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A novice nurse tells the assigned mentor, 'I admitted a patient today who has several bizarre delusions. I wanted to tell the patient that the ideas and conclusions simply are not logical. What do you think will happen if I do?' Which reply by the mentor is best?
- A. I think you'll give the patient something to think about.'
- B. The patient will probably incorporate you into the delusions as a persecutor.'
- C. Develop trust using empathy and calmness before pointing out discrepancies.'
- D. Initially, it would be better to go along with the patient's thinking to gain cooperation.'
Correct Answer: C
Rationale: Step 1: Establish trust - Developing trust with the patient is crucial in building a therapeutic relationship.
Step 2: Use empathy and calmness - Showing empathy helps the patient feel understood and valued.
Step 3: Point out discrepancies - Once trust is established, gently pointing out discrepancies in a non-confrontational manner can help the patient reflect on their delusions.
Summary: Choice C is the best because it emphasizes the importance of building trust and rapport before addressing the patient's delusions. Choices A, B, and D are incorrect because they do not prioritize the therapeutic relationship or show empathy towards the patient's experiences.
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Which of the following can potentially be diagnostic at the clinic?
- A. The Ages & Stages questionnaire
- B. The Vanderbilt Rating Scale
- C. The MCHAT R/F
- D. The Goodenough Draw a Man test
Correct Answer: C
Rationale: The MCHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-up) is a validated diagnostic screening tool for autism that can be used in a clinic setting, unlike the others which are more general developmental or cognitive assessments.
The nursing approach that will minimize power struggles between the client with an eating disorder and the nurse is best characterized as:
- A. authoritarian and autocratic.
- B. laid-back and flexible.
- C. rigid and unyielding.
- D. compassionate and firm.
Correct Answer: D
Rationale: The correct answer is D: compassionate and firm. This approach balances empathy and boundaries, fostering trust and cooperation while maintaining structure. Compassion helps build rapport and understanding, essential for addressing the underlying issues of the eating disorder. Firmness sets clear limits and expectations, promoting accountability and progress. Authoritarian and autocratic (A) can create resistance and hinder therapeutic alliance. Laid-back and flexible (B) may enable unhealthy behaviors. Rigid and unyielding (C) can lead to power struggles and hinder therapeutic progress.
A patient with Alzheimer's disease has been determined to have a dressing/grooming self-care deficit. Which intervention(s) would be appropriate for this nursing diagnosis? Select all that apply.
- A. Replace personal clothing with gym clothes that all match each other.
- B. Label the patient's clothing with his name and name of the item.
- C. Provide clothing with elastic waistbands and hook-and-loop closures.
- D. None of the above.
Correct Answer: A
Rationale: Rationale: Option A is correct because replacing personal clothing with matching gym clothes simplifies dressing, reducing confusion for a patient with Alzheimer's. This intervention promotes independence and minimizes frustration. Labeling clothing (Option B) may help in identifying items but does not address the deficit. Clothing with elastic waistbands and closures (Option C) may be helpful but does not directly address the deficit. "None of the above" (Option D) is incorrect as Option A is an appropriate intervention.
An elderly patient brings a bag of medications to the clinic. The nurse finds a bottle labeled Ativan and one labeled lorazepam, both of which are to be taken BID. There are also bottles labeled hydrochlorothiazide, Inderal, and rofecoxib, each to be taken once daily. Which conclusion is accurate?
- A. Rofecoxib should not be taken with Ativan.
- B. Lorazepam interferes with the action of Inderal.
- C. The patient should not self-administer medication.
- D. Lorazepam and Ativan are the same drug, so the dose is excessive.
Correct Answer: D
Rationale: Lorazepam and Ativan are generic and trade names for the same drug (D), creating an accidental misuse situation with an excessive dose. The patient needs medication education and help with proper labeling; there is no evidence they cannot self-administer (C). Options A and B are not factually supported.
The mother of a teen with an eating disorder tells the nurse, 'Our family is pretty well-adjusted. It's hard for me to imagine what we could have done to have this happen.' The nurse can promote more complete understanding of the etiology of eating disorders by mentioning that young women are also influenced by:
- A. The abundance of nutritious foods available.
- B. The fashion industry's idealization of thinness.
- C. Competition in the workplace.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: The fashion industry's idealization of thinness. This is correct because the portrayal of ultra-thin models in the fashion industry can contribute to societal pressure on young women to achieve an unrealistic body image, leading to body dissatisfaction and potentially eating disorders. The other choices are incorrect because option A does not address the societal influences on body image ideals, option C is not directly related to the etiology of eating disorders in young women, and option D is incorrect as the fashion industry can indeed play a significant role in shaping perceptions of beauty and body image.