Nokea
A nurse is planning a brief treatment program for a client who was raped. A realistic, short-term goal is to:
- A. identify all psychosocial problems.
- B. eliminate the client's enticing behaviors.
- C. resolve feelings of trauma and fear.
- D. verbalize feeling about the event.
Correct Answer: D
Rationale: A realistic short-term goal is for the client to verbalize feelings about the event. A brief treatment program is not designed to identify or resolve problems. The focus is on managing acute symptoms. If in-depth psychological problems are identified, the nurse might make referrals for treatment.
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An elderly client denies that abuse is occurring. Which of the following factors could be a barrier for the client to admit being a victim?
- A. knowledge that elder abuse is rare
- B. personal belief that abuse is deserved
- C. lack of developmentally appropriate screening tools
- D. fear of reprisal or further violence if the incident is reported
Correct Answer: D
Rationale: Barriers to reporting elder abuse include victim shame, fear of reprisals, fear of loss of caregiver, and lack of knowledge of agencies that provide services. Many elders fear that reporting abuse results in their placement in long-term care because the current caregiver is the abuser.
A client tells the nurse that his wife's nagging really gets on his nerves. He asks the nurse to talk with her about her nagging during their family session tomorrow afternoon. Which of the following responses is the most therapeutic for the client?
- A. Tell me more specifically about her complaints.
- B. Can you think why she might nag you so much?
- C. I'll help you think about how to bring this up yourself tomorrow afternoon.
- D. Why do you want me to initiate this in tomorrow's session rather than you?
Correct Answer: C
Rationale: The client needs to learn how to communicate directly with his wife about her behavior. The nurse's assistance enables him to practice a new skill and communicates confidence in his ability to confront this situation. Choices 1 and 2 inappropriately direct attention away from the client and toward his wife, who isn't present. Choice 4 implies that there might be a legitimate reason for the nurse to assume responsibility for something that rightfully belongs to the client. Instead of focusing on his problems, he'll waste precious time convincing the nurse that he or she should do his work.
Nurses should understand the chain of infection because it refers to:
- A. the linkages between various forms of microorganisms.
- B. the sequence required for transmission of disease.
- C. the clustering of bacteria in a specific pattern.
- D. increasing virulence patterns among species of microorganisms.
Correct Answer: B
Rationale: Infection occurs in a predictable sequence requiring virulence, movement from a reservoir, and entry into a susceptible host.
A client has been taking alprazolam (Xanax) for four years to manage anxiety. The client reports taking 0.5 mg four times a day. Which statement indicates that the client understands the nurse's teaching about discontinuing the medication?
- A. I can drink alcohol now that I am decreasing my Xanax.
- B. I should not take another Xanax pill. Here is what is left of my last prescription.
- C. I should take three pills per day next week, then two pills for one week, then one pill for one week.
- D. I should expect to be sleepy for several days after stopping the medicine.
Correct Answer: C
Rationale: Xanax, like other benzodiazepines, can cause withdrawal symptoms that include agitation, insomnia, hypertension, seizures, and abdominal pain. The drug must be slowly decreased to prevent withdrawal symptoms.
An adult who had been abused as a child is discussing the group therapy program. Which statement indicates that the client has gained insight?
- A. I think I was a lonely child because I could not tell anyone about my abuse.'
- B. I am now aware of how deep-seated my anger is. Before I did not realize I was angry.'
- C. The program has given me the courage to tell my mother how I felt about her role in my hurt.'
- D. There are so many people just like me, who are just normal people that had bad things happen to them.'
Correct Answer: B
Rationale: Children who are abused learn to cope with the painful experiences by ignoring painful feelings and avoiding getting close to people. As adults, victims of abuse usually continue to repress feelings, avoid close interpersonal relationships, and frequently use alcohol or drugs to block painful memories. Long-term effects in adults might include criminal/violent behavior (for adult males), substance abuse, and a variety of social and emotional problems (including suicidal thoughts, anxiety, hostility, dissociation, and interpersonal difficulties).