Professional Documents
Culture Documents
I
?
& nursing 8-tegy
wodd be mst important to fBe parents' sucewM mping?
. G i i supPmt-af e the parer o hold and
cume the infar
0 3, kplain to the p~reptshaw cleft palam dmelop d-g
Prwancy.
.Tell the parents ot to look the
mt)uth.
U D.Show the parats a vidw about omcth.e $wg& for
d& palate.
- -
tional fear ofbeing in open spaav ;e.g..shopping malls and spurts are-
nas!. Symptoms of panic include diKiculty b m t h i..i rapid andlor
-:w. * ,m
, tk) ,a pain, &@&m--,.seaa* &&-
Obsessive-Compulsive Disorder
Although different in meaning, obsession and compulsion aften occur
togethm An obsession is a p d t e n t , recurring thought or fe&ng
that is overpowering.A COcomgtIlSi~nis an irresistible urge to engage
in a behavior. CompWion may be in the form of frecpent handwash-
ing or shoplifting. Whatever the compulsion may be, it has a symbolic
meaning. The behavior is engaged in because it lowers a r y d q . When
the anxiety I d builda up, tbe obsessive-compulsive act is performed
again This process is cyclic and may occupy the person's entire life
It is not unusual for a person to experience murrent thoughts
periodically or to engage in ritualistic behaviors (handwashing, count-
ing and recounting eheclciqg and rechddngl. However, in the person
with an obsessive-compulsivedisorder, these thoughts and ritualistic
actions interfere with daily Mug. The person is unable to controI his
FEAR OF PHOBIA
Acrophobla HelghtS
Agoraphobla open spacer
or her thoughts and actiom even though the person k n m they are ment disorder of mixed disturbance of mood and conduc~The dlient
irratondj however irrational, they release pent-up anxiety and tension. appears wonied and upset about an event that occurmi in the past
Obsessivecompulsive behavior is often caused by repressed thtee months and describes trouble handkg the SRSSOTS. Usually,
&oughts and feeltngs. It is an attempt to relieve anxiety and is another there is no personal or family history uf mood disorders, although a
example of converting anxiety into other symptoms. pmo* disorder needs to be ruled om
of hmor. Activives of daily hvtng become a problem, and hair and time and become preoccupied with feelings of ft Theymay com-
&thing may appear disheveled, Mmemenf5 are slow, posture is municate depression via facial expressions of sadness Qrnegatiae ver-
smoped, the bray is h w e d , and sp& maybe kcpent in bal renmks. Daily stressom encountered on the job may bave an
the depresed ddmk pemn, tbm is an intense preocapation with ]Increasinglynegative impact on their outlooks. The effects of the aging
heslth, Coniplaints ofvague acbes aBti pains, c0nStipationtand anorex- prodess on men m y also become cause for heightened coneern.
ia are e o m m The severely depressed w bemme @st- Social isolation and boredom may be symptoms of a dysthymic
ed and appear to€@ mberabk. +disorde~ The inmvidual has a facial expression of sadnw, a blunted or
:flat affectand decreased verbal communication W~th lessened e n w
1& and migratoly aches and pains, they frequenay withdraw kom
oysthymlc DlsOrdeK The pemn experiencing a dysthpic dbordw a&% With soclal imeractions mluced, feelings of guilt and sadness
has a prolonged feeling of .%Beme sadnw that is ammpanied by prevail. Some peopIe experience agitatian and restlessness that result
guilt feelingsI self-f-deprcmtion,and SOW withdrawal. The &order is In pacing the floor and wringing the hands.The menopausal persm
usually associated with a 10% such as loss of a Imed one, possessto& Who feels meless and less attractive turns feelings of refection inward.
ar s e l f -Tne pmon feels rejected. helpless, and wrthless. He or These feebgs of self-auger and destmction can make a person with a
she is wedshe and disinterested in the surroundings and unable to eerious dystlgmic disorder a real suicide ri& Any indieations of suiei-
"p"ience pleasme in life. He or she ha6 a low energy level and is dal hughts should be dealt with. (See Cha$er M ViDlence and
always tired The person may either be unable to sleep or mQ' sleep Diswed Behvior.)
