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 helps to resocialize regressed and apathetic patients by focusing on a single topic, creating a bridge to reality as group members talk about the world in which they live and work and hobbies related to the topic. Group leaders give members acceptance and appreciation. Group psychotherapy would not be effective for this patient. An activity group does not address the patients problem.
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A history reveals that a patient virtually stopped eating 5 months ago and lost 25% of body weight. The nurse says, 'Describe what you think about your present weight and how you look.' Which response would be most consistent with anorexia nervosa?
- A. I'm fat and ugly.'
- B. What I think about myself is my business.'
- C. I'm grossly underweight, but I cover it well.'
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A. This response is most consistent with anorexia nervosa because it reflects a distorted body image common in individuals with this condition. Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image, leading to extreme weight loss and restrictive eating habits. Choice B suggests a lack of insight or denial, which is not typical of anorexia nervosa. Choice C acknowledges being underweight but does not reflect the negative body image associated with anorexia nervosa. Choice D is incorrect as option A aligns with the characteristic body image distortion seen in anorexia nervosa.
When a nurse overhears the spouse of a patient threaten to 'smack you good if you don't shut up' while sitting in the unit's dayroom, which action reflects the most immediate, therapeutic nursing intervention?
- A. Notify hospital security immediately that the situation exists!
- B. Tell the spouse, 'Your presence is no longer permitted on the unit.'
- C. Ask the patient if the spouse has ever engaged in physically abusive behavior.
- D. Tell the spouse, 'The police will be called unless you leave immediately.'
Correct Answer: A
Rationale: The correct answer is A: Notify hospital security immediately that the situation exists. This is the most immediate, therapeutic nursing intervention because the safety of the nurse, patient, and others in the unit is the top priority. By involving hospital security, the nurse can ensure a swift and appropriate response to the threatening behavior. This action helps to de-escalate the situation and protect everyone involved.
The other choices are incorrect because:
B: Asking the spouse to leave the unit could escalate the situation further and put the nurse at risk.
C: Asking the patient about the spouse's behavior may not be immediate enough to address the threat.
D: Threatening to call the police could escalate the situation and may not be the best approach to ensure safety for all parties involved.
A patient tells a nurse, 'The others won't give me my pain meds early, but you are more understanding, you know what it's like to be in pain, and you don't want to see your patients suffer. Could you find a way to get me my pill now? I won't tell anyone.' Which response by the nurse would be most therapeutic?
- A. I'm not comfortable doing that,' then ignore subsequent requests for early meds.
- B. I'll have to check with your doctor about that; I will get back to you after I do.'
- C. It would be unsafe to give the medicine early; none of us will do that.'
- D. I understand that you have pain, but giving medicine too soon would not be safe.'
Correct Answer: D
Rationale: Rationale:
- Choice D is the correct response because it acknowledges the patient's pain, shows empathy, and educates on the importance of safe medication administration.
- Step 1: Acknowledge the patient's pain to validate their feelings.
- Step 2: Express understanding but emphasize safety concerns to educate the patient on responsible medication use.
- Step 3: Maintain boundaries by emphasizing the importance of safe medication practices.
- Other Choices:
- A: Ignoring the patient's request can create distrust and may not address the underlying issue of pain management.
- B: Delaying the response by involving the doctor may increase the patient's anxiety and does not address the safety concern.
- C: Simply stating that it is unsafe without providing further explanation or addressing the patient's concerns lacks empathy and education.
A nurse assessing an elderly patient for depression and suicide potential should include questions about mood as well as: (Select one tha does not apply)
- A. anhedonia.
- B. increased appetite.
- C. sleep pattern changes.
- D. increased concerns with bodily functions.
Correct Answer: B
Rationale: The correct responses (A, C, E) relate to symptoms often noted in elderly patients with depression: anhedonia (loss of pleasure), sleep changes, and somatic concerns. Increased appetite (B) is less typical than anorexia, and grandiosity (D) relates to bipolar disorder, not depression.
The highest priority for assessment by nurses caring for older adults who self-administer medications is
- A. use of multiple drugs with anticholinergic effects.
- B. overuse of medications for erectile dysfunction.
- C. missed doses of medications for arthritis.
- D. trading medications with acquaintances.
Correct Answer: A
Rationale: The correct answer is A: use of multiple drugs with anticholinergic effects. This is the highest priority because anticholinergic medications are commonly prescribed to older adults and can lead to serious adverse effects such as confusion, memory issues, and falls. Nurses must assess for these effects to prevent harm.
Choice B (overuse of medications for erectile dysfunction) is not as high a priority as anticholinergic effects, as it is not as common and typically has less immediate serious consequences for older adults.
Choice C (missed doses of medications for arthritis) is important but not as critical as assessing for anticholinergic effects, as missed doses can generally be managed through education and adherence support.
Choice D (trading medications with acquaintances) is a serious concern but is not as high a priority as assessing for anticholinergic effects, as the immediate risks associated with anticholinergic medications are more severe.