The nurse is caring for a client with schizophrenia. Which of the following outcomes is the least desirable?

Correct Answer: A

Rationale: In caring for a client with schizophrenia, the least desirable outcome among the options provided is A) The client spends more time by himself. This outcome is unfavorable because social withdrawal and isolation can exacerbate the symptoms of schizophrenia, leading to increased feelings of loneliness, depression, and potentially worsening the client's condition. Option B) The client doesn't engage in delusional thinking is a positive outcome as it indicates a reduction in distorted thinking patterns that are characteristic of schizophrenia. Option C) The client doesn't harm himself or others is also a crucial outcome as it ensures the safety and well-being of the client and those around them. Option D) The client demonstrates the ability to meet his own self-care needs is a positive outcome indicating independence and functioning. In an educational context, understanding the implications of social withdrawal in clients with schizophrenia is essential for nurses and healthcare providers. Encouraging social interaction and providing support to prevent isolation can significantly impact the client's overall well-being and treatment outcomes. It is important to prioritize interventions that promote social engagement and community integration for individuals with schizophrenia to enhance their quality of life and recovery.

Correct Answer: C

Rationale: The correct answer is C) Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The DSM-V is the primary diagnostic manual used by mental health professionals to classify and diagnose psychiatric disorders. It provides detailed criteria for each disorder, including symptom presentation, duration, and exclusion criteria. By consulting the DSM-V, the nurse can accurately identify and understand the specific criteria used to establish the diagnosis of the unfamiliar psychiatric disorder. Option A, the International Statistical Classification of Diseases and Related Health Problems (ICD-10), is a classification system for diseases and related health conditions used for billing and statistical purposes. While it may include some psychiatric diagnoses, it does not provide the detailed criteria necessary for accurate diagnosis and treatment planning in mental health. Option B, the ANA's Psychiatric-Mental Health Nursing Scope and Standards of Practice, outlines the scope of practice and standards for psychiatric-mental health nursing. While it is a valuable resource for guiding nursing practice, it does not contain the specific diagnostic criteria needed to establish a psychiatric diagnosis. In an educational context, understanding the importance of using the appropriate diagnostic resources is crucial for healthcare professionals, especially in psychiatric settings where accurate diagnosis is foundational to effective treatment planning and patient care. Familiarity with the DSM-V is essential for nurses working in mental health to ensure accurate assessment and intervention for patients with psychiatric disorders.

Correct Answer: D

Rationale: In a multidisciplinary patient care planning session, it is crucial for nurses to advocate for patients effectively by considering their cultural background. Option D, "Assessment findings in mental illness reflect a person's cultural patterns," is the best belief to support a nurse's advocacy efforts in this context. This belief emphasizes the importance of understanding how cultural factors can influence the presentation of mental illness symptoms. By recognizing and taking into account a patient's cultural background in assessments, nurses can provide more culturally sensitive and effective care. Option A, "All mental illnesses are culturally determined," is incorrect because while culture can influence how mental illness is perceived and expressed, it is not the sole determinant of mental illness. Option B, "Schizophrenia and bipolar disorder are cross-cultural disorders," is incorrect because it oversimplifies complex mental health conditions by suggesting they manifest uniformly across all cultures. Option C, "Symptoms of mental disorders are unchanged from culture to culture," is incorrect because cultural factors can significantly impact how symptoms of mental disorders are experienced and expressed by individuals from different cultural backgrounds. Educationally, understanding the influence of culture on mental health is essential for healthcare professionals to provide holistic and patient-centered care. By recognizing the cultural nuances in mental health assessment and care, nurses can better advocate for their patients and promote culturally competent practices within multidisciplinary care teams.

Correct Answer: D

Rationale: Active listening is a crucial skill for nurses when engaging with clients to demonstrate empathy and understanding. Option D, where the nurse is looking at the client and nodding to answers, exemplifies active listening. By maintaining eye contact and nodding, the nurse shows attentiveness and validation, encouraging the client to open up. Options A, B, and C are incorrect because they do not reflect active listening. In option A, looking to the family for answers instead of focusing on the client disrupts the communication flow. Option B, with the nurse leaned back in the chair with crossed arms, creates a barrier and implies defensiveness. Option C, looking at the watch frequently, signals impatience and disinterest, which can hinder effective communication. Educationally, it is essential for nurses to master active listening skills to establish rapport, gather accurate information, and provide holistic care. Through active listening, nurses can build trust, demonstrate respect, and better understand the client's needs, ultimately leading to improved therapeutic relationships and positive health outcomes.

Correct Answer: B

Rationale: In the context of a psychosocial nursing assessment, asking whether the individual is a member of a faith community (option B) is the best nursing inquiry to assess spirituality/cultural data. This question directly delves into the individual's spiritual beliefs and cultural practices, which are essential aspects of their overall well-being and can significantly influence their behavior and health outcomes. Option A, asking about hobbies, is more focused on recreational activities rather than spirituality or culture. Option C, inquiring about sports, is also centered on leisure activities rather than deeper spiritual or cultural beliefs. Option D, asking about educational attainment, does not directly address spirituality or cultural background. In an educational context, it is crucial for nursing students to understand the significance of assessing spirituality and cultural data in a psychosocial nursing assessment. By asking about faith community membership, nurses can gain insights into a patient's belief system, values, and practices, allowing for more holistic and culturally sensitive care. This question also opens the door for discussions on how spirituality and culture influence health behaviors and coping mechanisms, enhancing the nurse-patient relationship and promoting patient-centered care.