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Which of the following outcome criteria is appropriate for the client with dementia?
- A. The client will return to an adequate level of self-functioning.
- B. The client will learn new coping mechanisms to handle anxiety.
- C. The client will seek out resources in the community for support.
- D. The client will follow an establishing schedule for activities of daily living.
Correct Answer: D
Rationale: Following established activity schedules is a realistic expectation for clients with dementia. All of the remaining outcome statements require a higher level of cognitive ability than can be realistically expected of clients with this disorder.
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A woman, aged 29, is admitted to the mental health hospital and diagnosed with Major Depressive Disorder with suicidal ideation. Her husband, aged 32, died in a tragic car accident 2 months prior to her admission. The nurse understands that the patient is experiencing
- A. dispositional crises
- B. crises of anticipated life transitions
- C. crises resulting from traumatic stress
- D. psychiatric emergencies
Correct Answer: C
Rationale: The sudden loss of her husband is a traumatic stress crisis, precipitating her depression and suicidal ideation.
A nurse is part of a multidisciplinary team working with groups of depressed patients. Half the patients receive supportive interventions and antidepressant medication. The other half receives only medication. The team measures outcomes for each group. Which type of study is evident?
- A. Incidence
- B. Prevalence
- C. Co-Morbidity
- D. Clinical Epidemiology
Correct Answer: D
Rationale: This describes a clinical epidemiology study, which evaluates treatment outcomes and effectiveness in a controlled setting.
While the nurse was taking her blood pressure, the patient suddenly stated. 'They are talking about me!' She was referring to other patients who were waiting for their consultation. Which of the following should be the APPROPRIATE nursing action?
- A. Present the reality situation
- B. Distract patient's attention
- C. Disagree with the patient
- D. Validate the statement
Correct Answer: A
Rationale: The client is presenting false beliefs or delusions. Intervention would include focusing on and directing the client's attention to concrete things in the environment as a way to present reality.
A mother telephones an adult psychiatric and mental health nurse practitioner to report that her 13-year-old son has been unusually active, irritable, and unable to sleep for more than a few hours each night. The adolescent has been diagnosed with a major depressive disorder and has been taking fluoxetine (Prozac) for six weeks. The nurse practitioner is most concerned about the possibility that:
- A. a therapeutic level of the drug has not been reached.
- B. an addition of hypnotic medication is warranted.
- C. the adolescent has been misdiagnosed.
- D. the adolescent is experiencing side effects.
Correct Answer: C
Rationale: Symptoms of hyperactivity, irritability, and sleeplessness suggest mania, indicating a possible bipolar disorder misdiagnosed as depression. Fluoxetine can trigger mania in bipolar patients, making misdiagnosis the primary concern over levels , hypnotics , or side effects .
Which of the following patients is at the HIGHEST risk for suicide?
- A. A 24-year-old woman who is successfully being treated for depression
- B. A 29-year-old man who was recently promoted with a large pay increase
- C. A 33-year-old man who regularly consumes alcohol and purchased a gun
- D. A 45-year-old woman who recently found out her cancer is in full remission
Correct Answer: C
Rationale: Alcohol use combined with access to a firearm significantly increases suicide risk due to impulsivity and means availability.