Question 1

Which economic factors are most critical to the success of discharge planning for a patient diagnosed with severe and persistent mental illness? (Select all that apply.)

Accepted Answer

The success of discharge planning requires careful attention to the patient's economic status. Access to housing is the first priority of the seriously mentally ill, and lack of income and health insurance is a barrier to effective treatment and rehabilitation. Although important aspects of ongoing care of the seriously mentally ill patient, ongoing interdisciplinary evaluation and individual psychotherapy are not economic factors.

Question 2

A man tells the nurse, "All my life, I have felt and acted like a woman while living in a man's body. For the past year, I have lived and dressed as a woman. I changed jobs to protect my new identity." Which request is the patient likely to make to the health care provider?

Accepted Answer

Before sexual reassignment surgery, the step that follows living as a member of the other sex is hormone therapy. The patient's decision to live as a woman makes this a natural request. Psychological testing occurs before sexual reassignment surgery, often after hormone therapy has begun. The patient has likely told his parents by this point.

Question 3

Before working with patients regarding sexual concerns, a prerequisite for providing nonjudgmental care is:

Accepted Answer

Only when a nurse has accepted his or her own feelings and values related to sexuality can he or she provide fully nonjudgmental care to a patient. If the nurse is uncomfortable, the patient might misinterpret discomfort as disapproval. The distractors are not prerequisites.

Question 4

Which information should a nurse include in health teaching for adults diagnosed with attention deficit hyperactivity disorder (ADHD) and their significant others? (Select all that apply.)

Accepted Answer

Evidence suggests that ADHD has a biological basis. This fact can help adults with the disorder to cope with low self-esteem. Cognitive therapy is helpful in reframing negative beliefs about self. Adults diagnosed with ADHD have a higher incidence of substance abuse problems. Psychostimulant medications, rather than SSRIs, are usually prescribed.

Question 5

An adult patient tells the case manager, "I don't have bipolar disorder anymore, so I don't need medicine. After I was in the hospital last year, you helped me get an apartment and disability checks. Now I'm bored and don't have any friends." Which resources should the nurse suggest for the patient? (Select all that apply.)

Accepted Answer

The patient does not understand the illness and the need for adhering to the medication regimen. Psychoeducation for the patient (and family) can address this lack of knowledge. Work gives meaning and purpose to life; vocational rehabilitation can assist with this aspect of care. The patient, who considers himself friendless, could also profit from social skills training to improve the quality of interpersonal relationships. Many patients with severe mental illness have such poor communication skills that others are uncomfortable interacting with them. Interactional skills can be effectively taught by breaking down each skill into small verbal and nonverbal components. The patient presently has a home and does not require the services of a homeless shelter. The nurse case manager functions in the role of crisis stabilizer, so no related referral is needed.

Question 6

A patient diagnosed with severe and persistent mental illness who recently moved to a homeless shelter says, "My life is out of control. I'm like a leaf at the mercy of the wind." The nurse formulates the diagnosis Powerlessness. Outcomes will focus on:

Accepted Answer

Powerlessness is associated with feeling unable to control events in one's life. It is often associated with low self-esteem. The goal is to increase one's sense of autonomy. The scenario does not indicate hopelessness or anxiety. Socialization is not the primary need.

Question 7

A patient tells the nurse, "My sexual functioning is normal when my partner wears lace. Without it, I'm not interested in sex." This comment evidences:

Accepted Answer

A person with a sexual fetish finds it necessary to have some external object present, in fantasy or in reality, to be sexually satisfied. Exhibitionism refers to exposing one's genitalia publicly. Voyeurism refers to viewing others in intimate situations. Pedophilia refers to the preference for having sexual relations with a child.

Question 8

A nurse cares for a patient diagnosed with paraphilia. The nurse expects the health care provider may prescribe which type of medication to reduce paraphilic behaviors?

Accepted Answer

SSRIs are reported to have a positive effect on paraphilia. The other medications are not indicated for this disorder.

Question 9

An adult has been feeling significant tension since losing a home through foreclosure. This person goes to a park, feeds the birds, and then impulsively exposes himself to a group of parents and children. Which term applies to this behavior?

Accepted Answer

Exhibitionism is obtaining sexual pleasure from exposing one's genitalia to unsuspecting strangers. Voyeurism refers to obtaining sexual pleasure from observing people who are naked. Frotteurism is associated with obtaining sexual arousal by rubbing one's genitals against an unsuspecting person. Sexual masochism refers to deriving sexual pleasure from being humiliated, beaten, or otherwise made to suffer.

Question 10

Which statements most clearly indicate that the speaker views mental illness with stigma? (Select all that apply.)

Accepted Answer

Stigma is represented by judgmental remarks that discount the reality and validity of mental illness. It is evidenced in stereotypical statements, by oversimplification, and by multiple other messages of guilt or shame.

Question 11

The manager of a health club put a hidden camera in the women's locker room and videotaped women as they showered and dressed. Which sexual dysfunction is evident?

Accepted Answer

Voyeurism is the viewing of others in intimate situations such as undressing, bathing, or having sexual relations. Voyeurs are often called "peeping Toms." Frotteurism is touching or rubbing against a non-consenting person to achieve sexual gratification. Exhibitionists are interested in exposing their genitals to others. Pedophiles seek sexual contact with prepubescent children.

Quiz 27: Adults