Mental Health Chapters 15-18

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Mental Health Chapter 15-18 Assignments

Name

1. Corey is a senior in college and is taking his final examinations for an engineering course. The professor catches him copying from the examination of his willing partner, Katie, and takes his exam away. Corey’s heart immediately begins to pound, his pulse and respiration rates increase, and he has to wipe perspiration from his hands and face several times. He feels like vomiting and has a throbbing in his head.

After the examination, he approaches the professor but has difficulty focusing. When he starts to speak, his voice trembles. Corey says that Katie suggested that cheating is no big deal, that he needed to do it to be competitive, and that it was done all the time. Corey goes on to say that this “silly exam” doesn’t mean anything anyway and that he already passed the important courses. He tells the professor, “I thought you were the greatest, and now I see that you’re a fool.”

The professor remains calm and explains that regardless of Corey’s thoughts on this matter, he was, in fact, caught cheating, and he will have to take responsibility for his actions. The professor will refer Corey to the disciplinary board. When Corey realizes how serious this incident is, he flips out and yells at the professor and calls him offensive names. Another professor walking past the classroom witnesses this encounter.

a. Identify the level of anxiety Corey was experiencing once he was caught cheating and describe the signs and symptoms that helped you determine this level.

b. Identify and define five defense mechanisms Corey used to lessen his anxiety.

c. Given the circumstances once Corey was caught, how could he have reacted more responsibly, using healthier coping defenses?

2. Jeanne is a 48-year-old woman with dissociative identity disorder who was admitted to the crisis unit for a short-term stay after a suicide threat. On the unit, she has repeated the statement that she will kill herself to get rid of “all the others”—meaning her alters.

a. How do you think the staff reacts to working with patients such as Jeanne?

b. What do you believe needs to be done to protect Jeanne?

3. A patient with suspected somatic symptom disorder has been admitted to the medical-surgical unit after an episode of chest pain with possible electrocardiographic changes. While on the unit, she frequently complains of palpitations, asks the nurse to check her vital signs, and begs staff to stay with her. Some nurses take her pulse and blood pressure when she asks. Others evade her requests. Most of the staff try to avoid spending time with her.

a. Consider why staff members wish to avoid her. How would you feel as a nurse in this situation?

b. . Design interventions to cope with the patient’s behaviors. Give rationales for your interventions.

4. Logan, a 19-year-old wrestler, experienced a rapid decrease in weight after his coach told him that he would have to lose weight or miss a match. Logan is 6 feet 2 inches tall; over a period of 4 months he went from his usual 176 pounds down to 132 pounds. He is brought to the emergency department with a pulse of 40 beats per minute and severe arrhythmias. His laboratory workup reveals severe hypokalemia. He has become extremely depressed, saying, “I’m too fat … I don’t want anything to eat. If I gain weight, my life will be ruined. There is nothing to live for if I can’t wrestle.” Logan’s parents are startled and confused, and his best friend is worried but feels powerless to help Logan. “I tell Logan he needs to eat or he will die … I tell him that he is a skeleton, but he refuses to listen to me. I don’t know what to do.”

a. Which physical and psychiatric criteria suggest that Logan should be hospitalized immediately?

b. What are some of the questions you would eventually ask Logan as you evaluate his biopsychosocial functioning?

c. What are your feelings toward someone with anorexia? Can you make a distinction between your thoughts and feelings toward women with anorexia and those toward men with anorexia?

d. What are some things you could do for Logan’s parents and friend in terms of offering them information, support, and referrals? Identify specific referrals.

e. Identify at least five criteria that, if met, would indicate that Logan was improving.