Nokea
Which of the following is NOT a suitable place for a family doctor outside the polyclinic to refer an adolescent patient for psychotherapy/counselling?
- A. Local Social Service Office
- B. Nearby polyclinic
- C. Patients school
- D. A reputable restructured hospital
Correct Answer: B
Rationale: A nearby polyclinic is less suitable for psychotherapy referral as it focuses on primary care, unlike the other options with counseling services.
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A person diagnosed with a serious mental illness (SMI) living in the community was punched, pushed to the ground, and robbed of 7 during the day on a public street. Which statements about violence and serious mental illness in general are accurate? Select one tha does not apply.
- A. Persons with SMI are more likely to be violent
- B. SMI persons experience higher rates of sexual assault and victimization than others
- C. Impaired judgment and social skills can provoke hostile or assaultive behavior
- D. Lower incomes force SMI persons to live in high-crime areas, increasing risk
Correct Answer: A
Rationale: Mentally ill persons are more likely to be victims of crime than perpetrators of criminal acts. They are often victims of criminal behavior, including sexual crimes, at a higher rate than others. When a mentally ill person commits a crime, it is usually nonviolent. Mental illnesses interfere with employment and are associated with poverty, limiting SMI persons to living in inexpensive areas that also tend to be higher-crime areas. SMI persons may inadvertently provoke others because of poor judgment or socially inappropriate behavior, or they may be victimized because they are perceived as passive, less likely to resist, and less likely to be believed as witnesses.
A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. He occasionally curses or calls another client a 'jerk' without provocation. The nurse asks the client how he is feeling, and he responds, 'Everybody picks on me. They frobitz me.' The nurse would assess 'frobitz' as:
- A. Circumstantial speech
- B. Loose associations
- C. Evidence of delusional thinking
- D. A neologism
Correct Answer: D
Rationale: The correct answer is D: A neologism. A neologism is a newly coined word or expression that is not easily understood by others. In this case, the client's use of the word 'frobitz' is not a recognized word, indicating it may be a neologism. This is commonly seen in individuals with schizophrenia who create new words or distort existing ones.
A: Circumstantial speech involves excessive and unnecessary details before reaching the main point. The client's response is not characterized by this.
B: Loose associations involve a lack of logical connections between thoughts. The client's response is not demonstrating this.
C: Evidence of delusional thinking would involve fixed, false beliefs that are not based in reality. The client's use of 'frobitz' does not necessarily indicate a delusion.
In summary, the use of 'frobitz' by the client is indicative of a neologism, as it is a new and potentially meaningless
A patient with acute mania approaches the nurse, waves a newspaper, and says, "I want the phone right now. I need to call this store while their sale is going on. I need ten dresses and four pairs of shoes." Select the nurse's best intervention.
- A. Suggest the patient ask a friend do the shopping and bring purchases to the unit.
- B. Invite the patient to sit with the nurse and look at new fashion magazines.
- C. Tell the patient phone use is not allowed until self-control is improved.
- D. Ask whether the patient has enough money to pay for the purchases.
Correct Answer: C
Rationale: The correct answer is C because the patient's behavior is impulsive and reflects poor judgment, which are common symptoms of acute mania. By telling the patient that phone use is not allowed until self-control is improved, the nurse is setting a boundary to prevent further impulsive actions. This intervention prioritizes safety and helps maintain a therapeutic environment.
A: This option does not address the immediate need to manage the patient's impulsive behavior and may put the friend in a potentially risky situation.
B: Inviting the patient to look at fashion magazines does not address the impulsivity and may even reinforce the behavior.
D: Asking about the patient's financial situation is not the most appropriate intervention at this time.
Individuals with Down Syndrome often have moderate to severe intellectual impairment with a measurable IQ usually between:
- A. 45-50
- B. 55-60
- C. 35-55
- D. 25-35
Correct Answer: C
Rationale: Down Syndrome: A disorder caused by an extra chromosome 21, characterized by intellectual impairment with IQ typically between 35-55.
A nurse has recently been assigned to a unit that specializes in the care of patients diagnosed with eating disorders. The nurse should consider which of the following actions as having priority when preparing for this new assignment?
- A. Becoming familiar with the unit's policies and procedures.
- B. Arranging to mentor with a nurse who has experience on the unit.
- C. Self-reflecting on personal feelings regarding body weight and size.
- D. Attending an educational seminar that focuses on maladaptive eating disorders.
Correct Answer: C
Rationale: The correct answer is C. Self-reflecting on personal feelings regarding body weight and size is crucial for the nurse to be aware of any biases or triggers that may affect patient care. Understanding personal attitudes towards body image can prevent unintentional harm or judgment towards patients.
A: Becoming familiar with the unit's policies and procedures is important but not the top priority when dealing with patients with eating disorders.
B: Arranging to mentor with a nurse who has experience on the unit can be helpful but does not address the nurse's personal biases.
D: Attending an educational seminar is valuable but may not address the nurse's own attitudes towards body image.