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A nurse has recently been assigned to a unit that specializes in the care of patients diagnosed with eating disorders. The nurse should consider which of the following actions as having priority when preparing for this new assignment?
- A. Becoming familiar with the unit's policies and procedures.
- B. Arranging to mentor with a nurse who has experience on the unit.
- C. Self-reflecting on personal feelings regarding body weight and size.
- D. Attending an educational seminar that focuses on maladaptive eating disorders.
Correct Answer: C
Rationale: The correct answer is C. Self-reflecting on personal feelings regarding body weight and size is crucial for the nurse to be aware of any biases or triggers that may affect patient care. Understanding personal attitudes towards body image can prevent unintentional harm or judgment towards patients.
A: Becoming familiar with the unit's policies and procedures is important but not the top priority when dealing with patients with eating disorders.
B: Arranging to mentor with a nurse who has experience on the unit can be helpful but does not address the nurse's personal biases.
D: Attending an educational seminar is valuable but may not address the nurse's own attitudes towards body image.
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Which of the following options is not useful for reducing mental conflict?
- A. Stay away from the causes of conflict.
- B. Find out the exact causes of the conflict.
- C. Think about what's left out.
- D. Consult an adult.
Correct Answer: C
Rationale: Mental conflict refers to a state of inner turmoil or struggle that arises when an individual experiences opposing thoughts, desires, or emotions. Strategies useful for reducing mental conflict include avoiding triggers (A), understanding root causes (B), and seeking support (D). Thinking about what's left out (C) can lead to overthinking, increasing conflict rather than reducing it.
When thinking about alcohol and drug abuse the clinical officer should be aware that
- A. Most alcoholics become poly drug abusers
- B. Addictive individuals tend to use hostile, abusive behavior
- C. An unhappy childhood is a causative factor in many addictions
- D. Most poly drug abusers also abuse alcohol
Correct Answer: D
Rationale: Most poly drug abusers also abuse alcohol, as it is a commonly available and socially accepted substance often combined with other drugs.
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: Correct Answer: B. Determine whether the patient can hear as the nurse speaks.
Rationale:
1. Hearing assessment is crucial to ensure patient understanding and communication.
2. Hearing loss may affect compliance with treatment and safety.
3. Identifying hearing deficits early can prevent misunderstandings and improve patient outcomes.
Summary:
- A: While a neurological assessment may be necessary, addressing hearing first is more immediate.
- C: Suggesting rest may help with headache management, but addressing hearing is more critical.
- D: Administering medication is premature without assessing hearing first.
A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his sales. Today, he argued with several office mates and threatened to kill one of them. The police were called, and he was brought to the mental health center for evaluation. He has had previous admissions to the unit for stabilization of paranoid schizophrenia. When the nurse meets him, he points at staff in the nursing station and states loudly, 'They're all plotting to destroy me. Isn't that true?' Which would be the most appropriate response?
- A. No, that is not true. People here are trying to help you if you will let them.'
- B. Let's think about it: what reason would people have to want to destroy you?'
- C. Thinking that people want to destroy you must be very frightening.'
- D. That doesn't make sense; staff are health care workers, not murderers.'
Correct Answer: C
Rationale: The correct answer is C: Thinking that people want to destroy you must be very frightening.
Rationale:
1. Acknowledges the patient's feelings: By stating that thinking people want to destroy him is frightening, the nurse shows empathy and validates his experience.
2. Validates the patient's emotions: This response does not directly agree or disagree but acknowledges the emotions behind the patient's statement.
3. Builds rapport: By showing understanding and empathy, the nurse can establish trust and rapport with the patient, leading to better communication and therapeutic relationship.
Summary of other options:
A: This response denies the patient's feelings and could potentially escalate the situation by invalidating his experiences.
B: This response may come off as confrontational and does not address the patient's underlying fears.
D: This response is dismissive and does not address the patient's emotional distress, potentially leading to further agitation.
An older adult patient who lives with a daughter and attends the Alzheimer day hospital program exhibits bilateral bruising for the second time on both upper outer arms. When the nurse questions the patient about the bruising, the patient starts to cry and pleads, 'Please don't say anything. It's not my daughter's fault. I just bruise easily.' Which intervention reflects the best management of this situation?
- A. Call the daughter to discuss both the bruising and her parent's reaction.
- B. Report the elder abuse, and inform the patient and the daughter of your intention.
- C. Notify the patient's social worker of the bruising after a complete assessment has been completed.
- D. Inform the patient and the daughter of your intention to document the bruising and arrange for appropriate counseling.
Correct Answer: B
Rationale: The correct answer is B: Report the elder abuse and inform the patient and the daughter of your intention. This is the best intervention as it prioritizes the safety and well-being of the older adult. Here's the rationale:
1. The patient's repeated bruising and fear of disclosure indicate potential abuse.
2. Reporting elder abuse is mandatory to ensure protection for the patient.
3. Informing the patient and daughter shows transparency and involves them in the process.
4. It is crucial to address the situation promptly to prevent further harm.
Summary:
A: Calling the daughter may escalate the situation and compromise the patient's safety.
C: Notifying the social worker without addressing the abuse directly may delay necessary action.
D: Counseling may be beneficial, but addressing the abuse is a priority to ensure the patient's safety.