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A man who reports frequently experiencing premature ejaculation tells the nurse, 'I feel like such a failure. It's so awful for both me and my partner. Can you help me?' Select the nurse's best response.
- A. Have you discussed this problem with your partner?
- B. I can refer you to a practitioner who can help you with this problem.
- C. Have you asked your health care provider for prescription medication?
- D. There are several techniques described in this pamphlet that might be helpful.
Correct Answer: B
Rationale: The correct answer is B because the nurse should refer the patient to a practitioner who specializes in treating premature ejaculation. This is the best response as it ensures the patient receives specialized care and treatment tailored to his needs. Referring to a specialist increases the likelihood of successful intervention and addresses the patient's concerns effectively.
Choices A, C, and D are incorrect. Choice A focuses on communication with the partner, which is important but not the primary intervention for premature ejaculation. Choice C suggests prescription medication without exploring other treatment options or assessing the patient's individual situation. Choice D provides general information without addressing the patient's emotional distress or offering specific help from a professional.
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A psychiatric clinical nurse specialist uses cognitive therapy with a patient with anorexia nervosa. Which statement by the nurse supports this type of therapy?
- A. What are your feelings about not eating foods you prepare?
- B. You seem to feel much better about yourself when you eat something.
- C. It must be difficult to talk about private matters to someone you just met.
- D. Being thin doesn't seem to solve problems. You're thin now but still unhappy.
Correct Answer: D
Rationale: The correct answer is D because it reflects a key principle of cognitive therapy, which is challenging distorted thoughts and beliefs. In this statement, the nurse is helping the patient recognize that being thin has not resolved their underlying unhappiness. This challenges the patient's belief that thinness equals happiness, promoting insight and cognitive restructuring.
A: This statement focuses on emotions related to food and preparation, not directly challenging distorted thoughts.
B: This statement focuses on self-esteem related to eating, not directly challenging distorted thoughts.
C: This statement addresses the difficulty of sharing personal information, not directly challenging distorted thoughts.
Which behaviors would indicate the need for further assessment to consider avoidant personality disorder?
- A. Withholding of feelings and low self-esteem
- B. Insistence on others conforming to own methods
- C. Engaging in impulsive acts like unsafe sex
- D. Initial charm dissolving into coldness and blaming others
Correct Answer: A
Rationale: Step 1: Withholding of feelings is a key feature of avoidant personality disorder, indicating difficulty in expressing emotions.
Step 2: Low self-esteem is also characteristic, as individuals with this disorder often feel inadequate and inferior.
Step 3: Insistence on others conforming to own methods (B) is more indicative of narcissistic personality disorder.
Step 4: Engaging in impulsive acts like unsafe sex (C) is more aligned with borderline personality disorder.
Step 5: Initial charm dissolving into coldness and blaming others (D) is a trait of antisocial personality disorder.
A patient is referred to the visiting nurse agency due to cognitive impairment. Which functional problems is this patient most likely to exhibit?
- A. Inability to bathe and dress independently.
- B. Wandering in and away from his home.
- C. Lability of moods, from sociable to irritable.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Inability to bathe and dress independently. Cognitive impairment can impact a person's ability to remember tasks and follow routines, resulting in difficulties with self-care activities like bathing and dressing. This is a common functional problem seen in patients with cognitive impairment.
Choice B (Wandering) is more indicative of behavioral symptoms like agitation and restlessness. Choice C (Mood lability) is related to emotional regulation and not directly related to functional problems caused by cognitive impairment. Choice D (None of the above) is incorrect as cognitive impairment often leads to difficulties with self-care tasks.
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 patient with bipolar disorder is hyperactive and has not slept for 3 days. Mood and behavior are labile. The patient threatens to hit another patient. Which response by the nurse is appropriate?
- A. Stop that now. No one did anything to provoke an attack by you.
- B. If you try that again, you will be placed in seclusion immediately.
- C. Do not hit anyone. If you are unable to control yourself, we will help you.
- D. You know we will not let you hit anyone. Why do you continue this behavior?
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the patient's struggle to control their behavior and offers support. It emphasizes the importance of not hitting anyone while also reassuring the patient that help is available if needed. This response promotes a therapeutic environment by setting clear boundaries and offering assistance rather than using threats or aggression.
Choice A is incorrect as it may escalate the situation by using a confrontational tone, potentially provoking further aggression. Choice B is also incorrect as it threatens the patient with seclusion, which can be seen as punitive and may not address the underlying issues causing the behavior. Choice D is incorrect as it does not provide a clear directive to prevent violence and instead questions the patient's behavior without offering immediate support.