For which patient is the nurse most likely to need to schedule a pre-ECT workup and teaching?

Correct Answer: C

Rationale: In this scenario, the nurse is most likely to need to schedule a pre-ECT workup and teaching for Patient C, who was unresponsive to a 6-week trial of SSRI antidepressant therapy. The correct answer is C because electroconvulsive therapy (ECT) is often considered when other treatments, such as SSRIs, have failed to produce the desired results. Pre-ECT workup is crucial to assess the patient's physical health, evaluate the need for anesthesia, and ensure the patient is well-informed about the procedure. Patient A is newly diagnosed with dysthymic disorder, which is a chronic but typically less severe form of depression, and ECT is not usually the first-line treatment for this condition. Patient B had a good response to ECT 2 years ago for melancholic depression, indicating that ECT may not be immediately necessary again. Patient D, who has depression associated with an inoperable brain tumor, may require a different treatment approach due to the underlying medical condition. Understanding the indications, contraindications, and considerations for ECT is essential for nurses working in mental health settings. Recognizing when to schedule pre-ECT workup and providing thorough patient education are key responsibilities to ensure safe and effective care for individuals undergoing this treatment.

Correct Answer: A

Rationale: In the context of Freud's psychoanalytic theory, the correct answer to the question is option A) id. The id is the part of the personality that is primarily concerned with the gratification of basic biological and primal urges and desires. It operates on the pleasure principle, seeking immediate gratification without concern for consequences or moral values. The id is characterized by unconscious impulses and drives, such as hunger, thirst, and sexual desires. It is present from birth and represents the primitive and instinctual aspect of personality. Freud believed that the id is driven by the libido, the psychic energy that fuels our desires. In contrast, the ego (option B) is the part of the personality that deals with reality and operates on the reality principle. It mediates between the demands of the id, superego, and the external world, seeking to satisfy the id's desires in a socially acceptable way. The superego (option C) represents the internalized moral standards and values of society. It acts as a person's conscience, striving for moral perfection and enforcing societal norms through feelings of guilt and shame. Option D, conscious, does not directly relate to Freud's structural model of personality. It refers to the state of being awake and aware of one's surroundings, which is not the focus of Freud's theory of personality. Understanding Freud's structural model of personality is essential in the study of behavioral theory and mental health. It provides insights into the underlying motivations and conflicts that shape human behavior and can help mental health professionals in psychoanalytic therapy to uncover unconscious processes influencing a person's mental well-being.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Achievement. In Maslow's Hierarchy of Needs, self-actualization is the highest level where individuals strive to realize their full potential, achieve personal growth, and fulfill their intrinsic goals. Achievement is a key component of self-actualization as it involves setting and attaining challenging goals that lead to a sense of accomplishment and mastery. Option B) Working to one's potential is closely related to self-actualization but does not fully capture the essence of achieving specific accomplishments as in the case of "Achievement". Self-actualization is more than just working towards potential; it involves concrete successes and personal growth. Option C) Achieve success is too broad and does not necessarily encompass the personal growth, self-awareness, and fulfillment that are central to self-actualization. Success can be defined in various ways and may not always align with Maslow's concept of self-actualization. Option D) Love, while important for overall well-being and fulfillment, is not a direct component of self-actualization in Maslow's theory. Love and belongingness needs are situated in a lower tier of the hierarchy and are prerequisites for self-actualization but are not synonymous with it. Educational Context: Understanding Maslow's Hierarchy of Needs and the concept of self-actualization is crucial in the field of mental health. By recognizing the components of self-actualization, mental health professionals can better support individuals in their journey towards personal growth, fulfillment, and achieving their full potential. This knowledge can inform therapeutic interventions, goal-setting strategies, and overall treatment approaches aimed at promoting holistic well-being.

Correct Answer: C

Rationale: The correct answer to the question is C) A person returning to college after an employer ceased operations. This situation would most necessitate a complete assessment of a person's stress status and coping abilities because it involves a significant life transition that can impact various aspects of their mental health. Returning to college after experiencing a job loss due to employer closure can be a highly stressful event, as it involves adapting to a new routine, financial uncertainties, and potentially a shift in personal identity and goals. This change can disrupt established coping mechanisms and support systems, leading to increased stress levels and potential mental health challenges. Option A, being assigned more responsibility at work, may cause stress but is more likely to be a gradual adjustment rather than a sudden life change requiring immediate assessment. Option B, a parent relocating for a job, is also a significant event but may not necessarily disrupt coping abilities or stress levels to the same extent as losing a job and returning to college. Option D, a recent separation, is emotionally challenging but may not require a complete assessment of stress status and coping abilities in the same way as a major life transition like returning to college after job loss. In an educational context, understanding the impact of significant life changes on mental health is crucial for healthcare professionals, counselors, and educators. Recognizing when individuals may need additional support and assessment based on their life circumstances can help in providing targeted interventions and resources to promote mental well-being. The Recent Life Changes Questionnaire is a valuable tool in identifying high-stress situations that warrant further evaluation and support.

Correct Answer: B

Rationale: Sleeping later in the morning may disturb circadian rhythms and in this case is adding, rather than reducing, stress. Going to bed earlier and arising at the usual time alleviates fatigue more effectively. Sedatives may offer some benefit but are a short-term intervention with potential side effects, and other nonpharmacological interventions might work as well or better. Exercise earlier in the evening could induce tiredness and ease the process of falling asleep, but doing so right before bedtime would stimulate and interfere with sleep. Alcohol is sedating but potentially addictive; encouraging its use could increase the risk of using alcohol maladaptively as a response to stress in general.