An adult patient tells the case manager, I don't have bipolar ...

[skymedlock]

An adult patient tells the case manager, I don't have bipolar disorder anymore, so I don't need medicine. After I was in the hospital last year, you helped me get an apartment and disability checks. Now I'm bored and don't have any friends.
 
  Where should the nurse refer the patient? Select all that apply.
 
  a. Psychoeducation classes
  b. Vocational rehabilitation
  c. Social skills training
  d. Homeless shelter
  e. Crisis intervention

Question 2

Which information should a nurse include in health teaching for adults who have with attention deficit hyperactivity disorder (ADHD) and their significant others? Select all that apply.
 
  a. Tendency for genetic transmission
  b. Prevention strategies related to substance abuse
  c. Negative reinforcement to help modify behaviors
  d. Psychostimulants for children (rarely effective in adults)
  e. Cognitive therapy to challenge internalized negative beliefs about self

[kaylee05]

Answer to Question 1

ANS: A, B, C
The patient does not understand the illness and the need for adhering to the medication regimen. Psychoeducation for the patient (and family) can address this lack of knowledge. Work gives meaning and purpose to life; vocational rehabilitation can assist with this aspect of care. The patient, who considers himself friendless, could also profit from social skills training to improve the quality of interpersonal relationships. Many patients with severe mental illness have such poor communication skills that others are uncomfortable interacting with them. Interactional skills can be effectively taught by breaking down the skill into small verbal and nonverbal components. The patient presently has a home and does not require the services of a homeless shelter. The nurse case manager functions in the role of crisis stabilizer, so no related referral is needed.

Answer to Question 2

ANS: A, B, E
Evidence suggests that ADHD has a biological basis. This fact can help adults with the disorder to cope with lowered self-esteem that is often the result of negative treatment and a lack of acceptance in childhood. Cognitive therapy is helpful in reframing negative beliefs about self. Adults with ADHD have a higher incidence of substance abuse problems. The other options are untrue.