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Which statements most clearly indicate that the speaker views mental illness with stigma?
- A. Everyone is a little bit crazy.'
- B. If people with mental illness would go to church, their problems would be solved with faith.'
- C. Many mental illnesses are genetically transmitted. It is no one's fault that the illness occurs.'
- D. Anyone can have a mental illness. War or natural disasters can be too stressful for healthy people.'
- E. People with mental illness are lazy. They expect the government to take care of everything they need.'
Correct Answer: A,B,E
Rationale: Statements that trivialize mental illness ('Everyone is a little bit crazy'), suggest simplistic solutions ('go to church'), or stereotype individuals as lazy reflect stigmatizing attitudes. The other statements acknowledge the biological and situational factors of mental illness without judgment, indicating a lack of stigma.
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A patient says, 'I often make careless mistakes and have trouble staying focused. Sometimes it's hard to listen to what someone is saying. I have problems putting things in the right order and often lose equipment.' Which problem should the nurse document?
- A. Inattention
- B. Impulsivity
- C. Hyperactivity
- D. Social impairment
Correct Answer: A
Rationale: Inattention refers to the failure to stay focused. A number of the other problems are the result of failure to pay attention, which contributes to problems with organization. Impulsivity refers to acting without thinking through the consequences. Hyperactivity refers to excessive motor activity. Social impairment refers to the failure to use appropriate social skills.
The treatment team believes medication will help a patient diagnosed with adult attention-deficit/hyperactivity disorder (ADHD). Which class of medications does the nurse expect will be prescribed?
- A. Benzodiazepines
- B. Stimulants
- C. Antipsychotics
- D. Anxiolytics
Correct Answer: B
Rationale: Stimulants, such as methylphenidate and amphetamines, provide the basis for treatment of both adult and childhood ADHD. They are the most commonly used medications; therefore, the nurse could expect the health care provider to prescribe a drug in this class. None of the other drugs listed as options have proved useful in the treatment of ADHD.
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.
A person diagnosed with severe and persistent mental illness enters a shelter for the homeless. Which intervention should be the nurse's initial priority?
- A. Develop a relationship.
- B. Find supported employment.
- C. Administer prescribed medication.
- D. Teach appropriate health care practices.
Correct Answer: A
Rationale: Basic psychosocial needs do not change because a person is homeless. The nurse's initial priority should be establishing rapport. Once a trusting relationship is established, then the nurse can pursue other interventions.
A patient diagnosed with severe and persistent mental illness lives independently. This patient often has command hallucinations and shouts warnings to neighbors. After a short hospitalization, the patient's landlord says, 'You can't come back here. You cause too much trouble.' What problem is the patient experiencing?
- A. Grief
- B. Stigmatization
- C. Recidivism
- D. Lack of insurance parity
Correct Answer: B
Rationale: The inability to obtain shelter because of negative attitudes about mental illness is an example of stigmatization. Stigma is defined as damage to reputation, shame, and ridicule society places on mental illness. Data are not present to identify grief as the patient's problem. Recidivism refers to repetition of a previous offense. Insurance parity is not relevant to this scenario.