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A child, aged 11 years, stays home from school to care for his siblings while his mother works, because the family cannot afford a babysitter. The home is cluttered and dirty. When asked about his parents, the child reluctantly reveals that he thinks his father does not like him very much because he calls him 'stupid' and says he can never do anything right. This should be assessed as:
- A. physical abuse.
- B. sexual abuse.
- C. emotional abuse.
- D. economic abuse.
Correct Answer: C
Rationale: Explanation:
C: Emotional abuse is the correct assessment as the father's behavior of calling the child 'stupid' and criticizing him can cause psychological harm. This behavior undermines the child's self-esteem and mental well-being. The child's reluctance to speak about his parents also indicates emotional distress.
Incorrect choices:
A: Physical abuse involves causing physical harm, which is not evident in the scenario.
B: Sexual abuse involves inappropriate sexual behavior, which is not indicated in the scenario.
D: Economic abuse involves financial control or exploitation, which is not the primary issue in this scenario.
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A nurse observes a patient who is sitting alone in a room put hands over both ears and vigorously shake her head as though saying, 'No.' Later the patient cries and mutters, 'You don't know what you're talking about! Leave me alone.' What assessment should the nurse attempt to validate?
- A. The patient is seeking the attention of staff.
- B. The patient is inappropriately expressing emotion.
- C. The patient is experiencing auditory hallucinations.
- D. The patient is displaying negative symptoms of schizophrenia.
Correct Answer: C
Rationale: The correct answer is C: The patient is experiencing auditory hallucinations. The patient's behavior of covering both ears and shaking her head as if responding to voices, along with muttering and crying, suggests a sensory perception that is not based on external stimuli. This aligns with the characteristic symptoms of auditory hallucinations, which are common in conditions like schizophrenia.
Choice A is incorrect because the patient's behavior is not necessarily seeking attention but rather responding to internal stimuli. Choice B is incorrect as the patient's emotional expression seems to be a result of the auditory hallucinations rather than being inappropriate. Choice D is incorrect as negative symptoms of schizophrenia typically involve a decrease or absence of normal functions, which is not clearly demonstrated in this scenario.
A depressed patient is receiving imipramine (Tofranil) 300 mg daily. Which side effect requires seeking medical attention?
- A. Dry mouth
- B. Blurred vision
- C. Nasal congestion
- D. Urinary retention
Correct Answer: D
Rationale: The correct answer is D: Urinary retention. Imipramine is known to cause anticholinergic side effects, such as urinary retention. This side effect is serious and requires immediate medical attention to prevent complications like bladder distention or urinary tract infections. Dry mouth and blurred vision are common but less urgent side effects of imipramine, while nasal congestion is not typically associated with this medication. Thus, urinary retention stands out as the side effect requiring immediate medical attention among the choices provided.
During occupational therapy a young patient diagnosed with schizophrenia sits staring at a piece of paper. Which response is most therapeutic at this time?
- A. If you prefer to sit and stare for a time, it is acceptable for you to leave.'
- B. You seem immobilized by anxiety. Is there anything I can do to help?'
- C. Are you having trouble deciding where you want to glue that piece?'
- D. Rub the glue stick on the back of the paper.'
Correct Answer: D
Rationale: The correct answer is D because it provides a clear and simple directive that guides the patient on what to do next, promoting engagement in the therapeutic activity. By instructing the patient to rub the glue stick on the back of the paper, it helps redirect their focus and encourages participation in the task.
Choice A is incorrect as it allows the patient to disengage from the activity, which does not promote therapeutic progress. Choice B assumes the patient is anxious without evidence and may not address the core issue. Choice C is incorrect as it may not be relevant to the patient's current state and may further confuse or frustrate them.
A new client admits to having been battered by her live-in boyfriend several times over the past 2 years. She states to the nurse, 'We plan to get married next June, and I think things will be better then. He is always so sorry afterward, that I think I can trust him to change.' Which intervention should be included in the client's teaching plan?
- A. Support her hope that the battering will end after they are married.
- B. Assist her to enroll in a class to learn techniques of self-defense.
- C. Emphasize that the battering pattern usually remains the same in frequency and severity over time.
- D. Assist her in developing an emergency plan, since the pattern of violence is likely to continue.
Correct Answer: D
Rationale: The correct answer is D: Assist her in developing an emergency plan, since the pattern of violence is likely to continue. This choice is correct because it focuses on safety planning, which is crucial for individuals in abusive relationships. By helping the client develop an emergency plan, the nurse is acknowledging the seriousness of the situation and providing practical strategies to ensure her safety. It is important to have a plan in place in case of future violence.
Explanation for the incorrect choices:
A: Supporting her hope that the battering will end after they are married is not appropriate as it may give false hope and does not address the immediate safety concerns.
B: Enrolling in a self-defense class may not be effective in situations of domestic violence as it can escalate the violence and may not address the underlying issues causing the abuse.
C: Emphasizing that the battering pattern usually remains the same in frequency and severity over time is not as helpful as developing a concrete safety plan to address the immediate danger.
A rape victim tells the emergency room nurse, "I feel so dirty. Help me take a shower before the doctor examines me."Â The nurse should:
- A. Arrange for the patient to shower.
- B. Explain that bathing would destroy evidence.
- C. Give the patient a basin of water and towels.
- D. Explain that bathing facilities are not available in the emergency department.
Correct Answer: B
Rationale: The correct answer is B: Explain that bathing would destroy evidence. This is the correct choice because bathing can potentially wash away crucial forensic evidence that can be collected during a sexual assault examination. Preserving evidence is essential for legal proceedings and ensuring justice for the victim.
Choice A is incorrect because arranging for the patient to shower would destroy evidence. Choice C is incorrect as giving the patient a basin of water and towels would still risk destroying evidence. Choice D is also incorrect as it does not address the importance of preserving evidence in cases of sexual assault.