Nokea
A nurse is using Piaget’s model to assess a child’s developmental stage. Which behaviors would determine that a child is successfully achieving the skills required of the formal operations level of development? (Select all that apply.)
- A. Becomes sad when the family pet dies.
- B. Plans a trip to attend a basketball game.
- C. Identifies two different bowls that hold 1 cup.
- D. Selects the appropriate clothing for a ski trip.
Correct Answer: B, D
Rationale: In Piaget's formal operations stage, children develop abstract thinking, planning abilities, and logical reasoning. Planning a trip and selecting appropriate clothing demonstrate these skills. Becoming sad over the pet's death and identifying objects by capacity are more related to emotional and concrete operational stages.
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Which person has the greatest potential for developing dysfunctional grief?
- A. A teen who has always been one of the popular kids
- B. A widow who regularly states, I really loved my deceased wife
- C. A woman whose husband died as a result of a sudden, traumatic injury
- D. An adult who has dealt with the loss of several family members over the years
Correct Answer: C
Rationale: The correct answer is C because sudden, traumatic deaths can lead to complicated grief reactions. This type of loss can disrupt the individual's ability to process and accept the death, resulting in prolonged and intense emotional distress. The other choices, A, B, and D, do not inherently indicate a higher potential for dysfunctional grief as they do not involve the same level of suddenness or trauma. Teen popularity, expressing love for a deceased spouse, and experiencing multiple losses over time are common situations that may not necessarily lead to dysfunctional grief if appropriate support and coping mechanisms are in place.
A young woman had just learned of the accidental death of her husband. She begins to cry
and states, Its not fair! How could he do this to me? This remark is assessed as:
- A. A plea for help
- B. An explosive episode
- C. An expression of anger
- D. Fear of making decisions alone
Correct Answer: C
Rationale: The correct answer is C, an expression of anger. The woman's statement "It's not fair! How could he do this to me?" indicates feelings of anger and resentment towards her husband for leaving her unexpectedly. This response does not show a plea for help (A), as she is expressing her emotions rather than seeking assistance. It is also not an explosive episode (B) as there is no indication of sudden outbursts or intense emotional reactions. Similarly, it is not about fear of making decisions alone (D) as her statement focuses on her feelings of unfairness and betrayal. In summary, the woman's remark reflects her anger and sense of injustice following her husband's accidental death.
The wife of a patient diagnosed with paranoid schizophrenia asks: “I’ve been told that my husband’s illness is probably related to imbalanced brain chemicals. Can you be more specific?”
- A. Breakdown of dopamine produces LSD, which in large amounts produces psychosis
- B. Decreased amounts of the brain chemical dopamine explain the presence of delusions and hallucinations.
- C. An increase in the brain chemical dopamine explains the presence of delusions and hallucinations.
- D. An increase in the brain chemical dopamine explains the presence of lack of motivation and disordered affect
Correct Answer: C
Rationale: The correct answer is C: An increase in the brain chemical dopamine explains the presence of delusions and hallucinations. In paranoid schizophrenia, there is an overactivity of dopamine receptors in the brain, leading to an excess of dopamine. This excess dopamine is associated with symptoms like delusions and hallucinations. Therefore, an increase in dopamine levels is directly linked to these specific symptoms in individuals with paranoid schizophrenia.
Explanation for why the other choices are incorrect:
A: Breakdown of dopamine producing LSD does not directly relate to the symptoms of paranoid schizophrenia.
B: Decreased amounts of dopamine do not explain the presence of delusions and hallucinations in paranoid schizophrenia; it is the increase in dopamine that is associated with these symptoms.
D: An increase in dopamine is more closely related to delusions and hallucinations rather than lack of motivation and disordered affect in paranoid schizophrenia.
The nurse determines that the most effective point of intervention for bereavement is:
- A. Promotion of mental and spiritual health across the life span
- B. At the time a newly discovered loss is impending
- C. Immediately after the loss has occurred
- D. When requested by the patient
Correct Answer: A
Rationale: The correct answer is A because promoting mental and spiritual health across the lifespan addresses bereavement proactively by providing support and resources before, during, and after losses occur. This approach allows individuals to build resilience and cope effectively with grief. Choice B is incorrect as it focuses on impending loss, missing the opportunity for early intervention. Choice C is incorrect as immediate intervention may not be suitable for everyone and may overlook the importance of ongoing support. Choice D is incorrect as waiting for the patient to request intervention may delay support and hinder the healing process.
Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for general anesthesia. The nurse should follow these steps for this procedure (place in the order they will occur):
- A. Monitor the patients vital signs before the procedure.
- B. Medicate as prior to procedure if ordered.
- C. Educate patient and patients family.
- D. Check a signed consent
Correct Answer: C
Rationale: Rationale:
1. Educating the patient and family is crucial as it helps alleviate anxiety and ensures informed consent.
2. Monitoring vital signs (A) should be done before, during, and after the procedure, not necessarily in a specific order.
3. Medication administration (B) should be based on physician's orders but is not the initial step.
4. Checking a signed consent (D) is important but typically done before proceeding with any procedure, not necessarily in a specific order.