A patient reports, The medicine prescribed to help me get to sleep worked well for about a month, but I dont have any more of those pills, and now my insomnia is worse than ever. I had nightmares the last 2 nights. Which type of medication did the health care provider most likely prescribe?

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Psychobiological Disorder Questions

Question 1 of 5

A patient reports, The medicine prescribed to help me get to sleep worked well for about a month, but I dont have any more of those pills, and now my insomnia is worse than ever. I had nightmares the last 2 nights. Which type of medication did the health care provider most likely prescribe?

Correct Answer: A

Rationale: Hypnotics can worsen existing sleep disturbances when they induce drug-dependency insomnia. Once the drug is discontinued, the individual may have rebound insomnia and nightmares. CNS stimulants worsen insomnia while they are in use. Tricyclic antidepressants and atypical antipsychotics may help insomnia but would not be used for initial therapy.

Question 2 of 5

A new staff nurse tells the clinical nurse specialist, I am unsure about my role when patients bring up sexual problems. The clinical nurse specialist should give clarification by saying, All nurses:

Correct Answer: B

Rationale: The basic education of nurses provides information sufficient to qualify the generalist to assess for sexual dysfunction and perform health teaching. Taking a detailed sexual history and providing sex therapy requires additional training in sex education and counseling. Nurses with basic education are not qualified to be sexual counselors. Additional education is necessary. A registered nurse may provide basic information about sexual function, but complex questions may require referral.

Question 3 of 5

A patient tells the nurse that his sexual functioning is normal when his wife wears short, red camisole-style nightgowns. He states, Without the red teddies, I am not interested in sex. The nurse can assess this as consistent with:

Correct Answer: D

Rationale: To be sexually satisfied, a person with a sexual fetish finds it necessary to have some external object present, in fantasy or in reality. Frotteurism involves deriving sexual pleasure from rubbing against others surreptitiously.Exhibitionism is the intentional display of the genitalia in a public place. Voyeurism refers to viewing others in intimate situations.

Question 4 of 5

A woman consults the nurse practitioner because she has not achieved orgasm for 2 years, despite having been sexually active. This is an example of:

Correct Answer: B

Rationale: The persistent inhibition of orgasm is a form of sexual dysfunction called female orgasmic disorder. Genitopelvic pain/penetration disorder applies to painful intercourse. The patient has not indicated that her interest in sexual activity is diminished, so female sexual interest/arousal disorder does not apply. Paraphilic disorder is not applicable.

Question 5 of 5

A nurse is anxious about assessing the sexual history of a patient who is considerably older than the nurse is. Which statement would be most appropriate for obtaining information about the patients sexual practices?

Correct Answer: A

Rationale: Explaining that sexual practices vary helps reduce patient anxiety about the topic by normalizing the full range of sexual practices so that whatever his situation, the patient can feel comfortable sharing it. Its your business of course implies the nurse does not have a valid reason to seek the information and in effect suggests that the patient perhaps should not answer the question. It might be helpful makes the information seem less valid or important for the nurse to pursue and, again, could discourage the patient from responding fully. Asking if the patient has any sexual problems that staff should know about is not unprofessional, but it is a very broad question that may increase a patients uncertainty about what the nurse wants to hear, thus increasing his anxiety. Defining or giving an example of sexual problem would make this inquiry more effective.

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