mceh;sive.lyTbe depressed person dwells on &e negative aspects of Me, Some antidepressant medicanom are listed in Table 9-3. The
whjch otdy add to his or herfeekg8 &&pleasured @ t He or she selective serotonin reuptake inhibitors (SSRI) subdue h y p e m a 4
may cry oftea and wiIy and may have serious tho%& of sui& symptoms, decrease avoidance symptom, and decrease emotional
A dysthymic or depressive disorder o k &ts horn p q l e rtysconrtul symptoms: mger, hostility, and irritability. kamplw of
feeling 0) that they ham no mm1 over th& lives, [.2J l t they @e SSItIs include fiuoxetine (Prozacl),m a h e (Zoloft3, and paroxetine
ti$Iureeg bemuse 'they have been unable to attain desired goals, or (31 ipaxil]. The side &&s to be monitored are irritability, insomnia, and
i n t d anger. Critical periods in the Mb ycle when a d@&Jrmic dis- sehlre3.
order is more W y to ocnu are adolesmoe, menopaw, and old age.
D&g adolescencq depmion must be &@erea?iated&.omtem-
porary stam of sadness. AdoleseenB are .su$ject to emotional ups md
downs. However, when a lack of feelings or a sense of' emptiness
b e m e s s dominant mood, this is wmidered ac-d or depm- TRADE GENERIC
sive &order, The adolescem with a dysthNc disorder is unable m
dealwith or express his or her feehgs. Bm&m and resfl~$snesSran -TI--
- -
.~ . . .. ~ ~
~.
~ , ,
:~ ;. .
t Darg use and unwanted risk-taking can be symptom af hid-
~ ~~
d TTamntl
~ ~ f l ~ l ,.@&fb$&fmf;FBl.
den depression. Mori,rafln
Piorpramin &esiPra&e$@l
, .~
as
D u k g menopauser women must cope wi& pb@d
the aging proeess oan-6. Menopause may have pkpical symptoms
€rave
Etavu m~cr~l~.m ~ @ i
AvenM
A~ellM St
naPtrig@ilfir%.
,. ~ ,
such as hot and cold %sheI p w e headaches, h- palpitiom* Binequan titt$qtn Mgl
imomni&and wsrsbtent fatime Some of these symptom am cawd
Desyrel tr&u@pje, MU
byzhe changededbomonaf~%ce between estrogea and progesterone. Pro*
Prow fiuqx~tine,.Hcl
Depression can be caused by by percdwd loss of womanhood and ?al& .s,emnn~g'
ZOlOft
chiid- abilities.
Women are not the onlp people who must mhtend with the Paxll paromtifie:
& x t ~of tncnopause. Me11miy &<;experience menopausal changes,
i Celexa ,. cj~tai~prarn-
-
which accompany the normal dirnirlution of sexual activity that ocnlrs
nith advandng age They may reduce their social interadion at-- this I L'"m
fluM,m?mifie
Maladaptive Behaviors
-
~gretol wraa*@@l#e. personalities are usually quire opposite to the oliginal personality.The
~opan9ax ' tupimmate original personality is not aware of the other personalities, although
?he seandary persgn.&ies are often M y aware of the thoqhts and
acrions ofthe original personality. Transition &om one persoM9 to
disordB another is sudden and usually f~IIowstress. This disorder is -me-
~yclothy'mlcDisorder. The person with a
expefimma-l* m a d s of depre~$i~ri
and &tion w
elationnsfee,the pmon is warm and Wdl% I)um the 6 e ~ f e s s ~ 0 ~
stage the emonj&ats himselfor herself d vdthdrW fromsgd DePersonalkation Disorder. Depers-tion disorder fnwlvesa
actiaiQ me person may apeilmoe n o d mods between: mi change in the p&sOn's perception of himself or herself:A sense ofthe
person's o
m reality is People are cut 05from a e W om aware-
ness. They feel disa9r;odated ~ I I their
I minds and bodies and my
. . .
-chwr 9
order to meet a need of their o m Remember, manipulation can be
WIw a &wee.They fimction in a &~JEJstate or
frorn viewed aS a positive or negative action Individuh who engage in
sense;9 are dded, h a m a f e a of
manipulation fW&Iendyevoke anger in others, yet theu behavior is a
n d b a ~ complete coat& ~f their 9 6 md adOmh form of guarding a very fragile self by attempting to control others.
