Mental Health Exam 3 practice questions || With correct answers.

A patient at a general medical clinic tells the nurse, "I have so many ailments that I need to see six different doctors. None of them has discovered what is really wrong with me." Which comment should the nurse offer next? a. "Let's review all the medications you currently take." b. "Tell me about allergic reactions you've had to medication." c. "Selecting one primary care provider would be better for you." d. "I'm not sure I understand how you can afford these expenses." correct answers Answer - a. Safety is the nurse's first concern. One serious risk associated with doctor-shopping is medication interactions and duplicate medications. A combat veteran from two tours of the war in Afghanistan tells the nurse, "Some guys in my unit have posttraumatic stress disorder, but I never had any problems other than my hearing is not as good as it once was." Which explanation for this comment should the nurse consider? a. The veteran wants to demonstrate toughness and strength. b. The veteran shows indicators of derealization and depersonalization. c. The veteran may be rationalizing this reaction to memories of combat. d. The veteran may have amnesia associated with the combat experience. correct answers Answer - d. War is a traumatic experience for anyone. The veteran's comments about his peers and hearing deficit clearly indicate that he was exposed to explosives. Some studies show that between 5% and 20% of veterans are amnesic for their combat experiences. A patient diagnosed with dissociative identity disorder is hospitalized on an acute care psychiatric unit after a suicide attempt. During a team meeting, which staff nurse's comment should prompt the nursing supervisor to intervene? a. "I have never taken care of a patient diagnosed with this disorder." b. "I think this patient was misdiagnosed and probably has schizophrenia." 165 c. "I find myself more fascinated and engaged with this patient than others." d. "I recently read an autobiographical book about someone with this problem." correct answers Answer - c. Working with people who have somatic symptom disorders can be frustrating as well as fascinating. The correct response presents a comment indicating that the nurse may have lost objectivity regarding the patient. Guidance from the nursing supervisor is needed. A nurse in an outpatient medical clinic talks to a patient with a long history of malingering and doctor-shopping. The patient continues to express complaints of multiple problems. Select the nurse's best comment to the patient. a. "The treatment team believes you would benefit more from seeing a mental health professional." b. "The treatment team discussed your case and wants to begin a special case management program for you." c. "Because you take a number of medications, it would be safer to have them all filled at the same pharmacy." d. "Diagnostic testing has shown no medical problems and you are using more than your fair share of health care services." correct answers Answer - b. It's important for the nurse to convey compassion and support to the patient but without reinforcing the symptoms. Case