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A nurse assigned to a mental health hotline receives a call from a nurse who has been working on a Covid-19 unit. The caller states, 'I just don't think I can be a nurse anymore.' Which of the following types of trauma should the nurse recognize this person is experiencing?
- A. Acute trauma
- B. Chronic trauma
- C. Complex trauma
- D. Secondary trauma
Correct Answer: D
Rationale: Secondary trauma occurs when healthcare professionals experience emotional distress as a result of caring for clients who have experienced trauma. The nurse's statement suggests they are experiencing secondary trauma due to their work on the Covid-19 unit.
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Which is an accurate planning goal?
- A. The patient will lose 20 pounds when he agrees to follow the prescribed diet
- B. The patient will lose 20 pounds in 20 days
- C. The patient will lose 1 to 2 pounds a week until the goal of 20 pounds is reached.
- D. The patient will lose 2 pounds a week for 10 weeks.
Correct Answer: C
Rationale: In order to provide attainable goals, each goal should be measurable, realistic and individualizedaccording to the patients emotional and physical health. The goal should also be measurable, by establishing a realistic target date of achievement.
A nurse is discussing relapse potential with a group of clients and their families. The nurse should include which of the following statements about relapse prevention?
- A. Relapses should be expected and be looked at as an opportunity.
- B. Relapses signal failure of the abstinence plan, and the plan must be changed.
- C. Relapses may indicate that the client has very little willpower.
- D. Relapses are rare and unlikely to occur.
Correct Answer: A
Rationale: Relapses should be expected and viewed as an opportunity to learn and grow in the recovery process. This perspective helps clients and families understand that relapse is a part of the journey and not a sign of failure.
During the first interview with a parent whose child died in a car accident, the nurse feels empathic and reaches out to take the patient’s hand. Select the correct analysis of the nurse’s behavior.
- A. It shows empathy and compassion. It will encourage the patient to continue to express feelings.
- B. The gesture is premature. The patient’s cultural and individual interpretation of touch is unknown.
- C. The patient will perceive the gesture as intrusive and overstepping boundaries.
- D. The action is inappropriate. Psychiatric patients should not be touched.
Correct Answer: B
Rationale: Touch requires cultural and individual assessment, as in Option B, to avoid misinterpretation. Options A, C, and D assume outcomes or overgeneralize without evidence.
A nurse assesses an older adult patient brought to the emergency department by a family member. The patient was wandering outside saying, I cant find my way home. The patient is confused and unable to answer questions. Select the nurses best action.
- A. Record the patients answers to questions on the nursing assessment form.
- B. Ask an advanced practice nurse to perform the assessment interview.
- C. Call for a mental health advocate to maintain the patients rights.
- D. Obtain important information from the family member.
Correct Answer: D
Rationale: When the patient (primary source) is unable to provide information due to confusion, secondary sources such as family members should be utilized. Option D is the best action as it ensures the nurse gathers critical data efficiently from the family member, who likely knows the patient’s history. Option A is impractical since the patient cannot answer, Option B unnecessarily escalates the task beyond the staff nurse’s scope, and Option C is irrelevant as a mental health advocate isn’t needed for this assessment.
A group is in the working phase. One member says, "That is the stupidest thing I've ever heard. Everyone whines and tells everyone else what to do. This group is a total waste of my time." Which comment by the group leader would be most therapeutic?
- A. "You seem to think you know a lot already. Since you know so much, perhaps you can tell everyone why you are back in the hospital?"
- B. "I think you have made your views clear, but I wonder if others feel the same way. How does everyone else feel about our group?"
- C. "It must be hard to be so angry." Direct this comment to another group member, "You were also angry at first but not now. What has helped you?"
- D. "I would like to remind you that one of our group rules is that everyone is to offer only positive responses to the comments of others."
Correct Answer: C
Rationale: The member is expressing anger, which is a common response to feeling vulnerable. Labeling the emotion and conveying empathy would be therapeutic. Focusing on members who are likely to be more positive can balance the influence of demoralizing members. "You seem to know a lot "¦" conveys hostility from the leader, who confronts and challenges the member to explain how he came to be readmitted if he was so knowledgeable, implying that he is less knowledgeable than he claims. This comment suggests countertransference and is non-therapeutic. Shifting away from the complaining member to see if others agree seeks to have others express disagreement with this member, but that might not happen. In the face of his anger, they might be quiet or afraid to oppose him, or they could respond in kind by expressing hostility themselves. A rule that only positive exchanges are permitted would suppress conflict, reducing the effectiveness of the therapy group.