect as developing an emergency plan is a proactive and necessary step in situations of potential violence.