Tfiis bTdw &a S-e sires* depression ream-
i5 Therefore our goal is to strengthen itlditidua~~,' inner, personal coI1tro~.
fEc-tm W d t i u n , fa&@& tQ&c illness,af p W 1 4 P* staffmust approach clients with a firm,consistent
~ ias d d Beople with a d e ~ - * ~ ~ ~
r a P ~ b u t r & c Q Y@ ~ ~ id
my stp&nce m~ qgieryzk ~ o r h o ~ ~and
t sa ,distded acting in a ludgmend way toward chents; rather, recognize your om
s e w af&&Tbeymm fed fhattbey are&% iIx+~e~~cIie. feelin@ of ~esenbnentOur goal is directed toward maintaining the
seEesteem of our clients.
Begh by stating dearly Your own expectations of the client at an
i n t e n l i s ~ p h ameeting
~ where everyone should on one
care
~ur~in g planned approach. with the client if there is a reason for this
behavior and then state clealy why the behavior is unaaeptable
Cop% ~ f%8i hemdual a a peW10@
F a is
*Y
a dqer* Clearly state the team's expectation. OEer alteroativa by stating choic-
fm ~ n m eN-, my that d b
how-, fxz*dd needs es or options (eitherlor statements). By having choices, the client will
er or f&e &*co*d, begin to fee1more in control and will learn h m to choose a]t-tives
help. he. a-0 should =ever k n y -is denfs W w -PIainw
~ w Y S the best 'Ourre that work positively for him or her. The staffmustpra* attentive&-
sh& be -@&& 1 e p t e . The tenfng [what 3 this chmt really trying to say?).Help the client verbal-
dlfonaatioa A m&& -~on should be dm@.to ride oat*
fze or her feelings in a more appropriate way. Be alert fork e w e d
po~sibiIityofpbyhd jllaesS m e w and refocus clients when they become distracted. Remember
Nw care ofthe ~sy&~1op;iral Clierrt F o W an.
that you are working together to achieve a change in behavior.
ierJI; paon d& a @ol~@sal di~orderis often m& a ! Im 3- Freguently a writyea contract works best A. contract clearly states
e.4- psycho-" cljenm oibn fed
the uni't, psydh~be;iddim* need to 2~ the m u m y agreed upon expectations and the tyay to arrive at this
tarion flh q fiem ~n god Look at the clienfs strengths, resources, arid energy for change
fhek@SSsindl
$lW~&kmstkin& decis'i, Tbis Maybe the client is m t l y in just a survivdpattem that wil~ need to
be addressed We want fo make reasonable requests SO &t the client
be held accountable, and we want s m d success expeemc~so
that we can give the client positive feedback Areas to consider w h
Mmg a contract are personal safe@,amount of sleep and rest food
intakepstructured m e , aetiviaes of d a ~ living,
y probl-o]hg tech-
and the client's level of sacid hteradon.
The bipolar clients concentration is lessened, and he or she is
Q s u ~distracted and provoked. Sodd activities must be p h e d
this in m d Exerdse can be advantageous, but competitive acmtie
I I I I,
Maladaptive Behaviors
,,
a@$
-2
....
&.. A
clients have been WelI-bahve&pd&pist youths wko restrleted Bne ofthe most important factom in a s c h h p b n i c disorda-is
loss of&-esteem. This may be manifested in.9yd-den and violent out-
-
their p w n a l s-f and did not v W y cotnmunicatte.A s&a&-
6ehg at6tude prevails. InitiaUpeatisg dim&%& clientsmwt be close bursts. It m y result in dissoaation or an exaggerated mnsem mer
ly evaluated Do thy need a hospltll sdmlssionto s a b h them met*? bo* hcriam and appmance. Dismbznces in tbhkhg may range
bolick@? Will dose observationwith a b&dv2mal approach be bend- from a h %of claatji in the personb ideas to t& incoherence. His or
cial? Coople or family therapy can be in&@ted.Bulimia appear her thorufkts are illogically cmaecte& so t h v are di86cult m under-
pmgres4 wi& group therapy Cornunity education pmgram5 am a
stand The person may m l e words SO they make no s a e i W is
&word salad. He Ox she may make up words to a p e s 8 con-
necessity in a time when eating &dram are of epidemic pmp0rrioIL
fused tltou&ts; tlwe arr cded neologbrm Echolalia is the pur-
poseless isep&tion ofa ward ox phmrse,
C-haxar3erktics of f h n i a indude dekxziam, ~~~
tiansI dbturbed thought pm%es.9es, and peculiar hehador. Delusions
are f&e id- rhet eannot be chwged by logid argument Delusions
a?e often aSsoQiated d t h hllua-. They may occur in any type of
psg.c$otic m a i o n
Delusional ideas may be in the form of guil.? or perseatian.
