Claude is a new nurse on the psychiatric unit. He asks a senior nurse on staff for the 'best advice' when working with oppositional defiant disorder. Which statement reflects advice on solid therapeutic communication?

Correct Answer: C

Rationale: The correct answer is C: When setting limits, be specific and outline consequences. This is the most appropriate advice for working with patients with oppositional defiant disorder. By being specific and outlining consequences, the nurse establishes clear boundaries and expectations. This approach helps the patient understand the consequences of their actions and promotes accountability. Explanation of incorrect choices: A: Using a loud firm tone can escalate the situation and may trigger defensiveness in patients with oppositional defiant disorder. B: Using language beyond the patient's education level can lead to misunderstandings and hinder effective communication. D: An aggressive body language can be perceived as threatening and may worsen the patient's behavior, rather than gaining respect.

Correct Answer: D

Rationale: The correct answer is D: Stimulus control. This technique involves associating the bedroom with sleep by only engaging in sleep-related activities in that space. By avoiding activities like watching TV or working in the bedroom, the client strengthens the association between the bedroom and sleep, improving sleep efficiency. A: Sleep restriction involves limiting the time spent in bed to increase sleep drive. B: Relaxation training focuses on reducing physical and mental tension to promote better sleep. C: Cognitive behavior therapy targets changing negative thought patterns related to sleep.

Correct Answer: C

Rationale: The correct answer is C: When setting limits, be specific and outline consequences. This is the most appropriate advice for working with patients with oppositional defiant disorder. By being specific and outlining consequences, the nurse establishes clear boundaries and expectations. This approach helps the patient understand the consequences of their actions and promotes accountability. Explanation of incorrect choices: A: Using a loud firm tone can escalate the situation and may trigger defensiveness in patients with oppositional defiant disorder. B: Using language beyond the patient's education level can lead to misunderstandings and hinder effective communication. D: An aggressive body language can be perceived as threatening and may worsen the patient's behavior, rather than gaining respect.

Correct Answer: B

Rationale: The correct answer is B: Cerebellum maturation. The cerebellum is responsible for emotional regulation and cognitive functions. As it matures during adolescence, individuals gain better emotional and behavioral control. Limited executive function (A) would hinder rather than improve control. Cerebral stasis and hormonal changes (C) do not directly contribute to emotional regulation. A slight reduction in brain volume (D) would not necessarily lead to increased emotional and behavioral control.

Correct Answer: A

Rationale: Step 1: During World War II, many soldiers experienced mental health issues, leading to increased awareness and acceptance of mental illness as commonplace. Step 2: The societal impact of witnessing the psychological effects of war shifted attitudes towards mental health. Step 3: This increased acceptance paved the way for advancements in mental health care and reduced stigma. Step 4: Choice A is correct as it reflects the societal shift towards viewing mental illness as more common and acceptable. Summary: Choice B is incorrect as the biologic understanding of mental illness was not fully developed during World War II. Choice C is incorrect as deinstitutionalization was a later phenomenon, not directly related to the effects of World War II. Choice D is incorrect as the categorization of mental illnesses as psychoses or neuroses predates World War II and was not a direct effect of the war.