A group of nursing students are reviewing information about co-occurring disorders and risks for substance abuse. The students demonstrate understanding of the information when they identify which psychiatric disorder as being associated with the highest risk for substance abuse?

Correct Answer: C

Rationale: The correct answer is C: Antisocial personality disorder. Individuals with antisocial personality disorder have a higher risk for substance abuse due to impulsivity, sensation-seeking behavior, and disregard for societal norms. This disorder is characterized by a lack of empathy and concern for others, leading to risky behaviors such as substance abuse. Mania, panic disorder, and phobias are not typically associated with as high a risk for substance abuse as antisocial personality disorder due to different underlying mechanisms. Mania is associated with impulsive behavior but may not always involve substance abuse. Panic disorder and phobias are anxiety disorders that are more focused on specific fears and avoidance behaviors rather than substance abuse tendencies.

Correct Answer: A

Rationale: The correct answer is A: One effective type of behavioral therapy used for tics is CBIT. This is correct because Comprehensive Behavioral Intervention for Tics (CBIT) is a well-established and evidence-based therapy for managing tics in individuals with tic disorders, including Tourette syndrome. CBIT focuses on teaching individuals techniques to monitor and control their tics through behavioral strategies. Choice B is incorrect because there are treatments available for Tourette syndrome, including medications and behavioral therapies like CBIT. Choice C is incorrect because not all people with tic disorders will have them for their entire lives; some may see improvement over time. Choice D is incorrect because Tourette syndrome typically starts in childhood, usually between the ages of 2 and 12 years old, not after age eighteen.

Correct Answer: A

Rationale: The correct answer is A: Herpes simplex viruses. Chronic stress can weaken the immune system, leading to increased susceptibility to viral infections. Elevated antibody titers to herpes simplex viruses would be expected due to the reactivation of latent infections during periods of stress. The other choices (B: Herpes zoster viruses, C: Acquired immune deficiency viruses, D: Influenza viruses) are less likely to be affected by chronic stress in the same way as herpes simplex viruses. Herpes zoster viruses typically reactivates due to decreased immunity in older age, acquired immune deficiency viruses are related to HIV infection, and influenza viruses are more commonly associated with acute infections rather than chronic stress.

Correct Answer: C

Rationale: The correct answer is C because it focuses on de-escalation by providing reassurance and support to the patient. By telling the patient to stop running and take a deep breath, the nurse acknowledges the patient's distress and offers assistance. This approach aims to help the patient regain control in a calming manner. Choice A is incorrect because asking for an example may not address the immediate need for de-escalation. Choice B is incorrect as physically restraining the patient could escalate the situation further. Choice D is incorrect as it may provoke feelings of fear or lack of control in the patient by mentioning seclusion.

Correct Answer: B

Rationale: The correct answer is B: The nurse expresses a sense of discomfort and limits behaviors. This is the appropriate intervention because it establishes clear boundaries and communicates the nurse's discomfort while maintaining a therapeutic relationship. By expressing discomfort and setting limits, the nurse asserts their personal space and ensures a safe environment for both parties. Choice A is incorrect because ignoring the behavior doesn't address the issue and may compromise the nurse's well-being. Choice C is incorrect as it passively accepts the invasion of personal space without addressing the discomfort. Choice D is incorrect as it immediately escalates the situation to a confrontational level, which may not be necessary at this stage and could harm the therapeutic relationship.

Correct Answer: D

Rationale: The correct answer is D: Dyslexia. Dyslexia is a learning disorder that affects reading ability despite average intelligence. In this case, the child's significantly lower-than-average mental age in reading but average IQ scores indicate a specific difficulty with reading and language processing, which aligns with dyslexia. A: Communication disorder does not specifically address the reading difficulties. B: Attention deficit hyperactivity disorder does not directly relate to the child's reading challenges. C: Asperger syndrome is a developmental disorder primarily affecting social interaction and communication, not reading skills.

Correct Answer: B

Rationale: The correct answer is B because asking about hallucinations is crucial for assessing the individual's mental state. Hearing voices that no one else can hear may indicate a psychotic disorder, which could be relevant for an insanity defense. Choice A is irrelevant to legal insanity defense as intellectual deficiency is not the same as legal insanity. Choice C focuses on the crime but does not directly address the individual's mental state. Choice D is also irrelevant to the legal insanity defense as knowing the victim does not determine legal sanity.

Correct Answer: A

Rationale: The correct answer is A: Depression. In complex somatic symptom disorder, individuals experience persistent, distressing physical symptoms without an underlying medical cause. Depression commonly coexists with this disorder due to the significant emotional distress and impact on daily functioning. The nurse would be alert for symptoms of depression such as persistent sadness, lack of interest in activities, changes in appetite or sleep, and feelings of worthlessness. Summary: - A: Depression is correct as it commonly coexists with complex somatic symptom disorder due to emotional distress. - B: Avoidant personality disorder is incorrect as it is a separate personality disorder characterized by avoidance of social interactions and feelings of inadequacy. - C: Delirium is incorrect as it is an acute confusional state with altered consciousness and attention. - D: Bipolar disorder is incorrect as it is a mood disorder characterized by episodes of mania and depression.

Correct Answer: A

Rationale: The correct answer is A because referring clients for aftercare services like day treatment programs can provide ongoing support and resources for managing severe or chronic mental illness, aiming to reduce residual defects. This intervention helps individuals access specialized care and therapies that target their specific needs, promoting recovery and minimizing long-term consequences. Choice B is incorrect as it focuses on providing care after assessing symptoms, which may not necessarily address residual defects associated with severe or chronic mental illness. Choice C is incorrect as it targets a different population and goal unrelated to reducing residual defects in severe mental illness. Choice D is incorrect as teaching mental health concepts to groups in the community may raise awareness but does not directly address reducing residual defects in severe or chronic mental illness.