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A nurse is anxious about assessing the sexual history of a patient who is considerably older than the nurse is. Which statement would be most appropriate for obtaining information about the patient's sexual practices?
- A. Some people are not sexually active, others have a partner, and some have several partners. What has been your pattern?
- B. Sexual health can reflect a number of medical problems, so I'd like to ask if you have any sexual problems you think we should know about.
- C. It's your own business, of course, but it might be helpful for us to have some information about your sexual history. Could you tell me about that, please?
- D. I would appreciate it if you could share your sexual history with me so I can share it with your health care provider. It might be helpful in planning your treatment.
Correct Answer: A
Rationale: The correct answer is A because it acknowledges the diversity of sexual practices and respects the patient's autonomy in sharing their sexual history. It also allows the patient to openly discuss their pattern without feeling pressured.
Choice B is incorrect because it focuses on potential medical problems rather than directly asking about the patient's sexual practices.
Choice C is incorrect as it may come across as too intrusive and lacks a non-judgmental approach.
Choice D is incorrect as it implies the patient's information will be shared without their consent, which violates patient confidentiality.
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The chief distinguishing feature of psychotic disorders is
- A. confusion of fantasy and reality
- B. antisocial conduct
- C. overwhelming anxiety
- D. obsessive behavior
Correct Answer: A
Rationale: Psychotic disorders are characterized by a loss of reality testing, such as hallucinations and delusions, distinguishing them from other conditions.
A couple in counseling reports fighting with their child when they are angry with each other. This behavior typifies:
- A. coalition
- B. indirect communication
- C. transference
- D. triangulation
Correct Answer: D
Rationale: Triangulation occurs when a third party (the child) is drawn into a conflict between two others, redirecting tension.
The Freudian explanation of anxiety disorders emphasizes
- A. the avoidance paradox
- B. learned habits of self-defeating behavior
- C. forbidden impulses that threaten a loss of control
- D. the development of a faulty or inaccurate self-image and distorted self-perceptions
Correct Answer: C
Rationale: Freud viewed anxiety as stemming from repressed impulses threatening to surface, disrupting control.
The mother of a 2-year-old tells the nurse at the well-child clinic that her child likes to take a blanket wherever he goes. The mother asks if she should take the blanket away from the child. The nurse counsels the mother to allow the child to have the blanket because it reminds him of his mother and comforts him. The basis for this counseling is:
- A. Mahler's theory of object relations
- B. Freud's developmental theory
- C. Kernberg's conceptualization object constancy
- D. Sullivan's theory of 'good me'
Correct Answer: A
Rationale: The correct answer is A: Mahler's theory of object relations. Mahler's theory focuses on the development of a child's sense of self and relationships. In the scenario provided, the child's attachment to the blanket can be seen as a transitional object, which is a source of comfort and security, similar to the mother. This concept aligns with Mahler's theory that objects like blankets can serve as symbols of the mother and aid in the child's emotional development.
Incorrect choices:
B: Freud's developmental theory primarily focuses on psychosexual stages of development, which do not directly address the use of transitional objects.
C: Kernberg's conceptualization of object constancy pertains to personality disorders and the ability to maintain stable relationships, not the use of transitional objects.
D: Sullivan's theory of 'good me' is centered around interpersonal relationships and self-esteem, which are not directly related to the use of transitional objects in early childhood development.
For those family members who desire to care at home for loved ones who have been given a diagnosis of Alzheimer's disease, it is important for the nurse to ensure that the family is aware of which caregiver skills and responsibilities will be necessary. What is one of the responsibilities of the caregiver during the middle stage of the disease?
- A. Helping the loved one with memory and communication problems.
- B. Providing a stable, routine environment.
- C. Providing complete assistance with physical care.
- D. None of the above.
Correct Answer: A
Rationale: Rationale:
1. During the middle stage of Alzheimer's disease, individuals often experience memory and communication problems.
2. Caregivers need to assist with memory tasks and facilitate effective communication.
3. Helping the loved one with memory and communication problems is crucial for their well-being and quality of life.
4. This responsibility helps maintain a sense of connection and understanding between the caregiver and the individual with Alzheimer's.
Summary:
- Option A is correct as it aligns with the specific needs of individuals in the middle stage of Alzheimer's.
- Option B is incorrect as providing a stable, routine environment is more relevant in the early stages.
- Option C is incorrect as complete assistance with physical care is more common in the later stages.
- Option D is incorrect as caregiver responsibilities are essential in all stages of the disease.