A nurse is discussing the diathesis-stress model with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the model?

The diathesis-stress model assists the client in identifying their level of stress or anxiety.

The diathesis-stress model assists in telling me how stressed a client is.

The diathesis-stress model assists in identifying risk factors or vulnerabilities for stress.

The diathesis-stress model assists in identifying what mental health disorder related to stress the client has.

Answer and Explanation

The Correct Answer is C

Choice A Reason: The diathesis-stress model assists the client in identifying their level of stress or anxiety.

This statement is incorrect because the diathesis-stress model does not primarily focus on helping clients identify their current levels of stress or anxiety. Instead, it is a framework used to understand how predispositional vulnerabilities (diatheses) and external stressors interact to influence the development of psychological disorders. While understanding stress levels can be part of a broader assessment, it is not the main purpose of the diathesis-stress model.

Choice B Reason: The diathesis-stress model assists in telling me how stressed a client is.

This statement is also incorrect. The diathesis-stress model is not a tool for measuring or quantifying a client’s current stress levels. Rather, it is a theoretical model that explains how stress interacts with an individual’s vulnerabilities to potentially trigger mental health issues. The model helps clinicians understand the interplay between genetic, biological, and environmental factors, but it does not provide a direct measure of stress.

Choice C Reason: The diathesis-stress model assists in identifying risk factors or vulnerabilities for stress.

This statement is correct. The diathesis-stress model is designed to identify and understand the risk factors or vulnerabilities (diatheses) that make an individual more susceptible to developing psychological disorders when exposed to stress. These vulnerabilities can be genetic, biological, psychological, or situational. By identifying these factors, clinicians can better predict which individuals are at higher risk for developing mental health issues under stress and can tailor interventions accordingly.

Choice D Reason: The diathesis-stress model assists in identifying what mental health disorder related to stress the client has.

This statement is partially correct but not entirely accurate. While the diathesis-stress model can help in understanding the development of mental health disorders, it does not specifically identify which disorder a client has. The model provides a framework for understanding how various factors contribute to the onset of disorders, but a comprehensive clinical assessment is required to diagnose specific mental health conditions.

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Correct Answer is ["A","C","D"]

Explanation

Choice A Reason: Perform a neurological assessment on a patient in seclusion to compare the nurse’s findings

This task is an example of overdelegation. Performing a neurological assessment requires specialized knowledge and skills that are beyond the scope of practice for unlicensed assistive personnel. Such assessments should be conducted by a licensed nurse or healthcare provider to ensure accuracy and appropriate clinical judgment.

Choice B Reason: Play cards with 3 patients during unstructured time

This task is appropriate for a PCT. Engaging patients in recreational activities like playing cards does not require specialized clinical skills and falls within the scope of practice for unlicensed assistive personnel. It helps in providing social interaction and can be beneficial for the patients’ mental health.

Choice C Reason: Review follow-up care with a patient about to be discharged

This task is an example of overdelegation. Reviewing follow-up care involves providing important information about the patient’s ongoing treatment and care plan, which requires clinical knowledge and the ability to answer any questions the patient may have. This responsibility should be handled by a licensed nurse or healthcare provider.

Choice D Reason: Set a goal for the day for a patient with a borderline personality disorder

This task is also an example of overdelegation. Setting therapeutic goals for patients, especially those with complex mental health conditions like borderline personality disorder, requires clinical expertise and an understanding of the patient’s treatment plan. This should be done by a licensed nurse or mental health professional.

Choice E Reason: Obtain a weight on a patient with bipolar disorder in a hypomanic state

This task is appropriate for a PCT. Obtaining a patient’s weight is a routine task that does not require specialized clinical skills and falls within the scope of practice for unlicensed assistive personnel. It is a straightforward task that can be safely delegated.

A. Prevents extrapyramidal side effects. B. Reduces agitation until the lithium takes effect. C. Cures manic symptoms. D. Ensures high-quality sleep.

Correct Answer is B

Explanation

Choice A Reason: Prevents Extrapyramidal Side Effects

Extrapyramidal side effects (EPS) are drug-induced movement disorders that include symptoms such as tremors, rigidity, bradykinesia, and tardive dyskinesia. These side effects are commonly associated with first-generation antipsychotics. While second-generation antipsychotics like olanzapine have a lower risk of causing EPS, their primary use in this context is not to prevent these side effects. Therefore, this choice is not the most appropriate response to the family’s question.

Choice B Reason: Reduces Agitation Until the Lithium Takes Effect

Olanzapine is a second-generation antipsychotic that is effective in managing acute agitation and psychotic symptoms in patients with bipolar disorder. Lithium, while effective for long-term mood stabilization, takes several days to weeks to reach therapeutic levels and exert its full effect. During this period, olanzapine can help reduce the client’s agitation and stabilize their mood. This makes it the most appropriate response to the family’s question.

Choice C Reason: Cures Manic Symptoms

While olanzapine can help manage manic symptoms, it does not “cure” them. Bipolar disorder is a chronic condition that requires ongoing management with medications and therapy. The term “cure” is misleading as it implies a permanent resolution of symptoms, which is not the case with bipolar disorder. Therefore, this choice is not accurate.

Choice D Reason: Ensures High-Quality Sleep

Olanzapine can have sedative effects and may help improve sleep in some patients. However, its primary use in this scenario is to manage acute agitation and psychotic symptoms rather than to ensure high-quality sleep. While improved sleep may be a beneficial side effect, it is not the main reason for its prescription in this context.

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A nurse is discussing the diathesis-stress model with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the model?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Psychiatric care technicians (PCTs) are unlicensed assistive personnel that are an integral part of the acute care mental healthcare team. Which of the following choices would be an example(s) of overdelegation by the nurse to a PCT? The nurse directs the PCT to (Select All that Apply):

Correct Answer is ["A","C","D"]

Explanation

Correct Answer is B

Explanation

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