Author Question: A client insists that his wife is having an affair despite repeated confirmation from her that she ... (Read 47 times)

newbem · **on:** Jul 19, 2018

A client insists that his wife is having an affair despite repeated confirmation from her that she is faithful. These beliefs began abruptly about a month ago, after the couple returned from a vacation.

The client shows no other signs of any personality or functional disturbances except for his firm belief about his wife's infidelity. When the client is found spying on his wife's boss at her office, a judge orders him to undergo a 10-day psychiatric evaluation. What is the most likely psychiatric diagnosis for James?

A) Delusional disorder or NOS
B) Induced psychotic disorder
C) Delusional disorder, erotomanic type
D) Conjugal paranoia

Question 2

Mr. Parkinson, aged 79, has moderately severe dementia of Alzheimer's type (DAT), a diagnosis that necessitated his move to a long-term care facility several months ago.

Today, the nurse has entered Mr. Parkinson's room to find him lying in bed and grimacing, moaning, and rubbing his left flank. Which of the following tools may assist the nurse in assessing Mr. Parkinson?

A) The Agitated Behavior in Dementia Scale
B) The Wong-Baker Faces Rating Scale
C) The NEECHAM Confusion Scale
D) The CAGE questionnaire

kishoreddi · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

Ans: D
In delusional disorder of the erotomanic type, the client has an erotic delusion of being loved by another person and tries to contact the object of the delusion through such behaviors as sending gifts, calling, and stalking. The object of the undesired attention may be a complete stranger and usually is of higher status. In a psychotic disorder, a delusion of suspicion occurs within the context of a close relationship. The individual may believe that someone has an inappropriate or sexual interest in him. Schizophreniform disorder involves bizarre delusions and hallucinations of less than 6 months duration. Conjugal paranoia is a delusion that the spouse is being unfaithful.

Answer to Question 2

Ans: B
The client's behavior is suggestive of pain, and the Wong-Baker Faces Rating Scale may be used to determine the presence or absence of pain in clients who are not able to communicate their needs. The other assessment scales do not measure pain.