Nokea
A new nurse asks the experienced nurse who is caring for a battered woman client, 'Why did you ask about culture when it was obvious you needed to focus on the battering?' The experienced nurse should respond:
- A. It's just a habit I got into a while ago.'
- B. It helps me focus on whether to do a complete physical assessment.'
- C. Culture is a determinant of how women interpret and respond to violence.'
- D. If I know more about her I can refer her to a shelter that caters to her ethnic group.'
Correct Answer: C
Rationale: Rationale:
- Choice C is correct because culture influences how individuals perceive and respond to violence, impacting their help-seeking behaviors and coping mechanisms.
- Understanding the client's cultural background is crucial for providing appropriate care and support.
- Choices A, B, and D are incorrect as they do not address the importance of considering culture in understanding and addressing domestic violence in this context.
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During a manic episode, a patient is hyperactive, restless, and disorganized. The patient goes to the dining room and begins to throw food and dishes. Verbal intervention is ineffective. The patient's behavior poses a substantial risk of harm to others. Staff escorts the patient to the patient's room to dine alone. What is the rationale for this action?
- A. Prevent other patients from observing the behavior.
- B. Reduce environmental stimuli that negatively affect the patient.
- C. Protect the patient's biological integrity until medication takes effect.
- D. Reinforce limit setting
Correct Answer: B
Rationale: The correct answer is B: Reduce environmental stimuli that negatively affect the patient. This action helps reduce stimulation that may be exacerbating the manic episode, promoting a calmer environment for the patient. Removing the patient from the dining room minimizes triggers for further disruptive behavior. This approach prioritizes the patient's well-being by managing the environmental factors contributing to the escalation of symptoms.
A: Preventing other patients from observing the behavior does not directly address the patient's needs during the manic episode and does not actively help in managing the situation.
C: Protecting the patient's biological integrity until medication takes effect may be important, but in this scenario, the immediate focus is on addressing the environmental factors contributing to the behavior.
D: Reinforcing limit setting is important in managing behavior, but in this specific situation, reducing environmental stimuli is a more immediate and effective intervention.
According to family systems theory, removing the 'identified patient' from the environment most likely causes the:
- A. patient to decompensate, due to the loss of their support system
- B. patient to significantly improve, often with minimal or no additional therapy
- C. remaining family members to decompensate, as evidenced by new dysfunctional behavior
- D. remaining family members to lose motivation and withdraw from therapy
Correct Answer: C
Rationale: Family systems theory posits that removing the 'patient' shifts dysfunction to other members, revealing underlying systemic issues.
A family has noted the following behaviors in one of their elderly parents: periodic indecisiveness, forgetfulness, mild transient confusion, occasional misperception, distractibility, and occasional unclear thinking. Where on the continuum of cognitive responses would this patient be?
- A. At point 1
- B. At point 2
- C. At point 3
- D. There is insufficient information to make a determination.
Correct Answer: B
Rationale: The correct answer is B: At point 2. This patient's symptoms indicate mild cognitive impairment, which falls between normal age-related decline (point 1) and dementia (point 3). Mild cognitive impairment involves noticeable cognitive changes but does not significantly interfere with daily functioning. Point 1 is too mild for the symptoms described, and point 3 is too severe as the patient's symptoms are not indicative of full-blown dementia. Therefore, the patient is best placed at point 2 on the continuum of cognitive responses.
A 75-year-old patient comes to the clinic reporting frequent headaches. As the nurse begins the interaction, which action is most important?
- A. Complete a neurological assessment
- B. Determine whether the patient can hear as the nurse speaks
- C. Suggest that the patient lie down in a darkened room for a few minutes
- D. Administer medication to relieve the patient's pain before continuing the assessment
Correct Answer: B
Rationale: Before proceeding with any further assessment, the nurse should assess the patients ability to hear questions. Impaired hearing could lead to inaccurate answers.
A history reveals that a patient virtually stopped eating 5 months ago and lost 25% of body weight. The nurse says, 'Describe what you think about your present weight and how you look.' Which response would be most consistent with anorexia nervosa?
- A. I'm fat and ugly.'
- B. What I think about myself is my business.'
- C. I'm grossly underweight, but I cover it well.'
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A. This response is most consistent with anorexia nervosa because it reflects a distorted body image common in individuals with this condition. Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image, leading to extreme weight loss and restrictive eating habits. Choice B suggests a lack of insight or denial, which is not typical of anorexia nervosa. Choice C acknowledges being underweight but does not reflect the negative body image associated with anorexia nervosa. Choice D is incorrect as option A aligns with the characteristic body image distortion seen in anorexia nervosa.