Clients may feel that they have anmitted grave sins or tbey m y
exaggerate a d e e d . Ptwple wih delusions of persecution
belime fhat an argankd g r a q htmds to harm them.They !nay per-
m i all happenings inrelation m t h e delusion,nsing eaentuxdated
events as proof of* delusion. Persons with s&impBr~& m y &Q
have deImfon8 of grandew:, be&- €hafThey have great power. Thw
may see t,bawdva as Napoleon or @us Ghfist
Halfa@h€ionsare pmeptiom that OWE in the &ma gf
stlmd and have no bash in Ilreyinelude hmhg nonexistent
VOW [audiforp],ha&pision$ [oimd),~mdkt~g (01.kctor3g or t w w
thjngs e;uStatbryl, or having 4 senwtion of being tcluehed (%Me).
C0nmzm.d haUui3n.at?om taa be very ~~g fox fhs: client and
may cpmmand the client to do somethin$ dangerous to seX or othe%s,
hinpmtant part of-dw dbtwbance of &en@with srhizo-
phrenia is their pmgfessive uiM.ragval 'They s&Wte faztasy fof
real life, Their actionsmay seem hqpmp14atetatlie sitnation beisuse
%ey be- incm&n&indifferent to their outside mvbonment a d
feel alienared and isolated
In an acute m e t af schizophrenia, them fs' usually normdIU a
normal hdin fuactioning, rhe absenee ofnegah symptom Cable
9%), and (i good response to anfipsyihofic mdicatiom. With a film
onset, there are enlarged anal ventricles, praminmtneg&?e s$mp
and a poor mpgnse to antipychoticp,.
m o t i c n'iedi8.W possw many side &mts that need to
be 856es9d by the nursing staffand repurred to the p-
Wt ITab1e 9-6).A 8erlous, Wrewsible side effect & tardfve rfy~kine
&a ITD). 'RJ detect TD at is e d & st-, an inwIun*ly
mamnent s d %W&fsl needs to @me ai a -lum of w r y six
months @-?I2
L
OSITIVE: NEGATIVE: ZbDE GENERIC
D~PQ'NEU~CILBPTI~%
Haldol demnoate halopesidoi decanoate
Prolixln decanoate fluphenai.[nedecanoate
Depot neuroieptlcsare Ueslgned fofindigduals who need anfTpsychotlc
medlcatlon yet have dim~ultyremembering totake it o,r paranoid
ideation. Medication is Wealoh form atid u$uallvgiven;eQ@y W o w e m
For P r o l i n decanoateand every four WeeKs for Haldol #@%noate.
impaired self-care,
BIrarre behaviors.
Elimination or signfircant redudtion of hai~u~inabans,
Poor Judement Poor delusions, anxiety, and troubleso.me thou$htS,
Poor lnnght Papr feelines; and behaviors
retentlon
ATYPICAL ANTIPSYCHOTICS
'.', , . ,, .
-. .
, ..: . .,;
& .
, : ;.
Clozaril Icl~zauinel typical antiusychotlcs that %'b la^
RiSPerdai Irisperidone) dopamlne and serotonin-hlpeanntagonlsts ZJ)..:
zvprexa (olanzapine)
- -
-- - A L-- - - - 7 . --.----
ChaNer 9 Maladaptive Behaviors
q~ersvns&NWexaL3gbraUOn of
~IHicultlerInabUttv torelax, cold
end unemotional
of warm tenderfewnngs M r others zrculw ln malmnina
IndlweAe; few close friends; "IOnW &tbactow relatlonMIP5
%,cia1 isolation; oddltles of mlnbng ~ntrto
and speech: Illusion$ sU$P~CIOa
nypersenSmvihl
~vetlvdramtlc expressions of ~tamaticandemotional
motion, overreactton to eve*
seRlndulgsntr wnrrpnt drawlfig of
attentlon to 9et IrmtJonaloutbur*.
