A primary intervention strategy for coping with a maturational crisis includes:

Marriage counseling for a couple contemplating divorce.

Recognizing symptoms of relapse for those with chronic mental illness.

Assisting parents to select a group home for their troubled teen.

Childbirth classes for a couple having their first child.

Answer and Explanation

The Correct Answer is D

Choice A reason: Marriage counseling addresses situational crises like divorce, not maturational crises, which involve developmental transitions. It targets interpersonal conflict, not the normative stress of life stages, missing the neuroadaptive challenges of maturational growth like childbirth.

Choice B reason: Recognizing relapse symptoms is relevant for chronic mental illness, not maturational crises. Relapse involves dopamine or serotonin dysregulation, not the normative developmental stress of life transitions, making this intervention unrelated to maturational coping needs.

Choice C reason: Selecting a group home addresses a situational crisis for a troubled teen, not a maturational one. Maturational crises involve normative developmental stages, like childbirth, requiring anticipatory guidance, not reactive interventions for behavioral issues.

Choice D reason: Childbirth classes prepare couples for the maturational crisis of parenthood, a normative life transition. They reduce stress by enhancing prefrontal cortex-mediated coping skills and serotonin-driven emotional regulation, supporting adaptation to developmental changes, making this the best intervention.

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Correct Answer is B

Explanation

Choice A reason: Olanzapine does not primarily increase serotonin or norepinephrine. It blocks dopamine D2 and serotonin 5-HT2 receptors, reducing hallucinations driven by mesolimbic dopamine excess in schizophrenia. Increasing monoamines would exacerbate psychosis, not alleviate it, making this mechanism incorrect.

Choice B reason: Olanzapine, an atypical antipsychotic, blocks dopamine D2 receptors in the mesolimbic pathway, reducing excessive dopamine signaling that causes hallucinations in schizophrenia. It also modulates serotonin 5-HT2 receptors, balancing limbic activity, making this the primary mechanism for controlling psychotic symptoms.

Choice C reason: Decreasing neurotransmitter breakdown enzymes is the mechanism of MAOIs, not olanzapine. Olanzapine’s dopamine and serotonin receptor blockade reduces psychotic symptoms, not enzyme activity, making this choice irrelevant to its antipsychotic action in schizophrenia.

Choice D reason: Olanzapine does not normalize serotonin, norepinephrine, and dopamine levels but blocks their receptors, particularly dopamine D2, to reduce hallucinations. Normalizing levels is not its mechanism, as schizophrenia involves dopamine hyperactivity, not deficiency, making this choice inaccurate.

A. High risk for self-directed violence. B. Chronic low self-esteem. C. Childhood trauma and abuse. D. Poor impulse control.

Correct Answer is C

Explanation

Choice A reason: Self-directed violence is a risk in dissociative identity disorder but is a consequence, not the cause, of identity disruption. Trauma-induced changes in amygdala-hippocampal connectivity drive dissociation, not violence, which arises from emotional dysregulation secondary to fragmented identity states.

Choice B reason: Chronic low self-esteem may co-occur in dissociative identity disorder but is not the primary cause. Identity disruption stems from trauma-induced neural changes, particularly in the amygdala and prefrontal cortex, leading to fragmented self-states, not primarily from self-esteem deficits.

Choice C reason: Childhood trauma and abuse are the primary causes of dissociative identity disorder, disrupting neural integration in the prefrontal cortex and hippocampus via chronic cortisol elevation. This fragments identity formation, creating distinct personality states as a coping mechanism for overwhelming stress.

Choice D reason: Poor impulse control is a symptom in some dissociative identity disorder cases but not the cause. Identity disruption results from trauma-induced amygdala hyperactivity and hippocampal dysfunction, leading to dissociated states, not primarily from impulsivity, which is a secondary behavioral outcome.

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A primary intervention strategy for coping with a maturational crisis includes:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with schizophrenia is being treated with olanzapine (Zyprexa) 10 mg daily. The client asks the nurse how this medicine minimizes hallucinations. The nurse explains that the mechanism by which olanzapine controls the client's psychotic symptoms is believed to be what?

Correct Answer is B

Explanation

A client is suspected to have dissociative identity disorder. Which characteristic does the nurse identify that the disturbed personal identity is most likely related to?

Correct Answer is C

Explanation

Positive symptoms seen in schizophrenia are believed to be a result of which type of neurological dysfunction?

A depressed older adult client is being treated with a tricyclic antidepressant (TCA). Which side effects are important to assess for?

The plan of care for a patient in the manic state of bipolar disorder should include which intervention?

A nurse provided medication education for a patient diagnosed with major depressive disorder who began a new prescription for phenelzine (Nardil). Which behavior indicates effective learning? The patient:

A client asks a nurse about the need to alter any activities because of taking lithium. Which response would be most appropriate?

After being told that his family will not be attending visitation, a 70-year-old patient turns over a table in a crowded common area. Which action takes priority?

A nurse is conducting a visit to a client who is receiving palliative care at home for dying. The client’s husband tells the nurse, "I know she needs to be with God. That is the best place for her now." The client is experiencing which stage of Kubler-Ross’ stages of grieving?

A patient presenting with delusions of persecution about being poisoned has refused all meals for 3 days. Which intervention will most likely be acceptable to the patient?