Nokea
A client has made multiple visits to the clinic. The nurse suspects that the client may be experiencing complex somatic symptom disorder based on which of the following?
- A. Expressions of concern about psychological problems
- B. Indications that parents were always in 'good health'
- C. Reports of the same symptoms repeatedly
- D. Evidence of a need for social support from her friends
Correct Answer: C
Rationale: The correct answer is C: Reports of the same symptoms repeatedly. In complex somatic symptom disorder, individuals often report persistent physical symptoms with no clear medical explanation. By repeatedly reporting the same symptoms, the client demonstrates a key characteristic of this disorder. Choices A, B, and D do not directly align with the diagnostic criteria for complex somatic symptom disorder. Expressions of concern about psychological problems (A) could indicate other mental health conditions. Indications that parents were always in 'good health' (B) and evidence of a need for social support from friends (D) are not specific to complex somatic symptom disorder.
You may also like to solve these questions
The parent of a 4-year-old rewards and praises the child for helping a sibling, being polite, and using good manners. These qualities are likely to be internalized and become part of which system of the personality?
- A. Id
- B. Ego
- C. Superego
- D. Preconscious
Correct Answer: C
Rationale: The correct answer is C: Superego. The superego is responsible for internalizing societal norms, values, and moral standards. By rewarding and praising the child for positive behaviors such as helping a sibling and using good manners, the parent is reinforcing these moral values, which are then internalized by the child through the development of the superego. The superego acts as the conscience and strives for perfection based on societal expectations.
Option A (Id) is incorrect because the Id is the instinctual and impulsive part of the personality driven by the pleasure principle. Option B (Ego) is incorrect as the Ego mediates between the Id and the external world, dealing with reality. Option D (Preconscious) is incorrect as it refers to the part of the mind that contains thoughts and memories that are not currently in awareness but can be easily accessed.
While leading a group, a nurse leader says to a patient, 'This is the fourth time that you've changed the subject when we have talked about child abuse. Is something going on?' The nurse is using which technique?
- A. Support
- B. Confrontation
- C. Summarizing
- D. Clarification
Correct Answer: B
Rationale: The correct answer is B: Confrontation. In this scenario, the nurse leader directly addresses the patient's behavior of changing the subject, which is a key aspect of confrontation technique. Confrontation is used to address discrepancies or inconsistencies in a nonjudgmental manner to promote self-awareness and insight. This technique encourages the patient to explore their thoughts and behaviors.
Incorrect Choices:
A: Support - Support involves providing empathy, understanding, and validation to the patient. The nurse in the scenario is not offering support, but rather challenging the patient's behavior.
C: Summarizing - Summarizing involves restating key points to ensure understanding and facilitate communication. The nurse's statement does not summarize but rather confronts the patient's behavior.
D: Clarification - Clarification is used to ensure mutual understanding by seeking clarification on unclear statements. The nurse's statement is not seeking clarification but rather addressing a specific behavior pattern.
A nurse documents: "Patient is mute despite repeated efforts to elicit speech. Makes no eye contact. Inattentive to staff. Gazes off to the side or looks upward rather than at speaker." Which nursing diagnosis should be considered?
- A. Defensive coping
- B. Decisional conflict
- C. Risk for other-directed violence
- D. Impaired verbal communication
Correct Answer: D
Rationale: The correct answer is D: Impaired verbal communication. The patient's inability to speak, make eye contact, and focus on the speaker indicates a communication issue. Impaired verbal communication relates to difficulty expressing thoughts, feelings, or needs. The patient's behavior aligns with this diagnosis as they are mute, inattentive, and not making eye contact. Defensive coping (A) involves protecting oneself from emotional pain. Decisional conflict (B) pertains to uncertainty about choices. Risk for other-directed violence (C) involves potential harm to others, which is not evident in the scenario. Thus, D is the most appropriate nursing diagnosis.
A staff nurse on a psychiatric unit knows that patients often have trouble sleeping because of their psychiatric conditions. Which of the following would reflect a psychiatric nursing intervention to appropriately address this problem?
- A. Limiting amounts of evening snacks and beverages
- B. Involving patients in a volleyball game immediately before bedtime
- C. Enforcing the rule that all patients be in bed with lights out by 10:30 PM
- D. Encouraging patients to take short naps in the afternoons
Correct Answer: A
Rationale: Correct Answer: A: Limiting amounts of evening snacks and beverages
Rationale:
1. Limiting evening snacks and beverages can help regulate patients' sleep patterns by reducing stimulants that may interfere with sleep.
2. Nutrition plays a role in sleep quality, and avoiding heavy meals close to bedtime can promote better sleep.
3. This intervention addresses a common issue in psychiatric patients without imposing strict rules or physical activity.
4. It focuses on a holistic approach to improving sleep quality by considering dietary factors.
Summary:
B: Involving patients in a volleyball game immediately before bedtime - This choice is incorrect as vigorous physical activity before bedtime can be stimulating and may disrupt sleep.
C: Enforcing the rule that all patients be in bed with lights out by 10:30 PM - This choice is incorrect as it is too rigid and may not address the underlying causes of sleep disturbances.
D: Encouraging patients to take short naps in the afternoons - This choice is incorrect as daytime
Which nurse would qualify as a fact witness in a case dealing with a physically abused young child?
- A. A psychiatric nurse
- B. A sexual assault nurse examiner nurse
- C. An emergency room nurse
- D. A pediatric intensive care unit nurse
Correct Answer: C
Rationale: The correct answer is C, an emergency room nurse. In cases of physical abuse, an emergency room nurse who directly treated the child and observed the injuries qualifies as a fact witness. They can provide firsthand accounts of the child's condition and the circumstances surrounding the incident. A psychiatric nurse (A) may not have direct knowledge of the physical abuse, focusing on mental health aspects. A sexual assault nurse examiner (B) specializes in sexual assault cases, not physical abuse. A pediatric intensive care unit nurse (D) may have limited interaction with the child and lack direct knowledge of the abuse.