dncanslderatlonof othen; Vahland
demamllng: constant seem9 df C).q A small success experlence for cllents may be seeing
reassurance: lackof 8enulneneS;
mavlng of excitement tneW artwork displayed; this builds self-esteem.
maggeratedsense ofn-npfsQ
e%
lincIat
need fQr canstant attention and
admlratloII: preoowbledwlihfantarles; Ber pressure can fiequatry be used to modify behavior. Guidance in
asserkness is hdpM for same clients. T h e clients need positive
lacks abllityto reCOgNZe how othenfeel
oefective judament feedback for open, dbeet fflmunicatioa The nurse should enwrmge
$eels Immediate pleasure; selRsh;
p o ~ r o c c ~ p a ~ wrformance;
ona~ nt r~skofsubstance r e k d rather than hostile exchaqps. He or she should set appropi+
unablem mamtaln lasting relatlonshltcrr abuse and harm ate limits and be sure the client knows the limitations. Dimsional
poor sexual adlusimentifailure t o aaivities are important The nurse might help by presenting gmwth
accept social norms; Irritability anll opportunttiw, chances to assme responsibility, and small suecess
aggreslveness; fallura to Plan ?hUu
dkreeanlM I tnemth:
~impulslvevel: exp6enee.s mgure 3-11. There is now a move tnward special &dm-
recklessvlolatlon of the PTahts of ottheK Gal homes for some clients Mth persor&tydisorda
impulsiveand unpreMctable; umtable infer- Erratic
personal matlonshlps; hec(U8ntdkplays of
anger, ldentiw problems, shim In moods;
Impulse Control Disorder
Intense d~scomfcrtwhen alone: pnyslcally Clients with an impulse disorder have uncon~oU&leimpulses that
qelf.damaglng act%reoumngPeellngS
of boredom m d emptmess
result in hmfd behaviare to seIf or othw. Their poor insight and
HypersenslbWto relechon, Social AnXloUS
inability to Mect and think of an alternative beharrior rmults in exit-
withdrawal: low self-esteem ing, dangerous behaviors that redue their sense oftension and pleas-
Lac& 9elf.cOnfldence; avolds relying on self; Fearful nre. As a result thv experience relief: hpulsive behaviors hdude
allowsothersto assumeresponslbllltY klepto- pyromania, pathological gambIirig, trichorikmlania, and
Pre~ccUpaUon N t h trivial detallS; overly compulsive skin picking Csometimw to the point of excoriation). Some
conventional and serlous, InSlStS Oh of the literatwe also includes compulsiw buying as a n impulse &or-
own way; lndeoisive der. Comorbidtty Mtith other disarders, such as bipolar disorder, psy-
lndlreetly resists demands MI adeauats choactive sabstance Use, attention defidtihyperactive disorder
perfurrnance; Intenttonal Ii7efUClenW
foramml; stubbQ~ReSS, prauaSMrlaU0n. CaDHDJ, malor borderline and antisocial pemamlity disorders need
aawunna rwntful to be -sea
@&\I
Maladaptive Behaviors 3-a
SUMMARY
Maladaptive behavim can develop anytime &om ihfancy through as tbry relate to
old age. Three critical times are adolescence, menopawe, and old
age. Coping acthity is required throughout the life cycle. D In a &s discuwion, mmlate the developmental stage of ado
The word m m l can be viewed in a sod& W c
a L m o d or leswce with the d e v d o p m t o f m mring dkorrler.
statistical way There is no sharp distinction between normal and D Investigate the a d m h h n p~cedma$0a day-freattllentcent*
abnonnd Psychiaay categorizes patterns ofbehavior, but it must be ar mental h d t h &tin ydtr coamm~@l%pon your kdhgs
remembered tbat &en@do not fit neatly into these categories.Each to the cla~3.
