Nokea
A 76-year-old is regressed, indifferent, and responds to others only when they initiate an interaction. What form of group therapy would be most useful to promote resocialization?
- A. Remotivation
- B. Activity group
- C. Psychotherapy
- D. Reminiscence (life review)
Correct Answer: A
Rationale: Remotivation therapy focuses on stimulating engagement and interaction in patients who are socially withdrawn or have limited emotional responses. It helps the individual reconnect with their environment and others.
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An advance directive gives legally binding direction for health care interventions when a patient:
- A. Has a new diagnosis of cancer.
- B. Is diagnosed with Parkinson's disease
- C. Diagnosed with amyotrophic lateral sclerosis is unable to speak.
- D. Is unable to make decisions for self because of illness.
Correct Answer: D
Rationale: An advance directive is used when a patient is unable to make their own healthcare decisions, typically due to a serious illness or injury. This legal document outlines the patient’s wishes for treatment and care.
A patient asks the nurse manager to help resolve a situation between her and another patient. Which action would best support the patient’s feelings of safety when experimenting with new ways of being?
- A. Encouraging the patient to report the incident to the other patient’s physician
- B. Intervening on the patient’s behalf and sorting out the incident with the other patient
- C. Suggesting that the patient ignore the situation since the other patient was probably not aware of her behavior
- D. Offering to be present and help the patient discusses her feelings about the incident with the other patient
Correct Answer: D
Rationale: Offering to be present and help the patient discuss her feelings about the incident with the other patient would best support the patient’s feelings of safety when experimenting with new ways of being. This option encourages open communication between the two patients in a safe and mediated environment. It allows the patient to express her feelings assertively while feeling supported by the nurse manager. Mediation can help both patients understand each other's perspectives, resolve conflicts, and potentially prevent similar incidents in the future. Ultimately, this approach empowers the patient to address the situation directly while providing a sense of safety and support.
An outcome for a patient experiencing anticipatory grieving for a spouse diagnosed with
terminal cancer would be that the patient will:
- A. Continue to be emotionally involved with the dying spouse
- B. Develop protective mental mechanisms to allay the pain of spousal loss
- C. Not voice threats of physical violence that is either self or others directed
- D. Agree to stay at home and care for the spouse with appropriate assistance
Correct Answer: D
Rationale: Anticipatory grieving involves preparing emotionally for the upcoming loss. The patient may begin to focus on caregiving and emotional preparation. Agreeing to care for the spouse with assistance reflects an adaptive coping mechanism during this period.
A new nurse asks the mentor, “How can I be sure I’m developing a therapeutic environment for my unit?” The mentor uses as a basis for the response the fact that a therapeutic milieu is characterized by:
- A. Rigid adherence to timelines and unit routine
- B. Relaxation of boundaries when doing so is accepted by all
- C. Working with a member to help improve their communication skill
- D. The focus of the staff is directed to the most critically disturbed patients
Correct Answer: D
Rationale: A therapeutic milieu is characterized by focusing on the needs and goals of the patients. By establishing specific patient-centered goals that are agreed upon mutually by the patient and the staff, it ensures that the care provided is individualized and tailored to the patient's needs. This approach fosters a collaborative and empowering environment where the patient feels heard and supported in their recovery journey. It also promotes a sense of ownership and accountability for both the patient and the staff in working towards these goals together. In contrast, rigid adherence to timelines and unit routine (option A) may not always take into account the unique needs of each patient, and relaxation of boundaries (option B) can potentially compromise the therapeutic process by blurring professional boundaries. Therefore, establishing patient-centered goals is a key component of creating a therapeutic environment on a nursing unit.
In the elderly, administering medication is a great concern for the nurse since these patients are more prone to side effects. The primary cause of this is:
- A. Altered circulation and renal function
- B. Accelerated gastrointestinal system
- C. Enlarged Lymph nodes
- D. Musculoskeletal system weakness
Correct Answer: A
Rationale: Aging causes decreased renal and hepatic function, leading to slower metabolism and clearance of drugs, making older adults more vulnerable to drug toxicity and side effects. Other options, such as accelerated gastrointestinal function, are incorrect as GI motility often slows with age.