A health care worker is concerned about a new mother being overwhelmed by caring for her infant. The health care worker should:
- A. immediately contact child protective services
- B. provide the mother with literature about child care
- C. consult a therapist to help the mother work out her fears
- D. refer the mother to parenting classes
Correct Answer: D
Rationale: Prevention of child abuse is centered on teaching parents how to care for their child and cope with the demands of infant care. Parenting classes can help build self-confidence, self-esteem, and coping skills. Parents benefit by understanding the developmental needs of their children, while learning how to manage their home environment more effectively. The classes also increase the parents' social contacts and teach about community resources. Contacting child protective services (Choice A) is not appropriate in this scenario as there is no indication of abuse or neglect. Providing literature (Choice B) may not be as effective as parenting classes in addressing the mother's concerns. Consulting a therapist (Choice C) may be beneficial for underlying mental health issues, but parenting classes specifically focus on child care and coping skills, making Choice D the most suitable option in this situation.
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Mrs. Owens is the 81-year-old mother of Jonathan, who is 54 years old. Jonathan has had schizophrenia since he was 16 years old. Which of Mrs. Owens's concerns is likely to predominate?
- A. "Will my retirement funds outlast me?"?
- B. "Who will handle my funeral arrangements?"?
- C. "What will become of Jonathan when I am gone?"?
- D. "How can I communicate effectively with Jonathan's physician?"?
Correct Answer: C
Rationale: The most prominent concern for Mrs. Owens is likely what will happen to her son, Jonathan, after she passes away. While retirement fund sustainability is important, it is not likely to be her primary concern. Funeral arrangements, although significant, are secondary to the welfare of her son with schizophrenia. The question of how to communicate with Jonathan's physician is less likely to be a predominant concern since Mrs. Owens has likely already addressed this issue over the 38 years of managing her son's care.
James returns home from school angry and upset because his teacher gave him a low grade on an assignment. After returning home from school, he kicks the dog. This coping mechanism is known as:
- A. denial
- B. suppression
- C. displacement
- D. fantasy
Correct Answer: C
Rationale: Displacement is the transference of emotions, such as anger, to a substitute target that may be less threatening. In this scenario, James redirects his anger from the teacher to the dog. Denial is refusing to acknowledge an aspect of reality. Suppression is consciously putting aside unwanted thoughts or feelings. Fantasy involves imagining unrealistic scenarios. Therefore, in this case, the correct answer is displacement as James displaces his anger towards the dog.
A 10-month-old child is brought to the Emergency Department because he is difficult to awaken. The nurse notes bruises on both upper arms. These findings are most consistent with
- A. wearing clothing that is too small for the child
- B. the child being shaken
- C. falling while learning to walk
- D. parents trying to awaken the child
Correct Answer: B
Rationale: The correct answer is 'the child being shaken.' Children who are shaken are frequently grasped by both upper arms, leading to bruises in that area. The presentation of a difficult-to-awaken child with bruises on the upper arms is highly concerning for non-accidental trauma, such as abusive shaking. Symptoms of brain injury associated with shaking include a decreased level of consciousness. Choices A, C, and D are less likely because the combination of a child being difficult to awaken and bruises on both upper arms is highly suggestive of non-accidental trauma rather than benign causes like ill-fitting clothing, falling while learning to walk, or parents trying to awaken the child.
The nurse observes bilateral bruises on the arms of an elderly client in a long-term care facility. Which of the following questions should the nurse ask this client?
- A. "How did you get those bruises?"?
- B. "Did someone grab you by your arms?"?
- C. "Do you fall often?"?
- D. "What did you bump against?"?
Correct Answer: B
Rationale: The correct answer is asking, "Did someone grab you by your arms?"? This question is direct and addresses the possibility of abuse, which is crucial when dealing with suspected abuse cases. It is important to ask direct questions in a sensitive and non-accusatory manner to gather information. Choice A is too general and may not prompt a disclosure of abuse. Choice C assumes falling as the cause without addressing abuse directly. Choice D is vague and does not specifically inquire about potential abuse, making it less effective in identifying abuse cases compared to the correct choice.
Who may legally give informed consent?
- A. an 86-year-old male with advanced Alzheimer's disease
- B. a 14-year-old girl needing an appendectomy who is not an emancipated minor
- C. a 14-year-old girl needing an appendectomy who is not an emancipated minor
- D. a 6-month-old baby needing bowel surgery
Correct Answer: C
Rationale: The correct answer is a 14-year-old girl needing an appendectomy who is not an emancipated minor. Informed consent can be given by individuals who are competent and not minors. Minors are generally unable to provide informed consent unless they are emancipated. Choice A is incorrect because an 86-year-old male with advanced Alzheimer's disease is considered incompetent to make decisions. Choice D is incorrect because a 6-month-old baby is unable to provide consent. Emancipated minors are an exception to the minor rule, as they can provide consent for their own treatment.
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