client has an individual reaction to stress and therefore an individ-
uaI pattern of behauior. Wain and review pamphlets from:
Psychological disorders are disturhanm characterized bymal- M c m PeytWatric h a ,Division nf Riblic
adaptive behavior aimed at dealing with high levels of d t r : L*OO K S*et NW
Arydety disorders, somatoform disorders, affective disorders, and Wa8bqton, DC. 20005
diswociative
- disddm are some common psychological disorders. 1-202m-62.20
Nursing m e focuses on reducing anxieq
Affective disorders deal with mood and emotions. This cat* m e f y m r d e r s Assadation of America @DA'Q
gory d u d e s dysthymi~depressive major, cyclothymic and bipolar UaOU Parlam Drive, bib 1.00
disorders, Bipolar disorders are subwed as m a n i ~depressed, or R d d & MD 2085d-2-
1-301-2313350
mixed Dissocfative disorde~sare characterized by changes in con-
sciousness and identi@ This category includes psychogenic amne- wwwxka.org
eia, psychogenic fugue, multiple personality, and d e p e r s o ~ o n CMdren a i d Adults with Atiwdirn DefW Dipordw [ C w . . D . )
disordm Schizophrenia is characterized by delusions, hallucina- 499 N.% 70th Avenue, SSuite 101
tions, disturbed thought processes, and peculiar behavior. Persons P W t i Q PI, 33317
with schiz~phreniaexperience conaiding feelings and demonstrate 1-800-2334050
inappropriate affect word saIa& neologism, delusions, and haIluci- -chaddq
nations. The m e s of schizophrenia are disorgdzed catatonic,
Pood and DrugAhinbmtion WA]
paranoid, and undEerentiat-ed. The client with a paranoid disorder
s d e n h m persistent delusions, generally of jealousy, persecution, 5800 Elshem, Lane
R o M e , MD t Q B 7
or grandeur. Personality disorders involve an indivi&alalsadaptation
1-800-3320178
to internal and external problems. The disorder interferes with
social or role functioni~g~ Med Warch: 16iJ0-33~-1088
Many psychia'tric clients are lugh risk for suicide. The www.vrn.~dagoli
depressed client is the client most likely to commit suicide. The NationaI Alkane for the Men* Ill @AMD
nurse should he able to recognize indirect cues that the client may; 200 Noah Glehe Roa& 3ta 1015
be considwing suicide Talking about suicide is a plea for help and Arhgroq, VA 22203-9754
must be recognized as such. (See Chapter 10, Violence and 1-800-950-NAMI
National Dqressive and M&c Dlepmwiae Disorders A s s o W n
730 N. FXankb S t w s S e e 501
chicage, 6UQO
1400-826-3G32
Chapter 9 Maladantbe Behaviors
National Foundation for Depmiive 11l0e$$ I= 3. Ap Irresistible urge to engage In a behavior is d e d @an
PO Box 2557 0 A. obsession.
Nw?Cork,M! 10.116 0 B. compuIsion.
1-800$39;1265 U C phobia
rndep1%95iOmg a D. psychosis.
i??a'ti.osdm t e o f h M H d r h 4. The @pesf schhphrenic disorder characte&ed by stupor
6001 Executive B o d e d and waxy E d i l i t y is d e d
Rrrom &MSG I$ &
9663 P A. dimganizsd
aethesda, MD 20892 U B. atatonic
1-301-443-4519 n C unMwatiat.ed.
r n a a . g O v R D. parmaid
National Menral He&& &sO&tiOn 5.The affective dismdef that deals with altemste moods 6f
l 0 &6&
~ swet depression and elation is the
&mdria, VPI 23314 D A d@We ctisurder,
1-800-968-6645 Ci B. depersmahtion disarde.
m e w 0 C. ppchogeenie f5gue.
ObsessivpCxrm~ive Foundation D D. bipolar disorder.
337 No& Hin Paad 5. For o r s t bWdnals, uBe of compulsive behdyior results in
Nor@Bradkrd, CT 064n which ofthe folowing7
1-203-315-ZI90 P A occupybg the mind
~.ocfounda&&arg D B. manipulating the envbnment
Croup &c&wion on folkwing 0 C. lowe* &eq
0 D. preventing mist&e6
M D S ~~Communic~on
, Swim Communicating with €%ents
j30mD3fferent @ l t W , B96. '7.Psychogenic amnesia is M das dan
D A f l e c k disorder.
-
REVIEW
KNOW ARID C O ~ E ~
D B.pasonaNtjr disoder.
0 C. dissociative &arrler.
Q D. wnvemion disorder.
