A patient insistently states, "I can decipher codes of DNA just by looking at someone." Which problem is evident?

Magical thinking

Ideas of reference

Visual hallucinations

Thought insertion

Answer and Explanation

The Correct Answer is A

A. Magical thinking involves belief that one has special powers or that thoughts/actions can influence unrelated events. Claiming an ability to decode DNA by sight reflects an irrational belief in a special, unrealistic power.
B. Ideas of reference are the belief that neutral events (TV, conversations) refer specifically to oneself; that is not described here.
C. Visual hallucinations are false sensory perceptions (seeing things that aren't there); the statement describes a belief about an ability, not a sensory experience.
D. Thought insertion is the delusional belief that others are putting thoughts into one’s mind; the patient is claiming a personal ability, not externally implanted thoughts.

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Correct Answer is B

Explanation

A. Offering platitudes can minimize the patient’s feelings and may shut down further disclosure.
B. Directly asking about suicidal thoughts is the most important and therapeutic response because the statement expresses hopelessness, a major risk factor for suicide. This question assesses immediate safety and guides next steps (ask about intent, plan, means; implement suicide precautions and notify the provider as indicated).
C. Exploring past interests can be therapeutic later, but it does not address the immediate safety concern suggested by the patient’s hopeless statement.
D. Saying you don’t understand is vague and avoids addressing the potential crisis; a direct, nonjudgmental assessment of suicidal ideation is required.

A. "I want to continue my education, but I'm not sure how I will fit in with other college students." B. "It's good to be home. I missed my home, family, and friends." C. "Sometimes I think I hear bombs exploding, but it's just the noise of traffic in my hometown." D. "I saw my best friend get killed by a roadside bomb. I don't understand why it wasn't me."

Correct Answer is D

Explanation

A. Concerns about returning to school reflect normal adjustment issues and do not indicate immediate danger.

B. Expressing happiness about being home is a positive statement and does not require urgent intervention.

C. Hypervigilance and startle responses are common symptoms of PTSD and should be monitored but are not immediately life-threatening.

D. Expressions of survivor’s guilt or thoughts questioning why one survived while others did not can indicate severe emotional distress and possible risk for self-harm or suicidal ideation. This statement requires immediate assessment and intervention by the nurse.

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A patient insistently states, "I can decipher codes of DNA just by looking at someone." Which problem is evident?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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