Nokea
A highly suspicious patient who has delusions of persecution about being poisoned has refused all hospital meals for 3 days. Which of the following interventions would be most appropriate under these circumstances?
- A. Feed the patient via tube, involuntarily via court order if needed.
- B. Offer to taste each food item on the tray yourself while he watches.
- C. Allow the patient to contact a local restaurant to deliver his meals.
- D. Allow him supervised access to use food vending machines in the hospital lobby.
Correct Answer: D
Rationale: Step 1: In this scenario, the patient is refusing hospital meals due to delusions of being poisoned, indicating a lack of trust.
Step 2: By allowing supervised access to food vending machines in the hospital lobby, the patient can choose his own food, promoting autonomy and trust-building.
Step 3: This intervention respects the patient's autonomy while ensuring access to food.
Step 4: In contrast, feeding via tube involuntarily (Option A) violates autonomy, tasting food yourself (Option B) doesn't address the issue of trust, and ordering from a restaurant (Option C) may not be feasible or safe in a hospital setting.
Summary: Option D is the most appropriate as it balances patient autonomy and safety, addressing the refusal of hospital meals effectively.
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Sleep disorders that are characterized by abnormal behavioral or physical events during sleep are called:
- A. insomnia.
- B. dyssomnias.
- C. hypersomnia.
- D. parasomnias.
Correct Answer: D
Rationale: The correct answer is D: parasomnias. Parasomnias are sleep disorders involving abnormal behaviors or physical events during sleep, such as sleepwalking or night terrors. This is the correct choice because it specifically addresses the description provided in the question.
A: Insomnia is characterized by difficulty falling or staying asleep, not abnormal behaviors during sleep.
B: Dyssomnias are a broad category of sleep disorders affecting the timing, quality, or amount of sleep, not necessarily involving abnormal behaviors during sleep.
C: Hypersomnia is a sleep disorder characterized by excessive daytime sleepiness, not abnormal behaviors during sleep.
In summary, the other choices do not align with the description of sleep disorders involving abnormal behavioral or physical events during sleep, making D the correct answer.
An Arab student new to an elementary school reports, 'I just don't want to go to gym class.' Which factor would be of primary concern for a school nurse?
- A. The student's family's cultural beliefs regarding females interacting with males in public
- B. Complaints from others of 'bullying' that occurs in gym class
- C. The student's problems adjusting to the new school environment
- D. A teacher's concern that the gym class is overcrowded
Correct Answer: B
Rationale: The correct answer is B because the primary concern for the school nurse would be addressing any potential bullying the Arab student is experiencing in gym class. This is important for the student's well-being and mental health. Choice A is not the primary concern as it does not directly address the student's reluctance to attend gym class. Choice C focuses on general adjustment issues, while choice D pertains to a logistical issue rather than the student's emotional or social well-being. Addressing bullying is crucial to creating a safe and inclusive environment for the student.
Which of the following statements about attention deficit hyperactivity disorder (ADHD) are true? (Select one tha does not apply)
- A. ADHD is more common in boys than in girls
- B. Children with ADHD tend to be of below-average intelligence
- C. Even though we think of ADHD as a disorder in children, adults can also have it
- D. Children with ADHD are often treated with the use of stimulants
Correct Answer: B
Rationale: Children with ADHD tend to be of above normal intelligence but often dont function at those levels. The causes of ADHD are more associated with brain dysfunction and genetic factors. Correct statements are: A (more common in boys), D (treated with stimulants), E (benefit from behavior modification), F (can persist into adulthood).
A victim of partner abuse, parent of one child, describes the partner as someone who is easily frustrated and more likely to be abusive after experiencing an event in which self-esteem is challenged. The most recent episodes of violence were related to feeling 'upset' over a job loss. What type of therapy would provide the greatest help to the victim?
- A. Individual therapy
- B. Group therapy
- C. Couples therapy
- D. Family therapy
Correct Answer: A
Rationale: The correct answer is A: Individual therapy. In this scenario, individual therapy would be most beneficial because it allows the victim to focus on healing and developing coping strategies for dealing with the abuse and rebuilding self-esteem. Addressing the victim's psychological well-being and empowering them to recognize and address the abusive behavior is crucial. Group therapy (B) may not provide the necessary individualized support. Couples therapy (C) could potentially put the victim at further risk of harm. Family therapy (D) may not address the specific dynamics of the abusive relationship.
A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self. Select the best outcome related to this diagnosis. Within 2 weeks, the patient will:
- A. appropriately express angry feelings.
- B. verbalize two positive things about self.
- C. verbalize the importance of eating a balanced diet.
- D. identify two alternative methods of coping with loneliness and isolation.
Correct Answer: D
Rationale: The correct answer is D because it directly addresses the nursing diagnosis of ineffective coping related to feelings of loneliness and isolation. By identifying two alternative methods of coping, the patient can develop healthier strategies to manage these emotions instead of resorting to overeating and vomiting. This outcome promotes long-term behavioral change and helps the patient build resilience.
Choice A is incorrect because expressing angry feelings may not necessarily address the underlying issues of loneliness and isolation. Choice B is incorrect as verbalizing positive things about oneself may be beneficial but does not directly address coping mechanisms for loneliness and isolation. Choice C is also incorrect because understanding the importance of a balanced diet does not directly address coping strategies for managing emotions like loneliness and isolation.