HPSSC Staff Nurse - 2021
Mental Health Nursing
Easy
The type of delusion most commonly seen in manic patient is?
Appeared in: HPSSC Staff Nurse - 2021
Explanation
- Delusions of grandiosity are a hallmark symptom of mania, a phase of bipolar disorder.
- These delusions are 'mood-congruent,' meaning they align with the patient's elevated, expansive, and euphoric mood.
- A person with grandiose delusions has an exaggerated sense of their own importance, power, knowledge, or identity. For example, they might believe they are a famous celebrity, have supernatural powers, or are on a special mission from God.
- This inflated self-esteem and belief in one's own superiority is a core feature of the manic state.
Why Other Options Were Wrong
- Option A: Delusions of guilt are mood-congruent with depression, not mania. The patient feels excessive, irrational guilt and may believe they are responsible for terrible events.
- Option C: While delusions of persecution can occur in mania (e.g., believing people are jealous of their greatness), they are not the most common type. Grandiosity is more characteristic of mania.
- Option D: Nihilistic delusions are the belief that oneself, a part of the body, or the world does not exist. This is associated with a profound sense of hopelessness and emptiness, which is characteristic of severe depression, not mania.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Types of delusions in psychiatric disorders to guide bedside assessment, documentation, and the next nursing action.
- Recognizing the type of delusion is crucial for a nurse to accurately assess a patient's mental state and distinguish between mania and depression.
- Patients with grandiose delusions may engage in risky behaviors (e.g., reckless spending, dangerous activities) due to an inflated sense of invulnerability. Nursing care must prioritize safety and setting firm limits.
- Therapeutic communication involves acknowledging the patient's experience without validating or arguing with the delusion. A nurse might say, 'I understand that you believe you are the president, but for now, we need to focus on your treatment here at the hospital.'.
How to Approach the Question
- First, identify the key terms in the question: 'manic patient' and 'most common delusion'.
- Recall the core features of a manic episode: elevated or irritable mood, increased energy, decreased need for sleep, and inflated self-esteem.
- Consider how these core features would manifest in a person's thought content. An inflated self-esteem logically leads to grandiose thoughts.
- Evaluate each option: 'Delusion of guilt' and 'Nihilistic delusion' are associated with negative, depressive states. 'Delusion of persecution' is possible but is more central to other disorders like schizophrenia.
- Conclude that 'Delusion of grandiosity' is the best fit as it directly reflects the inflated, expansive mood state of mania.
Concept Tested & Keywords
- Concept Tested: Types of delusions in psychiatric disorders
- Stem keywords: delusion, manic patient
- Lead-in keywords: most commonly
- Negative lead-in flag: false
Question ID
QMblxTlgQeDi_m1jv5BzDJ
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 3803-3805, 3807-3809, 3808-3810
Practise the full HPSSC Staff Nurse - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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