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A client, age 42, has been battered by her husband since they were married 8 years ago. Until this hospitalization for major depression, she had avoided dealing with her situation, but she now expresses a desire to deal with the problem. The attacks are occurring more often. Which outcome is realistic for the client?
- A. Citing possible ways she may have contributed to the abusive episodes
- B. Verbalizing an awareness of her increasingly dangerous situation
- C. Setting a goal date for divorcing her husband
- D. Employing methods of retaliating in order to get even with her husband
Correct Answer: B
Rationale: The correct answer is B: Verbalizing an awareness of her increasingly dangerous situation. This choice is the most realistic outcome for the client as it shows an initial step towards acknowledging the severity of her situation. By verbalizing awareness, the client can begin to understand the potential dangers she faces, which is crucial for developing a safety plan and seeking appropriate help.
Choice A is incorrect as it may lead to victim-blaming and does not address the root cause of the abuse. Choice C is premature as setting a goal date for divorcing her husband requires careful planning and consideration of various factors. Choice D is inappropriate as retaliation can escalate the violence and put the client at further risk.
In summary, choice B is the best option as it focuses on increasing the client's awareness of her situation, which is a crucial first step towards addressing and eventually overcoming the abusive relationship.
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When a patient with a personality disorder uses manipulation as a way of getting needs met, the staff agree to use limit setting as an intervention. How does limit setting work to reduce manipulation?
- A. Limit setting indulges the patient's desire for attention from staff.
- B. It gives the patient a different concern on which to focus his anger.
- C. External controls provide security while internal controls are developing.
- D. When staff limit the patient's behavior, he is no longer anxious about it.
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. External controls, like limit setting, provide structure and predictability for the patient.
2. This security allows the patient to gradually develop internal controls to manage their behavior.
3. By relying on external limits, the patient's need for manipulation decreases over time.
4. This approach fosters growth and autonomy in the patient, reducing the reliance on manipulative behaviors.
Summary:
A: Incorrect. Limit setting does not indulge attention-seeking behaviors; it establishes boundaries.
B: Incorrect. Limit setting does not redirect anger; it focuses on promoting internal control.
D: Incorrect. Limit setting does not solely address anxiety; it aims to foster self-regulation.
A child, age 5, was admitted to the children's unit, having been sexually abused by an acquaintance of her family. The child refuses to talk and participate in unit activities, choosing to stay in her room with her stuffed animals. Which therapeutic intervention will best help the child release pent-up feelings about the abuse?
- A. Individual communication with the nurse
- B. Play therapy
- C. Family therapy
- D. Role-play with other children on the unit
Correct Answer: B
Rationale: The correct answer is B: Play therapy. Play therapy is the most suitable therapeutic intervention for a child in this scenario because it allows the child to express their feelings and experiences through play, which is a natural form of communication for children. Through play therapy, the child can act out their experiences using toys and create a safe space to process their emotions without having to verbally communicate. It helps the child release pent-up feelings and trauma in a non-threatening environment.
Summary of other choices:
A: Individual communication with the nurse may not be as effective as play therapy in this case as the child is not yet comfortable verbalizing their feelings.
C: Family therapy may not be appropriate at this stage as the child is not ready to engage with family members about the abuse.
D: Role-play with other children on the unit may not be beneficial as it can potentially trigger more anxiety and discomfort for the abused child.
A client with undifferentiated schizophrenia is readmitted for an acute exacerbation of the disorder. The goal of hospitalization is symptom stabilization. The nurse has documented that, in addition to experiencing auditory hallucinations, the client seems uninterested in activities, has difficulty completing tasks, seems forgetful, and seems puzzled by information and directions given by staff. The nurse's plans for intervention will be effective if these behaviors are attributed to:
- A. Social isolation
- B. Deficient knowledge
- C. Situational low self-esteem
- D. Problems in cognitive functioning
Correct Answer: D
Rationale: The correct answer is D: Problems in cognitive functioning. In undifferentiated schizophrenia, cognitive deficits are common, leading to difficulties in memory, attention, problem-solving, and executive functioning. The client's symptoms of forgetfulness, difficulty completing tasks, being puzzled by information, and auditory hallucinations are indicative of cognitive impairment. Interventions should focus on addressing these cognitive deficits to improve the client's ability to function.
Incorrect choices:
A: Social isolation - This choice does not address the cognitive deficits and symptoms described by the client, such as forgetfulness and difficulty completing tasks.
B: Deficient knowledge - While cognitive deficits may contribute to deficient knowledge, the primary concern in this scenario is the client's cognitive functioning impairments.
C: Situational low self-esteem - This choice does not explain the cognitive deficits and symptoms experienced by the client, which are more indicative of problems in cognitive functioning.
A nurse is caring for a patient with bulimia nervosa. Which intervention should the nurse prioritize?
- A. Assist the patient in identifying triggers for binge-purge cycles.
- B. Focus solely on achieving a normal weight.
- C. Provide daily exercise routines to increase physical fitness.
- D. Discourage discussions about food to avoid increasing anxiety.
Correct Answer: A
Rationale: The correct answer is A. Assisting the patient in identifying triggers for binge-purge cycles is crucial in the treatment of bulimia nervosa. By understanding the triggers, the patient can learn to recognize and manage them effectively, leading to a reduction in the frequency of binge-purge episodes. This intervention helps address the root cause of the disorder and promotes long-term recovery.
Choice B is incorrect because solely focusing on achieving a normal weight overlooks the complex psychological factors involved in bulimia nervosa. Choice C is incorrect as providing daily exercise routines may exacerbate the patient's obsession with weight and body image. Choice D is incorrect as discouraging discussions about food can hinder the patient's ability to address their relationship with food and emotions.
A patient tells the nurse that his sexual functioning is normal when his wife wears short, red camisole-style nightgowns. He states, 'Without the red teddies, I am not interested in sex.' The nurse can assess this as consistent with
- A. exhibitionism.
- B. voyeurism.
- C. frotteurism.
- D. fetishism.
Correct Answer: D
Rationale: The correct answer is D: fetishism. Fetishism is a sexual disorder where a person is sexually aroused by an object or body part that is not typically considered sexual. In this scenario, the patient's arousal is dependent on his wife wearing a specific type of clothing (the red camisole-style nightgowns), indicating a fetishistic preference for that particular item. This is different from exhibitionism (A), which involves exposing one's genitals to unsuspecting strangers; voyeurism (B), which involves observing unsuspecting individuals undressing or engaging in sexual activity; and frotteurism (C), which involves touching or rubbing against a non-consenting person for sexual arousal.