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Based on assessment data, the nurse formulates the nursing diagnosis for a patient as sleep pattern disturbance. After teaching the patient how to relax before bedtime, the nurse determines that the teaching was effective by which outcome?
- A. Discusses feelings about not being able to fall asleep
- B. Reports feeling rested on awakening in the morning within 3 days
- C. Requests sleeping medication each night before bedtime
- D. Is able to sleep for short intervals throughout the night
Correct Answer: B
Rationale: The correct answer is B because feeling rested upon awakening indicates improved sleep quality, reflecting effective teaching on relaxation techniques. Choice A does not directly measure the effectiveness of the teaching intervention. Choice C indicates reliance on medication rather than improved sleep hygiene. Choice D, sleeping for short intervals, does not necessarily signify improved sleep quality.
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A client with signs and symptoms of double pneumonia states,"I will not agree to hospital admission unless my shaman is allowed to continue helping me." Which would be an appropriate nursing intervention?
- A. Tell the client that the shaman is not allowed in the emergency department.
- B. Have the shaman meet the attending physician at the hospital.
- C. Have the family talk the client into admission without the shaman.
- D. Explain to the client that the shaman is responsible for the client's condition.
Correct Answer: B
Rationale: The correct answer is B. Having the shaman meet the attending physician at the hospital is the most appropriate nursing intervention because it allows for collaboration between traditional beliefs and modern medical care. This approach respects the client's cultural and spiritual preferences while ensuring the client receives necessary medical treatment. It also helps establish a supportive and holistic care environment.
Choice A is incorrect because denying the shaman access may lead to resistance from the client and hinder effective communication and trust-building. Choice C is inappropriate as it disregards the client's autonomy and may create conflict within the family. Choice D is incorrect as blaming the shaman for the client's condition is disrespectful and unprofessional.
While caring for a family, the nurse determines that first-order changes have occurred with which of the following?
- A. The children are all in school, and the parent returns to work.
- B. The daughter leaves home to attend college.
- C. The son marries his long-time sweetheart and moves into his own home.
- D. The grandmother who has been living in the household dies.
Correct Answer: A
Rationale: The correct answer is A because first-order changes refer to small, incremental adjustments within the system. In this scenario, the parent returning to work while the children are all in school signifies a gradual shift in the family dynamic. The other choices involve significant and more disruptive changes like a daughter leaving for college, a son getting married and moving out, and the death of a family member, which are considered second-order changes that lead to more substantial shifts in the family system.
A psychiatric-mental health nurse is teaching a class about social factors associated with mental illness at a community health center. When describing the influence of poverty and effects of the downward economic spiral on mental health, which population would the nurse identify as being the most at risk?
- A. Older adults
- B. Individuals with physical disabilities
- C. Single-parent families
- D. Homeless individuals
Correct Answer: D
Rationale: The correct answer is D: Homeless individuals. Homeless individuals are the most at risk due to the severe impact of poverty and the downward economic spiral on their mental health. Homelessness often results from poverty, leading to chronic stress, lack of access to basic needs, social isolation, and increased vulnerability to mental health issues. Homeless individuals face multiple stressors that can exacerbate existing mental health conditions or lead to the development of new ones. Older adults (A) may face financial challenges but are not necessarily homeless. Individuals with physical disabilities (B) may encounter economic difficulties but are not automatically homeless. Single-parent families (C) may struggle financially, but homelessness is not exclusive to this group.
Forensic nursing combines scientific knowledge and inquiry in an effort to serve:
- A. Victims of crime
- B. Perpetrators of violence
- C. Victims and perpetrators of crime
- D. Families of crime victims
Correct Answer: C
Rationale: The correct answer is C because forensic nursing serves both victims and perpetrators of crime. Forensic nurses provide care, collect evidence, and testify in legal proceedings for all individuals involved in a crime. Choice A is incorrect because forensic nursing is not exclusive to victims. Choice B is incorrect as it does not encompass the holistic approach of forensic nursing. Choice D is incorrect as it focuses solely on the families of crime victims, rather than the individuals directly involved.
A patient has come to the clinic to discuss the stress she is experiencing because of failing two exams at school. Initially, she described her failures as 'the worst thing that has ever happened to me,' and she stated, 'There is absolutely nothing I can do to pass this course now.' In response to the nurse's questions, the nurse finds out there are three more equally weighted exams scheduled for the course in question. The nurse and patient collaborate and decide to use interventions to facilitate emotion-focused coping. Which additional comment from the patient would the nurse identify as providing support for this decision?
- A. You've got to figure out something for me to do to get me out of this situation!
- B. This is a waste of time because absolutely nothing you or I can do will make it any better.
- C. I overreacted; surely together we can figure out something for me to do.
- D. This is the worst thing that could ever happen to me. I'm nothing but a failure.
Correct Answer: C
Rationale: The correct answer is C because the patient's statement shows a shift in perspective from hopelessness to a willingness to collaborate and problem-solve. By acknowledging the possibility of working together to find a solution, the patient demonstrates openness to coping strategies. Choice A displays frustration without a willingness to participate actively. Choice B reinforces hopelessness and a defeatist attitude. Choice D reinforces negative self-perception without any indication of openness to change. In summary, choice C aligns with emotion-focused coping by showing a willingness to explore solutions collaboratively.