Nursing Elites

1. 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.

2. In the care plan of a male patient diagnosed with a dissociative disorder, the nursing diagnosis of ineffective coping is included. Which behavior demonstrated by the patient supports this nursing diagnosis?

• A. Has no memory of the physical abuse he endured.
• B. Using both alcohol and marijuana.
• C. Often reports being unaware of surroundings.
• D. Reports feelings of 'not really being here.'

Correct answer: B

Rationale: The correct answer is B because using substances like alcohol and marijuana can be a sign of ineffective coping mechanisms in patients with dissociative disorders. Substance abuse is often used as a maladaptive way to cope with stress, trauma, or other underlying issues. Choices A, C, and D may be related to dissociative symptoms but do not directly reflect ineffective coping behaviors as substance abuse does.

3. Which of the following are potential side effects of electroconvulsive therapy (ECT)? Select one that does not apply.

• A. Short-term memory loss
• B. Headache
• C. Confusion
• D. Tardive dyskinesia

Correct answer: D

Rationale: Potential side effects of ECT include short-term memory loss, headache, confusion, and nausea. Tardive dyskinesia is not a side effect of ECT; it is associated with long-term use of antipsychotic medications, particularly antipsychotics that block dopamine receptors over time. ECT is primarily used for severe depression, bipolar disorder, and certain psychotic disorders. The other choices, short-term memory loss, headache, and confusion, are known side effects of ECT and are usually short-term and manageable.

4. The mental health team is determining treatment options for a male patient experiencing psychotic symptoms. Which question shouldn't the team answer to determine whether a community outpatient or inpatient setting is most appropriate?

• A. Is the patient expressing suicidal thoughts?
• B. Does the patient have intact judgment and insight into his situation?
• C. Does the patient have experiences with either community or inpatient mental healthcare facilities?
• D. Does the patient require a therapeutic environment to support the management of psychotic symptoms?

Correct answer: C

Rationale: Assessing suicidal thoughts, judgment, insight, and the need for a therapeutic environment are crucial factors in determining the appropriate treatment setting for a patient experiencing psychotic symptoms. Past experiences with mental healthcare facilities do not play a direct role in deciding between a community outpatient or inpatient setting.

5. A healthcare professional is assessing a client who has been diagnosed with schizoid personality disorder. Which of the following behaviors should the healthcare professional expect?

• A. Preference for solitary activities
• B. Detachment from social relationships
• C. Indifference to praise or criticism
• D. Anxiety in social situations

Correct answer: C

Rationale: The correct behavior that the healthcare professional should expect in an individual with schizoid personality disorder is indifference to praise or criticism. While it is true that individuals with this disorder often exhibit a preference for solitary activities and detachment from social relationships, the key defining characteristic is their emotional detachment and lack of response to external feedback, which includes being indifferent to praise or criticism. Anxiety in social situations is not a typical feature of schizoid personality disorder.

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