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A nurse assesses four patients between the ages of 70 and 80. Which patient has the highest risk for alcohol abuse? The patient who:
- A. Consumes 1 glass of wine nightly with dinner.
- B. Drank socially throughout adult life and continues this pattern, saying, “I’ve earned the right to do as I please.”
- C. Began drinking alcohol daily after retirement and says, “A few drinks keep my mind off my arthritis.”
- D. Abused alcohol between the ages of 25 and 40 but now abstains and occasionally attends Alcoholics Anonymous (AA).
Correct Answer: C
Rationale: The correct answer is C because the patient who started drinking daily after retirement as a coping mechanism for arthritis has the highest risk for alcohol abuse. This behavior indicates a potential dependence on alcohol to manage physical and emotional discomfort, leading to increased consumption and potential addiction.
Choice A is not the correct answer because consuming 1 glass of wine nightly with dinner is generally considered moderate drinking and does not necessarily indicate alcohol abuse.
Choice B is also not the correct answer as social drinking throughout adult life, even if justified as a reward, does not inherently suggest alcohol abuse without further evidence of problematic drinking patterns.
Choice D is incorrect as the patient has a history of alcohol abuse but currently abstains and seeks support through AA, indicating active efforts to maintain sobriety and reduce the risk of alcohol abuse.
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By the end of the orientation phase, which outcome can be identified for a newly admittedpatient? The patient will demonstrate:
- A. Positive transference with a staff member
- B. Ability to ask for help in meeting needs
- C. Commitment to long-term therapy
- D. Ability to manage symptoms independently
Correct Answer: A
Rationale: The correct answer is A because positive transference with a staff member in the orientation phase indicates a developing therapeutic relationship, which is crucial for effective treatment. This outcome shows the patient is beginning to trust and feel safe with a staff member, enhancing their engagement in therapy.
Choice B is incorrect because the ability to ask for help in meeting needs may not be fully developed by the end of the orientation phase. Choice C is incorrect as commitment to long-term therapy is usually not established this early in the process. Choice D is incorrect because the ability to manage symptoms independently typically requires more time and therapy progress.
Which patient would the nurse determine to be at highest risk for dysfunctional grief? The patient:
- A. Whose 16-year-old daughter was raped and killed while going on an errand for the patient
- B. Whose 86-year-old mother, with whom she has shared her home, died after a long illness.
- C. Who attended a support group and had been assisted by hospice to care for her terminally
- D. Who attended a bereavement group, where she learned to express feelings after the deaths of her twin daughters
Correct Answer: A
Rationale: The correct answer is A because the patient whose 16-year-old daughter was raped and killed while going on an errand for the patient is at highest risk for dysfunctional grief. This traumatic and unexpected loss of a child to a violent act can lead to complicated or prolonged grief reactions. The sudden and violent nature of the death, along with the added trauma of rape, can significantly impact the grieving process. The intense emotions and feelings of guilt, anger, and helplessness may complicate the bereavement process and lead to dysfunctional grief reactions.
Summary:
Choice B is incorrect because the death of an 86-year-old mother after a long illness, although sad, does not necessarily indicate a higher risk of dysfunctional grief. Choice C is incorrect as attending a support group and receiving assistance from hospice are positive factors that can support healthy grieving. Choice D is incorrect as attending a bereavement group and learning to express feelings after the deaths of twin daughters indicate active engagement in the grieving process, which is
Family and friends rush to offer support to a friend who has lost her teenage son. Which of these persons, through an intended act of kindness, may contribute to prolonging the woman’s grief?
- A. The physician who prescribed antianxiety agents
- B. The nurse who offered to spend the night at her home
- C. The next-door teenager who provided care for the son’s pet
- D. The accountant who assisted with stabilizing financial affairs.
Correct Answer: A
Rationale: The correct answer is A because prescribing antianxiety agents may mask the woman's grief instead of allowing her to process and work through it naturally. This could potentially prolong her grief by avoiding the necessary emotional processing. The other choices, B, C, and D, all involve support that can help the woman cope with her loss in a healthy way. B offers emotional support and companionship, C helps with practical tasks, and D provides assistance in managing practical matters, all of which can facilitate the grieving process rather than prolong it.
According to Maslow’s hierarchy of needs, which nursing strategies would assist in meeting self-esteem needs of elderly patients?
- A. Providing privacy when spouses are visiting
- B. Arranging for the spouses to dine with the patients when visiting
- C. Including both the patients and spouses in all educational sessions
- D. Attending to patient hygiene and dress in preparation for spousal visits
Correct Answer: D
Rationale: Step-by-step rationale for why choice D is correct:
1. Maslow's hierarchy of needs places self-esteem as a fundamental psychological need.
2. Patient hygiene and dress contribute to self-esteem by promoting a sense of dignity and self-worth.
3. Attending to hygiene and dress before spousal visits shows respect for the patient's self-esteem.
4. This strategy directly addresses the self-esteem needs of elderly patients by enhancing their sense of self-worth and respect.
Summary of why other choices are incorrect:
A: Providing privacy for spouses does not directly address the patient's self-esteem needs.
B: Arranging dining with spouses may enhance social needs but not directly address self-esteem.
C: Including patients and spouses in educational sessions may promote social interaction but does not directly target self-esteem needs.
What is the primary reason for the nurse to have an understanding of the various types of activity and adjunct therapies?
- A. The nurse chooses the most cost-effective therapy group.
- B. The nurse is expected to encourage patients’ involvement in the therapies.
- C. The nurse is responsible for placing the patient in the appropriate group.
- D. The nurse needs to be supportive of the treatment team members who direct these therapies.
Correct Answer: B
Rationale: The correct answer is B because nurses are expected to encourage patients' involvement in therapies to promote holistic care and enhance patient outcomes. By understanding different types of therapies, nurses can educate and motivate patients to participate actively in their treatment plans. This empowers patients to take control of their health and improve their overall well-being. Choices A, C, and D are incorrect because the primary role of the nurse in this context is to support and advocate for the patients' engagement in therapies, rather than focusing on cost-effectiveness, placement, or support of other team members.