A patient who is admitted to the psychiatric unit

Question 1 of 5

A patient who is admitted to the psychiatric unit with a diagnosis of obsessive-compulsive disorder spends a significant amount of time during the day and night washing his or her hands. On the third hospital day, the patient reports feeling better and more comfortable with the staff and other patients. The psychiatric-mental health nurse knows that the most appropriate nursing intervention is to:

A. acknowledge the ritualistic behavior each time and point out that it is inappropriate. B. allow the patient to carry out the ritualistic behavior, since it is helping him or her. C. collaborate with the patient to reduce the amount of time he or she engages in ritualistic behavior. D. ignore the ritualistic behaviors, and the behaviors will be eliminated due to lack of reinforcement.

Correct Answer: C

Rationale: Collaborating to reduce rituals (C) builds on comfort and trust, addressing OCD therapeutically. Acknowledging (A) reinforces, allowing (B) avoids progress, and ignoring (D) neglects intervention.

Question 2 of 5

After taking an antidepressant for about a week, a patient reports constipation and blurred vision, with no improvement in mood. The psychiatric-mental health nurse informs the patient:

A. It takes approximately two to four weeks for depression to lessen, and side effects usually diminish over time.' B. Stop the medication immediately and contact your primary care physician.' C. You should contact your doctor. The doctor may need to change your medication.' D. You should schedule an appointment with your ophthalmologist.'

Correct Answer: A

Rationale: Antidepressants take 2-4 weeks for effect, and side effects like constipation and blurred vision often lessen (A). Stopping (B) is rash, changing (C) premature, and ophthalmology (D) unrelated.

Question 3 of 5

A patient is being discharged after spending six days in the hospital, due to depression with suicidal ideation. The psychiatric-mental health nurse knows that an important outcome has been met when the patient states:

A. I can’t wait to get home and forget that this ever happened.' B. I feel so much better. If I continue to feel this way, I can probably stop taking my medications soon.' C. I have a list of support groups and a crisis line that I can call, if I feel suicidal.' D. I have to leave here soon, if I want to make it to the shelter before they run out of beds.'

Correct Answer: C

Rationale: Having support resources (C) shows safety planning, critical for suicidal ideation. Forgetting (A) denies, stopping meds (B) risks relapse, and shelter (D) is logistical.

Question 4 of 5

A diagnosis of major depression presents which of the following signs and symptoms?

A. Overwhelming feelings of joy B. Feelings of worthlessness or excessive guilt, neglect of personal appearance, low mood most of the day C. Occasionally feeling down D. Bad temper

Correct Answer: B

Rationale: Major depression, per DSM-5, includes symptoms like feelings of worthlessness or guilt, neglect of appearance, and persistent low mood (B), lasting most of the day for at least two weeks. Joy (A) contradicts depression, occasional sadness (C) is too mild, and bad temper (D) is nonspecific.

Question 5 of 5

What is the difference between conduct disorder and oppositional disorder?

A. Conduct disorder and oppositional disorder are both the same B. Conduct disorder occurs due to environmental factors and oppositional disorder occurs due to biological factors C. Symptoms of conduct disorder fall into four main categories: i) aggressive behaviour ii) destructive behaviour iii) deceitful behaviour and iv) violation of rules. Symptoms of oppositional disorder include: i) throwing repeated temper tantrums ii) excessive arguing with adults iii) refusing to comply with requests and rules iv) defiant towards people in authority D. None of the above

Correct Answer: C

Rationale: Conduct disorder (CD) and oppositional defiant disorder (ODD) differ in severity and behavior patterns. CD involves serious violations like aggression, destruction, deceit, and rule-breaking, while ODD features defiance, tantrums, and arguing with authority (C). They are distinct (not A), causes are multifactorial (not B), and 'none' (D) is incorrect as C is accurate.

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