Nurse Daisy is aware that the following pharmacologic agents are sedative-hypnotic medication is used to induce sleep for a client experiencing a sleep disorder is:
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Solution
Triazolam (Halcion)
Option A: Triazolam is one of a group of sedative-hypnotic medication that can be used for a limited time because of the risk of dependence.
Option B: Paroxetine is a serotonin-specific reuptake inhibitor used for treatment of depression panic disorder, and obsessive-compulsive disorder.
Option C: Fluoxetine is a serotonin-specific reuptake inhibitor used for depressive disorders and obsessive-compulsive disorders.
Option D: Risperidone is indicated for psychotic disorders.
Charina, a college student who frequently visited the health center during the past year with multiple vague complaints of GI symptoms before course examinations. Although physical causes have been eliminated, the student continues to express her belief that she has a serious illness. These symptoms are typically of which of the following disorders?
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Solution
Hypochondriasis
Option C: Hypochondriasis, in this case, is shown by the client’s belief that she has a serious illness, although pathologic causes have been eliminated. The disturbance usually lasts at least 6 with identifiable life stressor such as, in this case, course examinations.
Option A: Conversion disorders are characterized by one or more neurologic symptoms.
Option B: Depersonalization refers to persistent recurrent episodes of feeling detached from one’s self or body.
Option D: Somatoform disorders generally have a chronic course with few remissions.
An 83-year-old male client is in extended care facility is anxious most of the time and frequently complains of a number of vague symptoms that interfere with his ability to eat. These symptoms indicate which of the following disorders?
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Solution
Hypochondriasis
Option B: Complaints of vague physical symptoms that have no apparent medical causes are characteristic of clients with hypochondriasis. In many cases, the GI system is affected.
Option A: Conversion disorders are characterized by one or more neurologic symptoms.
Option C: The client’s symptoms don’t suggest severe anxiety.
Option D: A client experiencing sublimation channels maladaptive feelings or impulses into socially acceptable behavior.
Katrina, a newly admitted is extremely hostile toward a staff member she has just met, without apparent reason. According to Freudian theory, the nurse should suspect that the client is experiencing which of the following phenomena?
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Solution
Transference
Option B: Transference is the unconscious assignment of negative or positive feelings evoked by a significant person in the client’s past to another person.
Option A: Intellectualization is a defense mechanism in which the client avoids dealing with emotions by focusing on facts.
Option C: Triangulation refers to conflicts involving three family members.
Option D: Splitting is a defense mechanism commonly seen in clients with personality disorder in which the world is perceived as all good or all bad.
Nurse Greta is aware that the following is classified as an Axis I disorder by the Diagnosis and Statistical Manual of Mental Disorders, Text Revision (DSM-IV-TR) is:
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Solution
Major depression
Option C: The DSM-IV-TR classifies major depression as an Axis I disorder.
Option B: Borderline personality disorder as an Axis II;
Options A and D: Obesity and hypertension, Axis III.
Marielle, 17 years old was sexually attacked while on her way home from school. She is brought to the hospital by her mother. Rape is an example of which type of crisis:
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Solution
Adventitious
Option B: Adventitious crisis is a crisis involving a traumatic event. It is not part of everyday life.
Option A: Situational crisis is from an external source that upset one’s psychological equilibrium.
Options C and D: These are the same. They are transitional or developmental periods in life.
Anthony is very hostile toward one of the staff for no apparent reason. He is manifesting:
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Solution
Transference
Option B: Transference is a positive or negative feeling associated with a significant person in the client’s past that are unconsciously assigned to another
Option A: Splitting is a defense mechanism commonly seen in a client with personality disorder in which the world is perceived as all good or all bad
Option C: Countertransference is a phenomenon where the nurse shifts feelings assigned to someone in her past to the patient
Option D: Resistance is the client’s refusal to submit himself to the care of the nurse
Nurse Sarah ensures a therapeutic environment for all the client. Which of the following best describes a therapeutic milieu?
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Solution
A living, learning or working environment.
Option C: A therapeutic milieu refers to a broad conceptual approach in which all aspects of the environment are channeled to provide a therapeutic environment for the client. The six environmental elements include structure, safety, norms; limit setting, balance and unit modification.
Option A: Behavioral approach in psychiatric care is based on the premise that behavior can be learned or unlearned through the use of reward and punishment.
Option B: Cognitive approach to change behavior is done by correcting distorted perceptions and irrational beliefs to correct maladaptive behaviors.
Option D: This is not congruent with therapeutic milieu.
Tristan is on Lithium has suffered from diarrhea and vomiting. What should the nurse in-charge do first:
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Solution
Hold the next dose and obtain an order for a stat serum lithium level
Option D: Diarrhea and vomiting are manifestations of Lithium toxicity. The next dose of lithium should be withheld and test is done to validate the observation.
Option A: The manifestations are not due to drug interaction.
Option B. Cogentin is used to manage the extrapyramidal symptom side effects of antipsychotics.
Option C: The common side effects of Lithium are fine hand tremors, nausea, polyuria and polydipsia.
Nurse Myrna develops a counter-transference reaction. This is evidenced by:
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Solution
Revealing personal information to the client
Option A: Counter-transference is an emotional reaction of the nurse on the client based on her unconscious needs and conflicts.
Options B and C: These are therapeutic approaches.
Option D: This is transference reaction where a client has an emotional reaction towards the nurse based on her past.