EAQs 6-10 Psychological Disorders

EAQs 6-10 Psychological Disorders. A client with the diagnosis of manic episode of bipolar disorder attends a mental health day treatment program. What supervised activity will be most therapeutic for this client during the early phase of treatment? - Walking around the facility with a nurse -Walking around the facility with a nurse does not involve an element of competition and still allows the client to channel excess energy safely. An individual whose employment has been terminated because his company has been acquired by another company is brought by a family member to the mental health clinic because of extreme depression. While talking with the nurse the client says, "I'm a useless, worthless person. No wonder I lost my job." What type of delusion does the nurse identify? - Self-deprecation -The client's statement is self-derogatory and reflects a low self-appraisal. A nurse is caring for a client with an obsessive-compulsive disorder. What is the basis for the obsessions and compulsions? - Unconscious control of unacceptable feelings An older client is transferred to a nursing home from a hospital with a diagnosis of dementia. One morning, after being in the nursing home for several days, the client is going to join a group of residents in recreational therapy. The nurse sees that the client has laid out several outfits on the bed but is still wearing nightclothes. What should the nurse do? - Help the client select appropriate attire and offer to help the client get dressed A client is admitted to a psychiatric hospital with the diagnosis of schizoid personality disorder. Which initial nursing intervention is a priority for this client? - Helping the client learn to trust the staff through selected experiences A client with the diagnosis of alcoholism explains to the nurse that alcohol has a calming effect and states, "I function better when I'm drinking than when I'm sober." What defense mechanism does the nurse identify? - Rationalization -The attempt to justify a behavior by giving it acceptable motives is an example of rationalization What are the "four A's" for which nurses should evaluate clients with suspected Alzheimer disease? - Amnesia, apraxia, agnosia, aphasia -Neurofibrillary tangles in the hippocampus cause recent memory loss (amnesia); temporoparietal deterioration causes cognitive deficiencies in speech (aphasia), purposeful movements (apraxia), and comprehension of visual, auditory, and other sensations (agnosia). A client with a borderline personality disorder receives the wrong meal tray for lunch and angrily states, "The next time I see the dietitian, I'm going to throw this tray at her!" What is the most appropriate response by the nurse? - Telling the client that it is frustrating not to get the correct tray but that throwing the tray at the dietitian is unacceptable behavior While watching television in the dayroom a client who has demonstrated withdrawn, regressed behavior suddenly screams, bursts into tears, and runs from the room to the far end of the hallway. What is the most therapeutic intervention by the nurse? - Walking to the end of the hallway where the client is standing -Walking to the end of the hallway where the client is standing lets the client know that the nurse is available. It also demonstrates an acceptance of the client. An older adult is brought to the clinic by a family member because of increasing confusion over the past week. What can the nurse ask the client to do to determine orientation to place? - Identify the name of the clinic's town A depressed older client has not been eating well since her admission to the hospital. The client repeatedly states, "No one cares." What is the most appropriate response by the nurse? - "I care about you. What are some foods you especially like?" -The statement "I care about you. What are some foods you especially like?" is a direct response to the client's concern and permits some exploration of food choices What is essential for the nurse to do when approaching a client during a period of overactivity? - Using a firm but caring and consistent approach A nurse, understanding the possible cause of alcohol-induced amnestic disorder, should take into consideration that the client is probably experiencing: - Thiamine deficiency -The deficiency of thiamine (vitamin B1) is thought to be a primary cause of alcohol-induced amnestic disorder. A nurse is in the process of developing a therapeutic relationship with a client who has an addiction problem. What client communication permits the nurse to conclude that they are making progress in the working stage of the relationship? (Select all that apply.) - 2 Verbalizes difficulty identifying personal strengths 4 Acknowledges the effects of the addiction on the family 5 Addresses how the addiction has contributed to family distress A client with the diagnosis of bipolar disorder, depressive episode, has been hospitalized on a psychiatric unit for 1 week. What is the most appropriate activity for this client? - Talking with the nurse several times during the day -Involving the client in a one-on-one conversation provides individualized, low-anxiety-producing attention and gives the message that the client is important, which supports self-esteem. The parent of a child with a tentative diagnosis of attention deficit-hyperactivity disorder (ADHD) arrives at the pediatric clinic insisting on getting a prescription for medication that will control the child's behavior. What is best response by the nurse? - "It must be frustrating to deal with your child's behavior." -Stating that it must be frustrating acknowledges the parent's distress and encourages verbalization of feelings. An adolescent who has had the diagnosis of conduct disorder since the age of 9 is placed in a residential facility. The adolescent has a history of fighting, stealing, vandalizing property, and running away from home. The adolescent is aggressive, has no friends, and has been suspended from school repeatedly. What is the nurse's priority when planning care? - Preventing violence What is the primary reason that the nurse encourages the family of an alcoholic to become involved in the treatment program? - Alcoholism involves the entire family. -Research indicates that alcoholism is a family disease, with its roots in the family of origin A recovering alcoholic joins Alcoholics Anonymous (AA) to help maintain sobriety. What type of group is AA? - Self-help group A client has just been admitted with the diagnosis of borderline personality disorder. There is a history of suicidal behavior and self-mutilation. The nurse remembers that the main reason that clients use self-mutilation is to: - Express anger or frustration -Typically, recurrent self-mutilation is an expression of intense anger, helplessness, or guilt or is a form of self-punishment. A female client who is severely incapacitated by obsessive-compulsive behavior has been admitted to the mental health hospital. The client's compulsive ritual involves changing her clothing 8 to 12 times a day. She continually asks the nurse for advice regarding her problems but then ignores it. This is an example of the conflict of: - Dependence versus independence