ESSENTIALS OF PSYCHIATRIC
MENTAL FINAL PAPER WITH
ACCURATE ANSWERS
⩥ Client is brought to the psychiatric clinic by family members, who tell
the admitting nurse that the client repeatedly drives while intoxicated
despite their pleas to stop. During an interview with the nurse, which
statement by the client most strongly supports a diagnosis of
psychoactive substance abuse?
A. "I'm not addicted to alcohol. In fact, I can drink more than I used to
without being affected."
B. "I only spend half of my paycheck at the bar."
C. "I just drink to relax after work."
D. "I know I've been arrested three times for drinking and driving, but
the police are just trying to hassle me.". Answer: D. "I know I've been
arrested three times for drinking and driving, but the police are just
trying to hassle me."
Rationale: According the Diagnostic and Statistical Manual of Mental
Disorders, 4th edition, diagnostic criteria for psychoactive substance
abuse include a maladaptive pattern of such use, indicated either by
continued use despite knowledge or having a persistent or recurrent
social, occupational, psychological, or physical problem caused or
exacerbated by substance abuse or recurrent use in dangerous situations
, (for example, while driving). For this client, psychoactive substance
dependence must be ruled out; criteria for this disorder include a need
for increasing amounts of the substance to achieve intoxication (option
A), increased time and money spent on the substance (option B),
inability to fulfill role obligations (option C), and typical withdrawal
symptoms.
⩥ A female client with borderline personality disorder is admitted to the
psychiatric unit. Initial nursing assessment reveals that the client's wrists
are scratched from a recent suicide attempt. Based on this finding, the
nurse should formulate a nursing diagnosis of:
A. Ineffective individual coping related to feelings of guilt
B. Situational low self-esteem related to feelings of loss of control
C. Risk for violence: Self-directed related to impulsive mutilating acts
D. Risk for violence: Directed toward other related to verbal threats.
Answer: C. Risk for violence: Self-directed related to impulsive
mutilating acts
Rationale: The predominant behavior characteristic of the client with
borderline personal out disorder is impulsiveness, especially of a
physically self-destructive sort. The observation that the client has
scratched wrists doesn't substantiate the other options.
⩥ A male client recently admitted to the hospital with sharp, substernal
chest pain suddenly complains of palpitations. The nurse notes a rise in
the client's arterial blood pressure and a heart rate of 144 beats/minute.
On further questioning, the client admits to having used cocaine recently
MENTAL FINAL PAPER WITH
ACCURATE ANSWERS
⩥ Client is brought to the psychiatric clinic by family members, who tell
the admitting nurse that the client repeatedly drives while intoxicated
despite their pleas to stop. During an interview with the nurse, which
statement by the client most strongly supports a diagnosis of
psychoactive substance abuse?
A. "I'm not addicted to alcohol. In fact, I can drink more than I used to
without being affected."
B. "I only spend half of my paycheck at the bar."
C. "I just drink to relax after work."
D. "I know I've been arrested three times for drinking and driving, but
the police are just trying to hassle me.". Answer: D. "I know I've been
arrested three times for drinking and driving, but the police are just
trying to hassle me."
Rationale: According the Diagnostic and Statistical Manual of Mental
Disorders, 4th edition, diagnostic criteria for psychoactive substance
abuse include a maladaptive pattern of such use, indicated either by
continued use despite knowledge or having a persistent or recurrent
social, occupational, psychological, or physical problem caused or
exacerbated by substance abuse or recurrent use in dangerous situations
, (for example, while driving). For this client, psychoactive substance
dependence must be ruled out; criteria for this disorder include a need
for increasing amounts of the substance to achieve intoxication (option
A), increased time and money spent on the substance (option B),
inability to fulfill role obligations (option C), and typical withdrawal
symptoms.
⩥ A female client with borderline personality disorder is admitted to the
psychiatric unit. Initial nursing assessment reveals that the client's wrists
are scratched from a recent suicide attempt. Based on this finding, the
nurse should formulate a nursing diagnosis of:
A. Ineffective individual coping related to feelings of guilt
B. Situational low self-esteem related to feelings of loss of control
C. Risk for violence: Self-directed related to impulsive mutilating acts
D. Risk for violence: Directed toward other related to verbal threats.
Answer: C. Risk for violence: Self-directed related to impulsive
mutilating acts
Rationale: The predominant behavior characteristic of the client with
borderline personal out disorder is impulsiveness, especially of a
physically self-destructive sort. The observation that the client has
scratched wrists doesn't substantiate the other options.
⩥ A male client recently admitted to the hospital with sharp, substernal
chest pain suddenly complains of palpitations. The nurse notes a rise in
the client's arterial blood pressure and a heart rate of 144 beats/minute.
On further questioning, the client admits to having used cocaine recently
