Nokea
A client, age 34, has been physically abused by her husband five times during the past 2 years. During her last discussion with the nurse, the client stated, 'I probably should not keep going back to my husband, since he continues to abuse me.' The nurse is aware that the final decision to leave a batterer:
- A. Often occurs after the victim suffers a serious injury
- B. Is usually a gradual process that occurs over time
- C. Is more likely if the client has approval from the church
- D. Is made with the batterer's permission
Correct Answer: B
Rationale: The correct answer is B: Is usually a gradual process that occurs over time.
Rationale:
1. Leaving an abusive partner is a complex and difficult decision that often requires careful planning and support.
2. Victims may face various barriers such as financial dependence, emotional attachment, and fear of further violence.
3. It is rare for victims to abruptly leave without considering their safety and well-being.
4. The statement 'I probably should not keep going back' indicates a gradual realization and contemplation of leaving.
Summary:
A: The decision to leave is not solely based on serious injury; victims may leave before any significant harm occurs.
C: Approval from the church may influence the victim's decision but is not a determining factor.
D: Leaving an abusive partner should not require the batterer's permission; it is a personal choice made by the victim.
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Which one of the following definitions is incorrect?
- A. Delusions – A fixed false belief not based in reality
- B. Mental illness – A condition affecting thinking, mood, or behavior
- C. Obsessive-compulsive disorder – A disorder with intrusive thoughts and repetitive behaviors
- D. Obsessive-compulsive disorder – A disorder with intrusive thoughts and repetitive behaviors
Correct Answer: C
Rationale: An illusion is actually a misinterpretation of a real stimulus, not the perception of something that does not exist. The incorrect definition given in option D confuses an illusion with a hallucination, which is a false sensory perception without an external stimulus.
An individual brought by ambulance to the emergency room is accompanied by a roommate. The patient fights against the restraints and shouts incoherently. The roommate reports that the patient was weak and confused on awakening this morning and about 3 hours ago began "rambling and talking crazy."Â A nurse notes that the patient's skin is flushed and dry. The priority nursing action is to:
- A. take the patient's vital signs.
- B. start intravenous fluids.
- C. administer a sedative.
- D. perform a mental status examination.
Correct Answer: A
Rationale: The correct answer is A: take the patient's vital signs. This is the priority action because the patient is exhibiting signs of potential medical emergency, such as altered mental status, flushed and dry skin, and confusion. Vital signs can provide crucial information about the patient's condition and help determine the urgency of the situation. Starting intravenous fluids (B) may be necessary but should be based on the assessment of vital signs first. Administering a sedative (C) is not appropriate without knowing the underlying cause of the symptoms. Performing a mental status examination (D) is important but not the priority in this situation where the patient's physical condition needs immediate attention.
Which statement would indicate the use and abuse of power in a violent family situation?
- A. I admit I was mad and yelling and swinging my fists in the air, but I wasn't trying to hit our child. I was letting off some steam. My spouse just overreacted.'
- B. When she found out I watched television instead of taking the kids to the park, she starting yelling about how I don't care about the kids. She has no right to get mad at me. I should have some time to myself.'
- C. I thought he would like this new recipe. I should have known better. I will not do that again. He was right. He works all day and should come home to a good meal that he can enjoy. It's not too much to ask of a wife.'
- D. All I did was tell him I need some money. I can't understand why he can't just give me what I need. I stay home and take care of his house and kids, and I have to almost beg before he gives me money to spend on myself.'
Correct Answer: C
Rationale: The correct answer is C because it reflects an imbalance of power within the family dynamic. The statement indicates an acceptance of blame and a submissive attitude, suggesting a power dynamic where one person feels the need to please and appease the other. This behavior can indicate an abuse of power by the dominant individual, leading to a controlling and potentially manipulative relationship.
In contrast, the other choices do not clearly demonstrate an abuse of power. Choice A shows anger management issues but does not necessarily indicate a power dynamic. Choice B focuses on a disagreement over parenting responsibilities rather than a power struggle. Choice D highlights financial disagreements but does not explicitly show an abuse of power.
Therefore, Choice C is the most indicative of power abuse in a family situation.
A patient experiencing delirium secondary to corticosteroid toxicity is manifesting paranoid thinking and noisy, assaultive behavior. The patient is currently pacing the hall and shouting. A nurse has placed a call to the physician and is anticipating the following order:
- A. the use of supervised restraints.
- B. a loading dose of phenytoin.
- C. a small dose of prednisone.
- D. an IV dose of thiamine.
Correct Answer: A
Rationale: The correct answer is A: the use of supervised restraints. In this situation, the patient is displaying agitated and assaultive behavior, posing a risk to themselves and others. Supervised restraints are necessary to ensure the safety of the patient and healthcare providers until the effects of corticosteroid toxicity subside. Restraints should only be used as a last resort when other interventions have failed.
Choice B: A loading dose of phenytoin is incorrect because phenytoin is not indicated for managing delirium secondary to corticosteroid toxicity.
Choice C: A small dose of prednisone is incorrect because adding more corticosteroids would exacerbate the toxicity and worsen the delirium.
Choice D: An IV dose of thiamine is incorrect as thiamine is used to treat thiamine deficiency, not corticosteroid toxicity-induced delirium.
Which information would be important to incorporate when teaching about medications for dementia in a caregiver's support group? Select all that apply.
- A. Antipsychotic medications have been shown to be the most useful category of drugs in reducing behavioral problems in dementias.
- B. Most currently available medications slow the progress of the disease in 20% to 50% of patients but usually do not significantly improve functioning.
- C. None of the currently available medications for dementias provide a cure.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B because it accurately conveys important information about medications for dementia to caregivers. It emphasizes that most medications do not significantly improve functioning but may slow disease progression in a subset of patients. This is crucial for setting realistic expectations.
Choice A is incorrect because antipsychotic medications are not the most useful category of drugs for reducing behavioral problems in dementia; they are associated with serious side effects and should be used cautiously.
Choice C is incorrect because it is essential for caregivers to understand that medications do not cure dementia; managing symptoms and slowing progression are the primary goals.
Choice D is incorrect as the correct answer is B, which provides valuable information for caregivers to understand the limitations and benefits of medications for dementia.