Population Based Health Care

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A mother discusses her concerns about genetic transmission of schizophrenia with the nurse saying, 'My son is a fraternal twin. He has been diagnosed with schizophrenia. Will my other son develop schizophrenia, too?' The response that is both sensitive and shows understanding of the genetic component is:

  • A. You poor woman! I wish I could tell you he will be free of the disorder.'
  • B. Studies show that 50% of twins develop schizophrenia when it is present in the other twin.'
  • C. No one can say what will happen, so we will hope for the best for you and your sons.'
  • D. In fraternal twins, the chance of the other twin developing the disorder is quite small.'
Correct Answer: D

Rationale: The correct answer is D because it provides an accurate and sensitive response. Fraternal twins do not share the same genetic makeup as identical twins, so the genetic risk for the other twin developing schizophrenia is lower. By acknowledging this fact, the nurse offers reassurance to the mother without giving false hope or inaccurate statistics. This response shows understanding of the genetic component of schizophrenia and addresses the mother's concerns in a compassionate and informative manner.

Choices A, B, and C are incorrect:
A: This response is dismissive of the mother's concerns and does not provide any helpful information. It also lacks sensitivity and empathy towards the mother's situation.
B: This response provides an inaccurate statistic about the likelihood of the other twin developing schizophrenia. It does not consider the difference between identical and fraternal twins, leading to a potentially misleading statement.
C: This response is vague and does not address the mother's question directly. It does not provide any useful information or reassurance, leaving the mother uncertain and anxious about

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What is the first intervention a nurse should take when assessing a patient with suspected anorexia nervosa?

  • A. Begin refeeding to restore nutritional status.
  • B. Measure vital signs to assess the extent of malnutrition.
  • C. Start a counseling session to discuss the patient's thoughts on eating.
  • D. Involve the family in discussions about treatment plans.
Correct Answer: B

Rationale: The correct answer is B. The first intervention a nurse should take when assessing a patient with suspected anorexia nervosa is to measure vital signs to assess the extent of malnutrition. This is crucial to determine the patient's current physiological status and to identify any immediate risks such as dehydration, electrolyte imbalances, or cardiac complications. By measuring vital signs, the nurse can quickly assess the severity of malnutrition and determine the urgency of intervention. Refeeding (choice A) should not be initiated abruptly due to the risk of refeeding syndrome. Starting a counseling session (choice C) may be important but is not the initial priority. Involving the family (choice D) can be beneficial but is not the first step in assessing and managing a patient with anorexia nervosa.

Prior to discharge, the nurse plans to teach the client and family about relapse. Which items will the nurse include in the teaching?

  • A. Recognition of warning signs of relapse
  • B. Notify the nurse of warning signs present for more than one month
  • C. Lower medication dosage to manage emerging side effects
  • D. Use street drugs judiciously and only in small amounts
Correct Answer: A

Rationale: The correct answer is A because recognizing warning signs of relapse is crucial for early intervention. By identifying these signs, the client and family can seek help promptly, preventing a full relapse. Choice B is incorrect as waiting for signs to persist for more than one month delays intervention. Choice C is incorrect as altering medication dosage without medical advice can be dangerous. Choice D is incorrect as using street drugs is never a safe or appropriate way to manage relapse.

A friend brings a teenager to the emergency department. The friend found the patient unconscious in a bedroom at a party. Semen is observed on the patient's underclothes. Priority actions by the nurse should focus on:

  • A. Preserving rape evidence.
  • B. Maintaining the patient's airway.
  • C. Obtaining a description of the rape.
  • D. Determining what drugs were ingested.
Correct Answer: B

Rationale: The correct answer is B: Maintaining the patient's airway. This is the priority action because the patient is unconscious and airway patency is crucial for survival. Preserving rape evidence (A) can be important, but the patient's immediate health takes precedence. Obtaining a description of the rape (C) can wait until the patient's condition stabilizes. Determining what drugs were ingested (D) is important but secondary to ensuring the patient can breathe.

A patient who has been physically abused says, 'When I called the police, I just wanted my spouse to stop shoving me around and kicking me. I didn't want anyone to get in trouble. It's easy to get angry with me because I spend too much money.' Which nursing intervention would be most therapeutic for this patient?

  • A. You feel your spouse was justified in the abuse because you overspent?'
  • B. Tell your spouse that if this happens again, I'll report it to the police.'
  • C. Your spouse abuses you when you overspend. So you think it will stop if you stop spending money?'
  • D. I can understand that you don't want to press charges, but your spouse needs help controlling anger.'
Correct Answer: A

Rationale: The correct answer is A because it focuses on therapeutic communication by reflecting the patient's feelings and thoughts back to them without judgment. By repeating the patient's words, the nurse shows empathy and understanding, which can help build trust and rapport. Choices B and D may escalate the situation and go against the patient's wishes, potentially causing further harm. Choice C assumes a causal relationship between overspending and abuse, which is not appropriate and may blame the victim. Overall, choice A promotes a non-judgmental and supportive environment, which is crucial in addressing issues of abuse.

A community health nurse is working with a family in which an elderly woman was neglected by her son and his wife. The elderly woman insists on remaining with the young couple despite the threat of future neglect. Which intervention should be given highest priority?

  • A. Identify community resources to decrease the caregivers' stress.
  • B. Establish family obligations, client rights, and consequences of abuse and monitor.
  • C. Educate the caregivers on the aging process and how to cope with it.
  • D. Provide stress management techniques for the caregivers.
Correct Answer: B

Rationale: The correct answer is B because establishing family obligations, client rights, and consequences of abuse is crucial in protecting the elderly woman from neglect. By setting clear boundaries and educating the family on their responsibilities and the consequences of neglect, the nurse can help ensure the woman's safety. This intervention addresses the root cause of the issue and empowers the family to understand and fulfill their duties.

Choice A is incorrect as solely focusing on decreasing caregivers' stress may not address the underlying neglect. Choice C is incorrect as educating caregivers on the aging process does not directly address the neglect issue. Choice D is incorrect as providing stress management techniques does not address the root cause of neglect or establish accountability within the family.

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