Nokea
A nurse prepares to assess a new patient who moved to the United States from Central America three years ago. After introductions, what is the nurses next comment?
- A. How did you get to the United States?
- B. Would you like for a family member to help you talk with me?
- C. An interpreter is available. Would you like for me to make a request for these services?
- D. Are you comfortable conversing in English, or would you prefer to have a translator present?
Correct Answer: D
Rationale: Assessing language comfort first (Option D) ensures effective communication, critical for an accurate assessment. Option A is irrelevant, Option B risks unreliable family translation, and Option C assumes a need without checking.
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A nurse is assessing a patient diagnosed with major depressive disorder. The patient states, 'I feel like everything is falling apart, and I can't keep up anymore.' Which nursing diagnosis is most appropriate for this patient?
- A. Impaired social interaction
- B. Risk for suicide
- C. Ineffective coping
- D. Hopelessness
Correct Answer: D
Rationale: The patient's statement reflects feelings of hopelessness, which is a common symptom in major depressive disorder and often leads to a sense of despair.
A client experienced the death of their grandmother six months ago. They present to the clinic today with feelings of hopelessness, sadness, not sleeping, and crying throughout the day. What does the nurse anticipate the cause of the client’s symptoms to be?
- A. Anxiety
- B. Prolonged grief
- C. Normal grieving process
- D. Emotional numbness
Correct Answer: B
Rationale: Symptoms persisting beyond six months and impairing daily functioning suggest prolonged grief rather than a normal grieving process.
According to Maslow's hierarchy of needs, the most basic needs category for nurses to address is:
- A. Physiological
- B. Safety
- C. Love and belonging
- D. Self-actualization
Correct Answer: A
Rationale: Physiological needs, such as food, water, and shelter, are the most basic and must be met before addressing higher-level needs.
Epidemiological studies contribute to improvements in care for individuals with mental disorders by:
- A. Providing information about effective nursing techniques.
- B. Identifying risk factors that contribute to the development of a disorder.
- C. Identifying individuals in the general population who will develop a specific disorder
- D. Identifying which individuals will respond favorably to a specific treatment.
Correct Answer: B
Rationale: Epidemiological studies help identify risk factors that contribute to the development of mental disorders, which can inform prevention and treatment strategies.
A nurse is caring for a client who has dementia. Which of the following requests should the nurse make to determine the client's social cognition?
- A. Repeat a list of words
- B. Initiate gestures of learned movements
- C. Identify emotion of faces on cards
- D. Interpret a sequence of pictures
Correct Answer: C
Rationale: Identifying emotions of faces on cards is a way to assess social cognition in clients with dementia. This task evaluates the client's ability to recognize and interpret emotional expressions.