A Native American patient describes difficulty learning as a ...

[TVarnum]

A Native American patient describes difficulty learning as a child, living on a reservation, and being sent away to a Native American boarding school.
 
  The patient began using alcohol as a teenager to escape feelings of isolation but stopped 10 years ago when gastritis developed. The patient now says, I feel stupid and good for nothing. I don't help my people. How should the treatment team focus planning for this patient? a. Group therapy for treatment of posttraumatic stress disorder
  b. Simultaneous treatment of depression and alcohol abuse
  c. Psychoanalytic approach
  d. Holistic approach

Question 2

During the mental status examination, the nurse observes that the client rapidly changes from one idea to another related thought. Which disordered thinking process is the client displaying?
 
  a. Delusions
  b. Perseveration
  c. Confabulation
  d. Flight of ideas

[bhavsar]

Answer to Question 1

D
Native Americans, because of their beliefs in the interrelatedness of parts and about being in harmony with nature, respond best to a holistic approach. No data are present to support dual diagnosis, because the patient has resolved the problem of excessive alcohol use. No data are present to support a diagnosis of posttraumatic stress disorder. Psychoanalysis is a long-term therapy that is very expensive. Cognitive therapy might be a better choice.

Answer to Question 2

D
It is difficult to follow a conversation with an individual who is experiencing flight of ideas because the conversation follows his rapidly changing thought pattern. Delusions result in false beliefs that cannot be corrected by logical explanations or reasoning; perseveration occurs when the client repeats the same word response to different questions; and with confabulation, the client uses untrue statements to fill in gaps of memory loss.