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A patient diagnosed with dementia associated with excessive alcohol use tells a nurse, "Last week I had to take my baby to the hospital for major surgery. That's why I've been so nervous and needed to come here."Â The nurse is aware that the patient has never parented any children. The symptom described can be assessed as:
- A. akathisia.
- B. confabulation.
- C. intellectualization.
- D. magical thinking.
Correct Answer: B
Rationale: The correct answer is B: confabulation. Confabulation is the production of fabricated or distorted memories without the conscious intention to deceive. In this case, the patient is creating a false memory about having a baby and needing to take it to the hospital, which is not based on reality. Akathisia (A) is a movement disorder associated with restlessness, not memory distortion. Intellectualization (C) is a defense mechanism involving excessive focus on facts to avoid uncomfortable emotions, not memory fabrication. Magical thinking (D) involves believing that one's thoughts can influence events, not creating false memories.
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In a sad voice, an elderly patient tells the nurse of the recent deaths of a spouse and close friend. The patient has no other family and only a few acquaintances in the community. The nurse's priority is to determine whether which nursing diagnosis applies to this patient?
- A. Risk for suicide related to recent deaths of significant others
- B. Anxiety related to sudden and abrupt lifestyle changes
- C. Social isolation related to loss of existing family
- D. Spiritual distress related to anger with God
Correct Answer: A
Rationale: The correct answer is A: Risk for suicide related to recent deaths of significant others. This is the priority because the patient's recent losses put them at high risk for suicide. The nurse must assess the patient's risk level and provide appropriate interventions to prevent harm. Choices B, C, and D are incorrect because anxiety and social isolation are secondary concerns compared to the immediate risk of suicide. Spiritual distress, while important, does not take precedence over the patient's safety.
What is an appropriate goal for a nurse working with a patient who has bulimia nervosa?
- A. The patient will engage in daily exercise to control weight.
- B. The patient will eliminate purging behaviors and establish healthy eating habits.
- C. The patient will maintain a low weight and avoid binge episodes.
- D. The patient will adopt a restrictive diet to manage their eating behaviors.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Eliminating purging behaviors addresses the primary symptom of bulimia nervosa.
2. Establishing healthy eating habits promotes long-term recovery and overall well-being.
3. Focusing on behavior change rather than weight control aligns with evidence-based treatment.
4. This goal is client-centered, prioritizing the patient's mental and physical health.
Summary:
A: Focusing solely on exercise does not address the root cause of bulimia.
C: Emphasizing weight maintenance may reinforce unhealthy body image and behaviors.
D: Adopting a restrictive diet can exacerbate disordered eating patterns and harm health.
A patient diagnosed with schizophrenia has difficulty completing tasks and seems forgetful and disinterested in unit activities. A nurse can best select successful strategies by understanding that these behaviors are due to:
- A. a lack of self-esteem.
- B. manipulative tendencies.
- C. shyness and embarrassment.
- D. problems in cognitive functioning.
Correct Answer: D
Rationale: The correct answer is D: problems in cognitive functioning. In schizophrenia, cognitive deficits are common, leading to difficulties in completing tasks, forgetfulness, and lack of interest. Understanding this helps the nurse select appropriate strategies, such as breaking tasks into smaller steps. Choice A (lack of self-esteem) is incorrect as cognitive deficits in schizophrenia are not solely related to self-esteem. Choice B (manipulative tendencies) is incorrect as these behaviors are not indicative of manipulation. Choice C (shyness and embarrassment) is incorrect as cognitive deficits in schizophrenia go beyond social anxiety.
A woman has concerns about a man she recently began to date. She confides to her friend, a nurse in the clinic, that she recently discovered that he had been charged with domestic violence in a previous relationship. She asks if this means he will also hurt her and what signs would indicate that he is likely to be abusive. What should the nurse tell her friend?
- A. If he hasn't been abusive or controlling so far, chances are he won't be abusive later.
- B. Abuse occurs within dysfunctional relationships, so it may not occur in your situation.
- C. Danger signs include pathological jealousy and controlling the partner's activities.
- D. Because you are not masochistic or provocative, it is unlikely you will be abused.
Correct Answer: C
Rationale: The correct answer is C because it provides specific warning signs of potential abuse, such as pathological jealousy and controlling behavior. These behaviors are often early indicators of an abusive relationship. Option A is incorrect as past behavior can indicate future behavior. Option B is not correct as abuse can occur in any type of relationship. Option D is also incorrect as it implies that abuse is the fault of the victim, which is not true. It is important to educate the woman on recognizing red flags and seeking help if needed.
What is not the primary evidence-based approach to managing oppositional behaviour in children?
- A. Cognitive-behavioural intervention
- B. Psychosocial intervention
- C. Pharmacological intervention
- D. Family therapy
Correct Answer: C
Rationale: Pharmacological intervention is not a primary approach for oppositional behavior; psychosocial interventions like parent training are first-line.