A Mdtipie choice Select the one be& mWWm 4. The pereon with a conmion disorder
fear ofa s p e a c stmation or object is
Z Anabnonnal, aces~ive Q A wnverts anndetJrto b o w symptoms.
ealled 4m Q B. expwienm.seven: m o d swings.
Q A obsession . . . Q C,is cut off from bis or her a v e e m
Q B. wmpulsion. . . .. R D. word@ about self obsessively.
Q C. phobia 9. Behavio~ that the person with an ar~tisodalpetsondffgi s like-
a n. pv&oss. ly tp display is
2. A reaming 0wzp-g tharght or fedhg is calld tJan D A withdra- &om p n p activity
A Q~WS~UIL D B. medmical obedience.
n B. ~ampu]sion. D C. ~ u l a r i a of n others.
P G. phobia D, ritwhtic behavior.
U D. p&osis.
Maladaptive Behaviors
10.W c h of the Mowing clients would hawe the a;gh&strisk kr 4. The nlnse prepares to administer fluphenzine d e w a t e
suidde? A client ctiapaed ~ 4 t aian
h (Prolixin d8canoate3 3E5 mg IlM to a dim diagnoed &h
d A @genic mesk paraoid s&mphr& Whtch needle should the hurse
P B. antisocial per6onality disorda. edect?
0 C major depressim r;l A 18 g, l/b
D cych&puc disorda. D B,20&142'
o c. 22 g, 31a
a D. 26 g, 2"
APPLY mm LEARWrnG $. The W e pxepaed to administtr hatcJ@dol d ~ ~ ~
B. MnZtipIe cho1ce. Seled f&eone, be& amwe% CEaldol deanoatel Ihd ta a &ent d B g ~ 0 6 with
d parnoid
1. A &ent diagnosed with paranoid a ~ tells the p ~ sddmphreniaa.The n m e could usa any ofthe follow@
n m &"I"m JuusCbrirrt pour Lord and Smior, Codeas your *s escqt:
alns to ma" Which response by.the n m e would be most Q A the ahdoma
~ P P ~ P ~ W Cl B. deltoid.
P A. "I am of the Jewibb f&th and do not accept Jesus as Lord P C.gIut9w -w.
and Sadosd 12D. bteralis.
0 B.Tour admission p a p a do nor Iist pour run%?as Jesw? Q;.The nmSe gathers informafion hr a nmly admiW &ent
P C. "You are out oftouch with red*. Your belief is a symp diagn~sedwith an eaiing &order. What info~mationwould
Tom of your illness? haw the highest priority to obtain?
R D. Y respectgour beliefbut 1do net share thebelieP D &age
a. A &atinith w t a t o n i c s c h k p ~ isa mute and sits for 0 B. heaa rare HLld rhythm
h m in a rigid posture. l%kb Cimmldmtim s t r a t e 0 62. m a w p m
would be most appmpxkie far the m e to use? P D. body m g e
0 A. PrqueriTl$ pat the & i t ' s shovMer to demonstrate car- W: A clldnt with hipolar disorder takes li.thinm Which h d i
in& would prompt the nlnse to mitthold the hedose and
0 B. Anoid verbd inferadan untiltke antips+&c metifa- ptoqtlp the &aician?
tion takes e f f e c t 9 A mstipation
0 C. Ask the dien'tls &@ant other to obtain infamatian 5 B. inffequent udnatton
fmm the &mY, 0 C. 1-and coRfusic9~
Q D. Offer short caring pbrases to ccmmd* mnsm for Q D, fncmaved dbt
the client
8. The nurse finds a dent, who is diagnosed with ma% depres-
3. A client has a medial &a@.& of bipolar disodm, manic sion,done aqi qing. Which r e s m e by the nurse would be
phase and a diagnosis ofhbalancednuDitio~less most therapeutic?
than body r-ents. Which n m b g interamtianmuld D. A. Administer the clfent's antidepressant medkatioa
be most imp~rtant? 5 B. Offer to sit quietly with the slient
0 A Reeord how much the dietit eats a€each mad. Ll C. A& the ellent, %at% the matter7".
Q B. Ask the client to keep a journal about eat@ ham. 0 D. Qffer the clfen't-arecrational actiuity,
Q C. Record the clie11tSintake and output
0 D. Frequen€Ir offerthe d i a t ma& dbevePagpSt