Nokea
A 35-year-old woman is being assessed related to suspected battering. In interviewing this patient, it is important for the nurse to keep in mind that: (Select all that apply.)
- A. The nurse's demeanor should be one of concern and caring.
- B. Professional terminology should be used and taught to the patient.
- C. All noted injuries should be thoroughly and explicitly documented.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A because when assessing a patient related to suspected battering, the nurse should demonstrate concern and caring to establish trust and encourage the patient to open up. This approach helps build rapport and facilitates communication, leading to a more accurate assessment and better support for the patient. Choice B is incorrect because using professional terminology might intimidate the patient and hinder effective communication. Choice C is incorrect because documenting injuries without sensitivity and consideration for the patient's emotional well-being can further traumatize the individual. Choice D is incorrect as the nurse's demeanor and approach are crucial in addressing cases of suspected battering.
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Which of the following is NOT a suitable place for a family doctor outside the polyclinic to refer an adolescent patient for psychotherapy/counselling?
- A. Local Social Service Office
- B. Nearby polyclinic
- C. Patients school
- D. A reputable restructured hospital
Correct Answer: B
Rationale: A nearby polyclinic is less suitable for psychotherapy referral as it focuses on primary care, unlike the other options with counseling services.
The mother of a teenager diagnosed with an eating disorder asks, 'How long will my daughter have this problem?' The nurse answers with the knowledge that:
- A. recovery is usual after one severe episode.
- B. less than 30% show improvement after 5 years.
- C. weight restoration is sufficient for recovery.
- D. long-term therapy combined with medication results in the best outcomes.
Correct Answer: D
Rationale: The correct answer is D because long-term therapy combined with medication results in the best outcomes for individuals with eating disorders. Therapy helps address underlying psychological issues, while medication can help manage symptoms. Recovery is a complex process that often requires ongoing support. Choice A is incorrect as recovery is not always guaranteed after one severe episode. Choice B is incorrect as many individuals do show improvement over time. Choice C is incorrect as weight restoration alone may not address all aspects of the disorder.
An 82-year-old widow with Alzheimer's disease lives with her daughter's family, which owns a catering business. During the week, the patient attends a day care center for patients with dementia. During the evenings, members of the family care for the patient. One day, the nurse at the day care center notices the patient's appearance is disheveled and that she startles easily. She has a strong odor of urine, and her hair is uncombed. When the nurse escorts the patient to the bathroom, she notices bruises on her wrists and back. What most likely explains the nurse's observations?
- A. The patient is being neglected and abused within the family.
- B. The dementia is progressing, reducing self-care and increasing falls.
- C. The patient is being inadequately cared for, resulting in accidents.
- D. The patient has developed delirium, resulting in poor hygiene and injuries.
Correct Answer: A
Rationale: The correct answer is A: The patient is being neglected and abused within the family. The nurse's observations of the patient's disheveled appearance, strong odor of urine, uncombed hair, and bruises indicate signs of neglect and abuse. Here's the rationale:
1. Disheveled appearance and strong odor of urine suggest lack of personal care.
2. Uncombed hair signals neglect in grooming.
3. Bruises on wrists and back are indicative of physical abuse.
4. Startling easily may be due to fear or anxiety from abuse.
In summary, the other choices (B, C, D) are incorrect because they do not account for the combination of neglect, poor hygiene, and physical injuries seen in the patient, which are more indicative of abuse and neglect within the family.
The first step in the treatment of incest is to:
- A. believe the child who reports the activity
- B. notify the proper authorities
- C. objectively confront the accused family member
- D. remove the child from the home
Correct Answer: A
Rationale: Believing the child establishes trust and validates their experience, forming the foundation for further protective and therapeutic actions.
An older adult patient who lives with a daughter and attends the Alzheimer day hospital program exhibits bilateral bruising for the second time on both upper outer arms. When the nurse questions the patient about the bruising, the patient starts to cry and pleads, 'Please don't say anything. It's not my daughter's fault. I just bruise easily.' Which intervention reflects the best management of this situation?
- A. Call the daughter to discuss both the bruising and her parent's reaction.
- B. Report the elder abuse, and inform the patient and the daughter of your intention.
- C. Notify the patient's social worker of the bruising after a complete assessment has been completed.
- D. Inform the patient and the daughter of your intention to document the bruising and arrange for appropriate counseling.
Correct Answer: B
Rationale: The correct answer is B: Report the elder abuse and inform the patient and the daughter of your intention. This is the best intervention as it prioritizes the safety and well-being of the older adult. Here's the rationale:
1. The patient's repeated bruising and fear of disclosure indicate potential abuse.
2. Reporting elder abuse is mandatory to ensure protection for the patient.
3. Informing the patient and daughter shows transparency and involves them in the process.
4. It is crucial to address the situation promptly to prevent further harm.
Summary:
A: Calling the daughter may escalate the situation and compromise the patient's safety.
C: Notifying the social worker without addressing the abuse directly may delay necessary action.
D: Counseling may be beneficial, but addressing the abuse is a priority to ensure the patient's safety.