a client with generalized anxiety disorder gad is being discharged which of the following instructions should the nurse include in the discharge teach

ATI RN

ATI Mental Health Practice B

1. A client with generalized anxiety disorder (GAD) is being discharged. Which of the following instructions should the nurse include in the discharge teaching? Select one that does not apply.

A. Practice relaxation techniques daily
B. Avoid caffeine and alcohol
C. Engage in regular physical activity
D. Use benzodiazepines as the first line of treatment

Correct answer: D

Rationale: When discharging a client with GAD, it is important to provide instructions that promote holistic well-being and support without exacerbating the condition. Practicing relaxation techniques daily, avoiding caffeine and alcohol, and engaging in regular physical activity can help manage anxiety symptoms effectively. These strategies focus on self-care and healthy lifestyle choices. Seeking support from friends and family also plays a crucial role in maintaining mental health. However, using benzodiazepines as the first line of treatment is not recommended due to their potential for dependence and other associated risks. Non-pharmacological interventions and therapy are usually preferred as initial approaches in managing GAD. Therefore, the option 'D: Use benzodiazepines as the first line of treatment' is incorrect and should not be included in the discharge teaching for a client with GAD.

2. Which behavior is consistent with therapeutic communication?

A. Offering your opinion when asked to convey support.
B. Summarizing the essence of the patient's comments in your own words.
C. Interrupting periods of silence before they become awkward for the patient.
D. Telling the patient they did well when you approve of their statements or actions.

Correct answer: B

Rationale: Summarizing the essence of the patient's comments in your own words is a key aspect of therapeutic communication as it demonstrates active listening and understanding. It shows the patient that their words have been heard and understood, fostering a sense of validation and empathy. Offering opinions, interrupting silence, or giving approval may not always align with the principles of therapeutic communication, which focus on patient-centered interactions and empathetic responses.

3. Which characteristic in an adolescent female is sometimes associated with the prodromal phase of schizophrenia?

A. Constantly afraid another student will steal her belongings.
B. An unusual interest in numbers and specific topics.
C. Demonstrates no interest in athletics or organized sports.
D. Appears more comfortable among males.

Correct answer: B

Rationale: During the prodromal phase of schizophrenia, individuals may exhibit subtle changes in behavior or interests. An unusual interest in numbers and specific topics may be a sign of cognitive disturbances that can precede the onset of schizophrenia. While the other choices may also be observed in adolescents, an unusual interest in numbers and specific topics is more specifically linked to potential prodromal symptoms of schizophrenia.

4. How do psychiatrists determine which diagnosis to give a patient?

A. Psychiatrists use pre-established criteria from the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
B. Hospital policy dictates how psychiatrists diagnose mental disorders.
C. Psychiatrists assess the patient and identify diagnoses based on the patient's unhealthy responses and contributing factors.
D. The American Medical Association identifies 10 diagnostic labels that psychiatrists can choose from.

Correct answer: A

Rationale: The correct answer is A. Psychiatrists use the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association (APA) to determine diagnoses. The DSM-5 provides standardized criteria for the classification of mental disorders, ensuring accurate and reliable diagnosis and treatment. Choices B and D are inaccurate as hospital policy does not dictate psychiatric diagnoses, and the American Medical Association is not responsible for psychiatric diagnostic criteria. Choice C describes a more general approach to assessment and does not specifically address the standardized criteria used in psychiatric diagnosis.

5. While assessing a distraught female high school student who is overly concerned because her parents can't afford horseback riding lessons, how should the nurse interpret the student's reaction to her perceived problem?

A. The problem is endangering her well-being.
B. The problem is personally relevant to her.
C. The problem is based on immaturity.
D. The problem is exceeding her capacity to cope.

Correct answer: B

Rationale: In this scenario, the student being overly concerned about not being able to afford horseback riding lessons indicates that the problem is personally relevant to her. Psychological stressors related to self-esteem and self-image are influenced by how an individual perceives a situation or event. Adolescents, in particular, place significance on self-image and feeling entitled to experiences that other adolescents have, which can lead to distress when such desires are not met. Choice A is incorrect because there is no indication that the student's physical well-being is at risk. Choice C is incorrect as it simplifies the issue by attributing it solely to immaturity. Choice D is incorrect as there is no evidence provided that the problem is beyond the student's coping abilities.