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A nursing colleague says, 'This patient was admitted claiming to have been raped by her boyfriend, but just look at the sexy clothes she's wearing.' Which response reflects an understanding of the most likely source of the colleague's comment?
- A. Have you ever cared for other sexual assault victims?'
- B. Your sister was raped when she was in college, wasn't she?'
- C. You have three unmarried brothers about the patient's age, don't you?'
- D. Do you think that wearing sexy clothes caused her to be sexually assaulted?'
Correct Answer: D
Rationale: The correct answer is D because it addresses the underlying misconception that a person's clothing choices can justify or provoke sexual assault. By asking if the colleague believes the victim's clothing caused the assault, it challenges victim-blaming and highlights the importance of understanding consent and boundaries.
Option A does not directly address the colleague's potentially victim-blaming statement. Option B brings up the colleague's personal experience, which is irrelevant and may not effectively challenge the problematic comment. Option C makes assumptions about the colleague's personal life, which is not relevant to the situation at hand.
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Which statement by a patient with an eating disorder reflects a correct understanding of the condition?
- A. Gaining 1 pound is as much of a disaster as gaining 100 pounds.
- B. I was happy when I was a size 4, so I must diet to that size.
- C. I've been coping with my feelings by overeating.
- D. Binging is the only way I can soothe myself.
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the emotional aspect of eating disorders. Coping with feelings by overeating indicates insight into using food to manage emotions, a common characteristic of eating disorders. This understanding is crucial for addressing the underlying issues contributing to the disorder.
A: Incorrect. This statement suggests an extreme and distorted view of weight gain, which is not reflective of a healthy understanding of an eating disorder.
B: Incorrect. This statement implies a fixation on a specific size for happiness, which may perpetuate disordered eating behaviors.
D: Incorrect. This statement indicates reliance on binging as the sole coping mechanism, overlooking the emotional aspect of the disorder.
A 72-year-old patient has the medical diagnosis of delirium secondary to anticholinergic medication toxicity. Family members are very anxious and express their concerns about the patient's condition. What information should serve as the basis for the nurse's reply?
- A. Provide education and information regarding the medical diagnosis, delirium secondary to anticholinergic medication toxicity.
- B. Reassure the family that the patient will recover fully.
- C. Suggest that the family consider nursing home placement.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A. The nurse should provide education and information about the medical diagnosis, delirium secondary to anticholinergic medication toxicity. This is important because it helps the family understand the condition, its causes, symptoms, and treatment. By educating the family, they can better support the patient and be involved in the care plan.
Choice B is incorrect because it provides false reassurance without addressing the underlying issue or providing necessary information.
Choice C is incorrect because suggesting nursing home placement is premature and not based on the patient's current condition or needs.
Therefore, the best approach is to choose option A to empower the family with knowledge and understanding to better assist the patient.
When told that he is scheduled to interview a patient with narcissistic personality disorder, the nurse can anticipate the assessment findings will include the following:
- A. charm, drama, seductiveness, and admiration seeking.
- B. preoccupation with minute details and perfectionism.
- C. difficulty being alone, indecisiveness, and submissiveness.
- D. grandiosity, self-importance, and a sense of entitlement.
Correct Answer: D
Rationale: The correct answer is D. In narcissistic personality disorder, individuals exhibit grandiosity, self-importance, and a sense of entitlement. This is a key feature of the disorder where individuals have an inflated sense of their own importance and require excessive admiration. This behavior is often accompanied by a lack of empathy and exploitation of others.
Choice A (charm, drama, seductiveness, and admiration seeking) is more characteristic of histrionic personality disorder.
Choice B (preoccupation with minute details and perfectionism) is more characteristic of obsessive-compulsive personality disorder.
Choice C (difficulty being alone, indecisiveness, and submissiveness) does not align with the typical presentation of narcissistic personality disorder.
The sibling of a patient who was diagnosed with a serious mental illness asks why a case manager has been assigned. The nurses reply should cite the major advantage of the use of case management as:
- A. The case manager can modify traditional psychotherapy for homeless patients so that it is more flexible.
- B. Case managers coordinate services and help with accessing them, making sure the patients needs are met.
- C. The case manager can focus on social skills training and esteem building in the real world where the patient lives.
- D. Having a case manager has been shown to reduce hospitalizations, which prevents disruption and saves money.
Correct Answer: B
Rationale: Case managers coordinate services and access (B), overcoming obstacles for the mentally ill, making it the primary advantage. Other options (A, C, D) are less central to their role.
A rape victim tells the emergency room nurse, "I feel so dirty. Help me take a shower before the doctor examines me."Â The nurse should:
- A. Arrange for the patient to shower.
- B. Explain that bathing would destroy evidence.
- C. Give the patient a basin of water and towels.
- D. Explain that bathing facilities are not available in the emergency department.
Correct Answer: B
Rationale: The correct answer is B: Explain that bathing would destroy evidence. This is the correct choice because bathing can potentially wash away crucial forensic evidence that can be collected during a sexual assault examination. Preserving evidence is essential for legal proceedings and ensuring justice for the victim.
Choice A is incorrect because arranging for the patient to shower would destroy evidence. Choice C is incorrect as giving the patient a basin of water and towels would still risk destroying evidence. Choice D is also incorrect as it does not address the importance of preserving evidence in cases of sexual assault.