You have been working closely with a patient for the past month. Today he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic?

Correct Answer: B

Rationale: The correct answer is B because it demonstrates active listening and empathy. By acknowledging the patient's conflicting nonverbal cues, the response shows understanding and encourages further exploration of the patient's feelings. This approach helps build rapport and trust. A: This response is overly optimistic and dismisses the patient's nonverbal cues, missing an opportunity to address underlying concerns. C: This response jumps to conclusions and may come across as judgmental, potentially shutting down communication. D: This response imposes a judgment on the patient without exploring the underlying reasons for the conflicting behavior, which can be counterproductive.

Correct Answer: D

Rationale: The correct answer is D: Social cognition. Ophelia's inability to recognize familiar faces at the reunion indicates a deficit in social cognition, which involves the ability to understand and interact with others socially. This deficit is not related to lower-level cognitive domains like memory or attention (choice A), delirium threshold (choice B), or executive function which is more related to planning and decision-making (choice C). Social cognition impairment can manifest as difficulty recognizing faces, interpreting social cues, or understanding others' emotions, all of which are evident in Ophelia's situation.

Correct Answer: B

Rationale: The correct answer is B because it indicates a personal connection and emotional reaction from the nurse due to her past experiences with alcoholic parents, suggesting countertransference. Choice A focuses on the patient's denial, not the nurse's reaction. Choice C pertains to the patient's lack of goals, not the nurse's feelings. Choice D relates to the patient's comment about the nurse, not the nurse's emotional response. In summary, B is correct as it directly reflects the nurse's personal history impacting her feelings towards the patient, while the other choices do not address the nurse's emotional reaction.

Correct Answer: B

Rationale: The correct answer is B because switching from prn (as-needed) pain medication to patient-controlled analgesia empowers the patient to manage their pain effectively, addressing the issue of feeling powerless and dependent on nursing staff for pain relief. This intervention also aligns with the patient's impulsivity and need for immediate gratification. Choice A is incorrect because teaching coping strategies may not address the immediate pain relief the patient desires. Choice C is incorrect as it focuses on addressing the behavior without addressing the underlying issue of pain management. Choice D is incorrect because it does not provide a solution to the immediate problem of pain control and may not be relevant to the patient's current behavior.

Correct Answer: C

Rationale: Rationale: Choice C is correct because borderline personality disorder is believed to be associated with frontal lobe dysfunction, impacting emotional regulation and impulsivity. The frontal lobe plays a crucial role in personality development. Choices A, B, and D are incorrect because there isn't conclusive evidence linking the disorder to increased serotonin or decreased dopamine activity, or hormonal imbalances.