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 C
Explanation
Rationale:
A. Amphetamines can cause agitation and psychosis but are less commonly associated with delirium.
B. Antihistamines, particularly those with sedative properties, can contribute to delirium, but they are not the primary culprit.
C. Benzodiazepines, especially when used in high doses or in older adults, can cause delirium. They have sedative effects and can impair cognitive function, leading to confusion and delirium, particularly in vulnerable populations.
D. Sertraline, a selective serotonin reuptake inhibitor (SSRI), is generally not associated with causing delirium, though any medication can contribute to altered mental status depending on the patient’s overall health.
Correct Answer is A
Explanation
Rationale:
A. Taking bronchodilators before meals can help improve breathing, which is essential for eating comfortably, so it is better to take them before meals rather than after.
B. Resting before eating helps conserve energy and can make eating easier for individuals with COPD.
C. Eating small, frequent meals is beneficial for managing COPD because it prevents large meals that can lead to respiratory discomfort.
D. Choosing non-gas-forming foods can help reduce abdominal distention and discomfort during meals for individuals with COPD.