Core Concepts of Patient Family Care

Core Concepts of Patient Family Care Related

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A family has presented at a community mental health clinic. The mother reports that the children ages 8 and 10 are 'not doing well since their father died three months ago.' The nurse demonstrates an understanding of the goals of a family mental health assessment when initially:

  • A. Assessing the mother's ability to provide physical care for her children.
  • B. Encouraging the mother to discuss the problems with the children's teachers.
  • C. Observing how the children interact with both their mother and with each other.
  • D. Arranging for the family members to attend age-appropriate grief management groups.
Correct Answer: D

Rationale: The correct answer is D because arranging for the family members to attend age-appropriate grief management groups aligns with the goal of assessing and addressing the family's mental health needs following a significant loss. This approach recognizes the impact of the father's death on the children and the mother, providing them with support and coping strategies. It acknowledges the importance of addressing grief and promoting healthy coping mechanisms within the family unit.

Choices A, B, and C are incorrect because they do not directly address the family's mental health needs in the context of grief and loss. Assessing the mother's ability to provide physical care, encouraging discussions with teachers, and observing interactions are important but do not specifically target the emotional and psychological impact of the father's death on the family.

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A patient admitted yesterday for injuries sustained while intoxicated believes the window blinds are snakes trying to get into the room. The patient is anxious, agitated, and diaphoretic. Which medication can the nurse anticipate the health care provider will prescribe?

  • A. Monoamine oxidase inhibitor, such as phenelzine (Nardil)
  • B. Phenothiazine, such as thioridazine (Mellaril)
  • C. Benzodiazepine, such as lorazepam (Ativan)
  • D. Narcotic analgesic, such as morphine
Correct Answer: C

Rationale: The correct medication to anticipate for this patient is a benzodiazepine, such as lorazepam (Ativan).

Rationale:
1. Benzodiazepines are commonly used to treat acute agitation and anxiety in patients, which is present in this case.
2. Lorazepam has a rapid onset of action and can help calm the patient quickly.
3. It can help manage the patient's perception of the window blinds as snakes and reduce agitation.
4. Benzodiazepines are safer for patients with alcohol intoxication compared to other sedatives or antipsychotics.

Summary of Incorrect Choices:
A: Monoamine oxidase inhibitors are not typically used for acute agitation and anxiety. They have a slower onset of action and are not first-line for this situation.
B: Phenothiazines may worsen the patient's condition due to their potential side effects like sedation and hypotension.
D: Narcotic analgesics are not appropriate for managing anxiety or agitation

How might the perspectives of financially secure patients with respect to end-of-life care differ from those of disadvantaged patients?

  • A. Financially secure patients are more likely to insist that everything be done to keep them alive
  • B. Disadvantaged patients may interpret end-of-life care as an attempt to deny essential treatments
  • C. Disadvantaged patients are more likely to want to spend their last days outside the hospital
  • D. Financially secure patients are more likely to demand placement in assisted living facilities to avoid burdening their families
Correct Answer: B

Rationale: Disadvantaged patients may distrust end-of-life care due to historical inequities, perceiving it as withheld treatment.

Sociologists use the term 'sex' to refer to

  • A. Anatomical and psychological differences
  • B. Emotional and cultural practices
  • C. Erotic and physical practices
  • D. Psychological and social differences
Correct Answer: A

Rationale: Sex refers to biological and sometimes psychological distinctions.

At this stage the group members will begin to develop a feeling of group cohesion and identity:

  • A. Forming
  • B. Storming
  • C. Norming
  • D. Performing
Correct Answer: C

Rationale: Norming (Tuckman) fosters cohesion and a unified group identity through shared norms.

What is the role of the physician when the patient lacks decisionmaking capacity and someone other than a family member has been designated as the surrogate decision maker?

  • A. Follow the instructions of the family and ignore the surrogate
  • B. Ignore the family and talk only to the surrogate
  • C. Serve as a mediator between parties and encourage all groups to work together in the best interest of the patient, consistent with the patient's wishes
  • D. Consult legal affairs to determine who should be the decisionmaker
Correct Answer: C

Rationale: Mediation ensures collaboration and honors the patient's designated surrogate.

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