Nokea
Which of the following services is not part of family consultation?
- A. assisting with vocational rehabilitation
- B. providing information about the client's illness
- C. teaching effective communication
- D. helping families solve problems
Correct Answer: A
Rationale: Family consultation does not involve vocational rehabilitation. It involves helping families deal with their feelings, focus, and find solutions. Choices 2, 3, and 4 are components of family consultation.
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Which intervention should the nurse take first to assist a woman who states that she feels incompetent as the mother of a teenage daughter?
- A. Recommend that she discipline her daughter more strictly and consistently.
- B. Make a list of things her husband can do to help her improve.
- C. Assist the mother to identify what she believes is preventing her success and what she can do to improve.
- D. Explore with the mother what the daughter can do to improve her behavior.
Correct Answer: C
Rationale: The intervention priority with a mother who feels incompetent to parent a teenage daughter is to assist the mother to identify what she feels her crisis events are and to help her develop better coping skills and improve her mothering skills. With a teenager, the growth and development parameters have to be concentrated on self as well as acquiring an added event. Choices 1, 2, and 4 do not directly address the mother's feelings of inadequacy.
Milieu therapy is best employed to perform which activity?
- A. Investigating the client's view of the world
- B. Promoting socialization skills
- C. Focusing on inappropriate behavior
- D. Providing repetitive ordinary experiences on a daily basis
Correct Answer: D
Rationale: Milieu therapy provides repetitive ordinary experiences to minimize change, reduce disruptive behavior, and promote stability.
A batterer is usually someone who:
- A. grew up in a loving, secure home.
- B. was an only child.
- C. was physically or psychologically abused.
- D. admits he has a problem with anger.
Correct Answer: C
Rationale: Many batterers report having been abused as children.
A person using over-the-counter nasal decongestant drops who reports unrelieved and worsening nasal congestion should be instructed to:
- A. switch to a stronger dose of the medication.
- B. discontinue the medication for a few weeks.
- C. continue taking the same medication, but use it more frequently.
- D. use a combination of medications for better relief.
Correct Answer: B
Rationale: Prolonged use of decongestant drops (3 to 5 days) can lead to rebound congestion, which is relieved by discontinuing the medication for 2 to 3 weeks. Nasal congestion results from dilation of nasal blood vessels due to infection, inflammation, or allergy. With this dilation, there is a transudation of fluid into the tissue spaces, resulting in swelling of the nasal cavity. Nasal decongestants (sympathomimetic amines) stimulate the alpha-adrenergic receptors, producing vascular constriction (vasoconstriction) of the capillaries within the nasal mucosa. The result is shrinking of the nasal mucous membranes and a reduction in fluid secretion (runny nose). Decongestants can make a client jittery, nervous, or restless. These side effects decrease or disappear as the body adjusts to the drug. When nasal decongestants are used for longer than 5 days, instead of the nasal membranes constricting, vasodilation occurs, causing increased stuffy nose and nasal congestion. The nurse should emphasize the importance of limiting the use of nasal sprays and drops. As with any alpha-adrenergic drug (for example, decongestants), blood pressure and blood glucose levels can increase. These drugs are contraindicated and should only be used with extreme caution for clients with hypertension, cardiac disease, hyperthyroidism, and diabetes mellitus.
Which of the following coping mechanisms protects an individual from anxiety?
- A. denial and fantasy
- B. rationalization and suppression
- C. regression and displacement
- D. reaction formation and projection
Correct Answer: A
Rationale: Denial and fantasy reduce anxiety by avoiding or reimagining reality, serving as protective coping mechanisms, unlike the other options, which may not consistently reduce anxiety.