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A nurse is caring for a patient who has a maladaptive response to eating regulation. The patient tells the nurse, 'I know my parents are already upset, but I need to lose another 10 pounds to be at an ideal weight.' This statement suggests that the best treatment setting for this patient would be:
- A. the hospital.
- B. an outpatient program.
- C. a day treatment program.
- D. at home with weekly nursing visits.
Correct Answer: A
Rationale: The correct answer is A: the hospital. This patient's maladaptive eating behavior and desire to lose more weight despite concerns from family indicate a serious condition requiring intensive care and monitoring. In the hospital, the patient can receive immediate medical attention, nutritional support, and psychological intervention to address underlying issues. Outpatient programs (B) may not offer sufficient supervision, while day treatment programs (C) may not provide round-the-clock care. Home with weekly nursing visits (D) is not appropriate for a patient with such severe eating regulation issues.
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Asking the husband to leave is likely to increase the client's anxiety and alter test results. Testing in the more familiar, comfortable surroundings of the home will yield more reliable results.
- A. Asking the husband to leave is likely to increase the client's anxiety and alter test results because the presence of a loved one can provide comfort and support during a potentially stressful situation.
- B. Testing in the more familiar, comfortable surroundings of the home will yield more reliable results because the client is in a setting where they feel safe and secure, which can help reduce anxiety and promote accurate test outcomes.
- C. Both A and B.
- D. None of the above.
Correct Answer: C
Rationale: The correct answer is C because both statements A and B provide valid reasons supported by psychological principles. Statement A is correct as the presence of a loved one can indeed provide comfort and support, reducing anxiety and potentially improving test outcomes. Statement B is also accurate as testing in familiar surroundings can help the client feel safe and secure, leading to more reliable results. Therefore, combining these two factors - the presence of a loved one and testing in a comfortable environment - would likely yield the most reliable results by addressing both emotional and environmental factors impacting the client's anxiety levels during the test.
A client, age 42, has been battered by her husband since they were married 8 years ago. Until this hospitalization for major depression, she had avoided dealing with her situation, but she now expresses a desire to deal with the problem. The attacks are occurring more often. Which outcome is realistic for the client?
- A. Citing possible ways she may have contributed to the abusive episodes
- B. Verbalizing an awareness of her increasingly dangerous situation
- C. Setting a goal date for divorcing her husband
- D. Employing methods of retaliating in order to get even with her husband
Correct Answer: B
Rationale: The correct answer is B: Verbalizing an awareness of her increasingly dangerous situation. This choice is the most realistic outcome for the client as it shows an initial step towards acknowledging the severity of her situation. By verbalizing awareness, the client can begin to understand the potential dangers she faces, which is crucial for developing a safety plan and seeking appropriate help.
Choice A is incorrect as it may lead to victim-blaming and does not address the root cause of the abuse. Choice C is premature as setting a goal date for divorcing her husband requires careful planning and consideration of various factors. Choice D is inappropriate as retaliation can escalate the violence and put the client at further risk.
In summary, choice B is the best option as it focuses on increasing the client's awareness of her situation, which is a crucial first step towards addressing and eventually overcoming the abusive relationship.
A nurse is working with a patient with bulimia nervosa. Which outcome would indicate successful intervention?
- A. The patient eats three full meals daily without purging.
- B. The patient agrees to begin psychotherapy without resistance.
- C. The patient loses 5% of their body weight over 3 months.
- D. The patient expresses improved body image but still purges occasionally.
Correct Answer: A
Rationale: The correct answer is A because it indicates successful intervention in bulimia nervosa by demonstrating healthy eating behavior without purging. This outcome reflects improved control over binge-purge cycles and supports physical health. Choices B and D show progress but do not directly address the core issue of purging behavior. Choice C, losing weight, can be a misleading indicator and may not necessarily reflect improved psychological and behavioral outcomes associated with recovery from bulimia nervosa.
A novice nurse tells the assigned mentor, 'I admitted a patient today who has several bizarre delusions. I wanted to tell the patient that the ideas and conclusions simply are not logical. What do you think will happen if I do?' Which reply by the mentor is best?
- A. I think you'll give the patient something to think about.'
- B. The patient will probably incorporate you into the delusions as a persecutor.'
- C. Develop trust using empathy and calmness before pointing out discrepancies.'
- D. Initially, it would be better to go along with the patient's thinking to gain cooperation.'
Correct Answer: C
Rationale: Step 1: Establish trust - Developing trust with the patient is crucial in building a therapeutic relationship.
Step 2: Use empathy and calmness - Showing empathy helps the patient feel understood and valued.
Step 3: Point out discrepancies - Once trust is established, gently pointing out discrepancies in a non-confrontational manner can help the patient reflect on their delusions.
Summary: Choice C is the best because it emphasizes the importance of building trust and rapport before addressing the patient's delusions. Choices A, B, and D are incorrect because they do not prioritize the therapeutic relationship or show empathy towards the patient's experiences.
A patient living independently had command hallucinations to shout warnings to neighbors. After a short hospitalization, the patient was prohibited from returning to the apartment. The landlord said, 'You cause too much trouble.' What problem is the patient experiencing?
- A. Grief
- B. Stigma
- C. Homelessness
- D. Nonadherence
Correct Answer: B
Rationale: The inability to obtain shelter because of negative attitudes about mental illness is an example of stigma. Stigma is defined as damage to reputation, shame, and ridicule society places on mental illness. Data are not present to identify grief as a patient problem. Data do not suggest that the patient is actually homeless.