A 25-year-old woman who recently had abdominal surgery was admitted to the psychiatric unit, where it was determined that she had a borderline personality disorder. During the first week on the unit, it was determined that she also has diabetes. Her diabetes mellitus would be listed in which axis of her DSM-IV-TR diagnosis?

Correct Answer: C

Rationale: The correct answer is C: Axis III. Axis III in the DSM-IV-TR is used for medical conditions that are relevant to the individual's mental health diagnosis. In this case, the woman's diabetes would be listed on Axis III because it is a medical condition that can impact her mental health and treatment. Diabetes is a physical health issue that can affect emotional well-being and may influence the course of her psychiatric treatment. A: Axis I is for clinical disorders such as mood disorders or anxiety disorders. B: Axis II is for personality disorders and mental retardation. D: Axis IV is for psychosocial and environmental stressors. Therefore, the correct placement for the woman's diabetes mellitus in her DSM-IV-TR diagnosis would be on Axis III.

Correct Answer: C

Rationale: The correct answer is C: Axis III. Axis III in the DSM-IV-TR is used for medical conditions that are relevant to the individual's mental health diagnosis. In this case, the woman's diabetes would be listed on Axis III because it is a medical condition that can impact her mental health and treatment. Diabetes is a physical health issue that can affect emotional well-being and may influence the course of her psychiatric treatment. A: Axis I is for clinical disorders such as mood disorders or anxiety disorders. B: Axis II is for personality disorders and mental retardation. D: Axis IV is for psychosocial and environmental stressors. Therefore, the correct placement for the woman's diabetes mellitus in her DSM-IV-TR diagnosis would be on Axis III.

Correct Answer: C

Rationale: The correct answer is C: Identifying the underlying beliefs. In cognitive behavior therapy, identifying the underlying beliefs is crucial as they drive the patient's thoughts and behaviors. By focusing on these core beliefs first, the nurse can help the patient understand the root causes of their issues and work towards challenging and modifying them effectively. A: Identifying alternative explanations of an event - This step usually comes after identifying the underlying beliefs. B: Exploring evidence to support or refute the beliefs - This step comes after identifying the beliefs and is not the initial focus. D: Examining the real implications if the beliefs are true - This step is important but is typically addressed after identifying and working on the underlying beliefs.

Correct Answer: B

Rationale: The correct answer is B, "I find that hard to believe." This statement demonstrates the therapeutic communication technique of voicing doubt by expressing skepticism in a non-confrontational manner. It allows the client to further elaborate on their thoughts and feelings, fostering open communication and exploration of underlying issues. Choice A paraphrases the client's statement, choice C assumes the client's feelings, and choice D shifts the focus to finding a solution rather than exploring the client's perspective.

Correct Answer: D

Rationale: The correct answer is D. The nurse should examine interventions for possible revision of the target date. This is because the patient is not meeting the desired outcome of sleeping for a minimum of 5 hours nightly within 7 days. By examining interventions, the nurse can assess the effectiveness of the current plan and make necessary adjustments to help the patient achieve the desired outcome. Continuing the current plan without changes (choice A) would not address the issue of the patient not meeting the sleep goal. Removing the nursing diagnosis from the plan of care (choice B) would neglect the patient's ongoing sleep difficulties. Writing a new nursing diagnosis (choice C) does not address the need to evaluate and adjust the current interventions.