A nurse is sharing information with a client who has been diagnosed with a serious mental illness (SMI) and their family about living with an SMI. Which of the following information should the nurse include?
Most clients find their SMI becomes easier to manage as they get older.
The client’s treatment will focus on helping the client manage their manifestations.
With treatment, the client is unlikely to relapse after their initial diagnosis.
The client might experience periods of remission from the manifestations of their SMI.
The Correct Answer is D
Choice A reason: There is no clinical evidence to suggest that serious mental illnesses, such as schizophrenia or bipolar 1 disorder, naturally become easier to manage solely due to the aging process. In fact, age-related physiological changes can sometimes complicate medication metabolism and the management of comorbid conditions.
Choice B reason: While managing manifestations (symptoms) is a part of the care plan, the contemporary focus of SMI treatment is on "recovery," which involves helping the client achieve a meaningful life and functional goals despite their illness, rather than just symptom management or the medical model of "fixing" manifestations.
Choice C reason: It is medically inaccurate to tell a family that relapse is unlikely. Serious mental illnesses are typically chronic and characterized by a cyclical nature. Relapse is common even with adherence to treatment, and part of family education involves recognizing early warning signs of a pending relapse.
Choice D reason: SMI is often characterized by an episodic course where the client experiences exacerbations followed by periods of remission. Understanding that symptoms may wax and wane helps the client and family maintain hope during difficult times while remaining vigilant for the return of active disease manifestations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Antisocial personality disorder is clinically characterized by a pervasive pattern of disregard for, and violation of, the rights of others and social norms. These individuals frequently demonstrate deceitfulness, impulsivity, and a flagrant refusal to conform to lawful behaviors or institutional rules, often rationalizing their non-compliance as being above the regulations.
Choice B reason: Schizotypal personality disorder primarily involves acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior. While these clients may appear odd or have magical thinking, their primary clinical presentation is not the active, defiant violation of social rules or institutional policies that characterizes the antisocial diagnostic profile.
Choice C reason: Narcissistic personality disorder focuses on grandiosity, a profound need for admiration, and a lack of empathy. While a narcissistic individual might believe they are special or deserve unique treatment, the specific clinical manifestation of actively breaking rules and stating they do not apply is most pathognomonic of antisocial personality disorder.
Choice D reason: Histrionic personality disorder is defined by a pattern of excessive emotionality and attention-seeking behavior. These clients typically use their physical appearance or exaggerated speech to remain the center of attention. They do not generally exhibit the consistent pattern of rule-breaking or legal defiance seen in those with antisocial personality traits.
Correct Answer is D
Explanation
Choice A reason: While focusing on positive memories can be a component of resilience-building, it may inadvertently encourage the suppression of trauma in a child who has witnessed violence. Nursing care must first address the child's current psychological distress and safety rather than merely redirecting thoughts away from the traumatic event.
Choice B reason: Journaling can be an effective therapeutic tool for adolescents or adults, but for a 10-year-old child experiencing acute anxiety post-trauma, it may be overwhelming. Without a stable therapeutic foundation, asking a child to revisit traumatic experiences independently through writing could potentially trigger further emotional dysregulation or secondary traumatization.
Choice C reason: Deep breathing exercises are valuable somatic interventions for managing the physiological symptoms of anxiety. However, for a child who has witnessed intimate partner violence, the priority is establishing a sense of safety and trust. Relaxation techniques are secondary to the primary need for a secure therapeutic relationship.
Choice D reason: Establishing therapeutic rapport is the foundational step in trauma-informed care for children. Providing anticipatory guidance helps the child and guardians understand that their reactions are normal responses to abnormal events. This builds a safe environment, allowing the child to feel supported while navigating the complexities of their emotional recovery.
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