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Which patient statement suggests the presence of dissociative amnesia?
- A. I keep forgetting where I put my keys.
- B. I don't remember the accident that brought me here or the past two days.
- C. Sometimes I feel like I'm watching myself from outside my body.
- D. I often lose track of time when I'm reading.
Correct Answer: B
Rationale: The correct answer is B because the statement reflects a significant gap in memory related to a traumatic event, which is characteristic of dissociative amnesia. Choice A is more indicative of normal forgetfulness and absentmindedness. Choice C suggests depersonalization or dissociative identity disorder rather than dissociative amnesia. Choice D describes a common experience related to concentration while reading, not memory loss as seen in dissociative amnesia.
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When developing a care plan for a patient with generalized anxiety disorder (GAD), which long-term goal is most appropriate?
- A. The patient will experience no episodes of anxiety.
- B. The patient will recognize and modify anxiety-provoking thoughts.
- C. The patient will avoid situations that cause anxiety.
- D. The patient will take medication as prescribed.
Correct Answer: B
Rationale: The most appropriate long-term goal for managing generalized anxiety disorder is for the patient to recognize and modify anxiety-provoking thoughts. By addressing and modifying these thoughts, the patient can develop coping mechanisms and strategies to manage their anxiety more effectively in the long term. Choices A and C are not ideal long-term goals as complete elimination of anxiety episodes or avoidance of anxiety-provoking situations may not be realistic or sustainable. Choice D focuses solely on medication adherence, which is important but does not address the core cognitive-behavioral aspects of managing anxiety in GAD.
What is the most appropriate intervention for a patient experiencing severe anxiety?
- A. Encourage the patient to talk about their anxiety.
- B. Teach the patient deep breathing exercises.
- C. Remain with the patient and provide a calm presence.
- D. Suggest the patient engage in physical activity.
Correct Answer: C
Rationale: When a patient is experiencing severe anxiety, remaining with the patient and providing a calm presence is the most appropriate intervention. This approach can help the patient feel supported and safe, which can help in reducing their anxiety levels. Encouraging the patient to talk about their anxiety may not be suitable during a severe anxiety episode, as it can potentially escalate their distress. Teaching deep breathing exercises can be helpful, but in cases of severe anxiety, the patient may find it challenging to focus on such techniques. Suggesting physical activity may not be suitable as the patient might not be in a state to engage in such activities when experiencing severe anxiety.
When caring for a patient with dissociative identity disorder, which nursing intervention is a priority?
- A. Providing detailed education about the condition
- B. Monitoring for signs of self-harm or suicidal ideation
- C. Encouraging the patient to recall traumatic events
- D. Helping the patient develop a strong sense of identity
Correct Answer: B
Rationale: When caring for a patient with dissociative identity disorder, the priority nursing intervention is to monitor for signs of self-harm or suicidal ideation. Ensuring patient safety is crucial, as individuals with this disorder may be at increased risk of self-harm or suicidal behaviors. Providing education about the condition is beneficial but ensuring immediate safety takes precedence. Encouraging the patient to recall traumatic events can be detrimental and should be done cautiously under professional guidance. While helping the patient develop a strong sense of identity is important in the long term, it is not the immediate priority when safety is a concern.
What is a primary goal of treatment for a patient with obsessive-compulsive disorder (OCD)?
- A. To eliminate all obsessive thoughts and compulsive behaviors
- B. To reduce the frequency and intensity of obsessive thoughts
- C. To increase the patient's social interactions
- D. To improve the patient's sleep quality
Correct Answer: B
Rationale: The primary goal of treating obsessive-compulsive disorder (OCD) is to reduce the frequency and intensity of obsessive thoughts and compulsive behaviors. While complete elimination of all obsessive thoughts and compulsive behaviors may be an ideal outcome, it is often unrealistic. Focusing on reducing the impact of these symptoms on the patient's daily life and functioning is more achievable and practical. Choices C and D are incorrect as they are not primary goals in the treatment of OCD. Increasing social interactions and improving sleep quality may be beneficial as part of a comprehensive treatment plan, but they are not the primary focus when managing OCD.
Which assessment finding best supports dissociative fugue?
- A. The patient states that he cannot remember important information about himself.
- B. The patient is found to be wandering in a park and cannot remember his name or where he lives.
- C. The patient reports feeling as if she is outside her body and observing herself from a distance.
- D. The patient has a sudden onset of symptoms after experiencing a traumatic event.
Correct Answer: B
Rationale: The key feature of dissociative fugue is sudden, unexpected travel away from home during which the individual may not be able to recall their identity or past events. Choice B best reflects this by describing a scenario where the patient is found wandering in a park and unable to remember their name or residence, which aligns with the characteristic dissociative amnesia seen in dissociative fugue. Choices A, C, and D do not directly support dissociative fugue. Choice A refers more to general dissociative amnesia, Choice C describes depersonalization/derealization disorder, and Choice D suggests acute stress reaction rather than dissociative fugue.