Nokea
A nurse and social worker co-lead a reminiscence group for eight elite-old adults. Which activity is appropriate to include in the group?
- A. Mild aerobic exercise
- B. Singing a song from World War II
- C. Discussing national leadership during the Vietnam War
- D. Identifying the most troubling story in todays newspaper
Correct Answer: B
Rationale: Elite-old adults (100+ years) were young during World War II. Singing a song from that era (B) aligns with reminiscence therapy by sharing relevant past memories. Other options (A, C, D) are less tied to their life experiences.
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What is the priority nursing intervention when caring for a patient with bulimia nervosa who has a history of purging?
- A. Provide emotional support and assist with stress management.
- B. Monitor vital signs and electrolyte levels closely.
- C. Encourage the patient to exercise regularly to prevent weight gain.
- D. Help the patient identify triggers for binge eating and purging behaviors.
Correct Answer: B
Rationale: The correct answer is B because monitoring vital signs and electrolyte levels closely is crucial in managing a patient with bulimia nervosa who has a history of purging. Purging can lead to electrolyte imbalances and dehydration, which can have serious consequences such as cardiac arrhythmias and electrolyte disturbances. By closely monitoring vital signs and electrolyte levels, nurses can quickly identify and intervene in case of any abnormalities, preventing potential life-threatening complications.
Choice A is incorrect because emotional support and stress management are important but not the priority when dealing with physical complications from purging. Choice C is incorrect because encouraging exercise may exacerbate the patient's unhealthy behaviors and should be approached cautiously. Choice D is incorrect because identifying triggers is important but not as immediate as monitoring vital signs and electrolyte levels in this situation.
A patient states that unit staff members have been avoiding them since an attempt to self-mutilate. The psychiatric-mental health nurse's most appropriate response is to:
- A. apologize for the staff's behavior
- B. explain that feelings of rejection are typical after self-mutilation
- C. listen, redirect the patient to their feelings, and explore the issue with the staff
- D. report the matter to the nurse manager
Correct Answer: C
Rationale: Listening validates the patient, redirecting focuses on their emotions, and exploring with staff addresses care quality.
A client with schizophrenia tells the nurse as they sit in the day room, 'I hear voices telling me bad things.' The most therapeutic response the nurse can make is:
- A. Tell me what the voices are saying.'
- B. I understand you hear these so-called voices, but I hear only the people in the room talking.'
- C. The voices are not real. They're only your imagination.'
- D. Do you think the voices would go away if we went into your room to talk?'
Correct Answer: B
Rationale: The correct answer is B because it demonstrates empathy and validation of the client's experience. By acknowledging the client's reality of hearing voices and emphasizing that the nurse does not hear them, the nurse establishes trust and rapport. This response shows active listening and validates the client's feelings without judgment.
Incorrect responses:
A: Asking the client to describe the voices may increase distress and is not as supportive as acknowledging their experience.
C: Dismissing the voices as not real can invalidate the client's experience and may lead to mistrust.
D: Suggesting a change of location does not address the client's immediate concerns and may not be therapeutic in this situation.
A 14-year-old female comes into clinic for a medical certificate once a week for multiple complaints of chest pain and abdominal pain. The complaints are non-specific, and her physical examination is normal. She is quiet with poor eye contact. She states the pain is worse on school days. Her mother is concerned that her daughter is being bullied but won't talk to her. Her mother is also worried that her complaints represent an undiagnosed medical condition. The next best step in management is:
- A. Referral to tertiary hospital to rule out organic cause
- B. HEADSS or other psychosocial screening
- C. Referral for counselling
- D. Reassurance that nothing is wrong
Correct Answer: B
Rationale: HEADSS screening assesses psychosocial factors (e.g., bullying, stress) that may underlie somatic complaints, making it the best next step before referral or reassurance.
Behaviorists would say that self-defeating behaviors are maintained by immediate reinforcement in the form of
- A. relief from anxiety
- B. defending the ego
- C. protecting one's self-image
- D. avoiding existential anxiety
Correct Answer: A
Rationale: Behaviorists argue self-defeating actions persist because they provide short-term anxiety relief.