A nurse on an inpatient mental health unit is assisting with a series of group therapy sessions for a small group of clients.
Nurses Notes
Session 1:
Client A states they are fearful at times.
Client B is sobbing and states they can't go a day without their partner.
Client C remains silent during the session.
Client D wears boots 24 hr per day.
Client E continuously twists their hair.
Session 4:
Client A admits to having an extreme fear of mice, among other things.
Client B brings a picture of their partner to the session and cries when looking at the photo.
Client C has yet to speak during a group session.
Client D tells the group they wear boots all the time because they have the world’s ugliest feet and don’t want anyone to see them.
Client E is now pulling out hair after they have twisted it
The nurse is reviewing the observations made from the various group sessions. Drag words from the choices below to fill in each blank in the following sentences.
1. Client A is exhibiting manifestations of ___Target 1
2. Client B is experiencing manifestations of ____Target 2
3. Client C continues to exhibit manifestations of ____Target 3
4. Client D is displaying manifestations of ___Target 4
5. Client E has worsening manifestations that have now progressed to ___Target 5
Word Choices
separation anxiety
trichotillomania
murophobia
Mutism
Body dysmorphism
The Correct Answer is C, A, D, E, B
Rationale:
Murophobia: Client A's extreme fear of mice indicates a specific phobia. In this case, it is specifically referred to as murophobia.
Separation anxiety: Client B's distress over their partner's absence aligns with separation anxiety.
Mutism: Client C's continued silence in group sessions suggests mutism, a form of non-verbal behavior often associated with anxiety or trauma.
Body dysmorphism: Client D's behavior of wearing boots due to negative feelings about their feet reflects body dysmorphic disorder, where a person has a distorted view of their body.
Trichotillomania: Client E’s behavior of pulling out their hair after twisting it indicates trichotillomania, a disorder characterized by compulsive hair pulling.
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Correct Answer is B
Explanation
Rationale:
A. A sense of power from restricting food intake is more indicative of anorexia nervosa, not bulimia nervosa.
B. An emotional high during binge-purge episodes is consistent with bulimia nervosa, as individuals with this disorder often experience a temporary sense of relief or pleasure during these episodes.
C. While bingeing and purging in secret can be a behavior seen in bulimia nervosa, the statement does not directly address the emotional aspects of the disorder.
D. Using laxatives solely for constipation is not specific to bulimia nervosa; it is a broader symptom management issue.
Correct Answer is C
Explanation
Rationale:
A. Reporting the incident to other RNs on the shift does not ensure that the appropriate actions will be taken to address the issue.
B. Agreeing not to report the incident in exchange for the coworker seeking treatment is unethical and does not follow the correct reporting protocol.
C. Reporting the incident to the appropriate person in the chain of communication, such as a supervisor or nurse manager, is the correct course of action. This ensures that the situation is handled according to hospital policy and legal requirements, protecting patient safety and addressing the coworker's substance use disorder.
D. Agreeing not to report the incident if the coworker promises to report themselves is also unethical and fails to meet professional responsibilities.