Nokea
A patient in the long-term phase of the rape-trauma syndrome had intrusive thoughts of the attack and developed fears of being alone. Which finding best demonstrates the patient has improved? The patient!
- A. Uses increased activity to reduce fear.
- B. Plans coping strategies for fearful situations.
- C. Temporarily withdraws from social situations.
- D. Expresses willingness to engage in sexual activity.
Correct Answer: B
Rationale: The correct answer is B because planning coping strategies for fearful situations indicates the patient is actively working on managing their fears and trauma, showing progress and improvement. Choice A is incorrect as increased activity may be a maladaptive coping mechanism. Choice C suggests social withdrawal, which is a sign of regression. Choice D may indicate premature attempts to engage in sexual activity without addressing the underlying trauma. Overall, choice B demonstrates proactive steps towards healing and recovery.
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Which of the following is not a common type of water pollutant?
- A. Protists
- B. Bacteria
- C. Particulates
- D. Carbon Monoxide
Correct Answer: D
Rationale: Carbon Monoxide is an air pollutant, not a common water pollutant, unlike protists, bacteria, and particulates.
In addition to antidepressants, which of the following is usual treatment for postpartum depression?
- A. Antipsychotics
- B. Psychotherapy
- C. Hormone replacement
- D. Temporary removal of the baby from the home
Correct Answer: B
Rationale: Psychotherapy (B) along with antidepressants are the major treatments for postpartum depression. Patients usually are not psychotic (A), hormone replacement (C) is not indicated, and mother and baby should be kept together with support (D).
A patient diagnosed with a serious mental illness died suddenly at age 52. The patient lived in the community for 5 years without relapse and held supported employment the past 6 months. The distressed family asks, 'How could this happen?' Which response by the nurse accurately reflects research and addresses the family's question?
- A. A certain number of people die young from undetected diseases, and its just one of those sad things that sometimes happen.'
- B. Mentally ill people tend to die much younger than others, perhaps because they do not take as good care of their health, smoke more, or are overweight.'
- C. We will have to wait for the autopsy to know what happened. There were some medical problems, but we were not expecting death.'
- D. We are all surprised. The patient had been doing so well and saw the nurse every other week.'
Correct Answer: B
Rationale: The family is in distress. Because they do not understand his death, they are less able to accept it and seek specific information to help them understand what happened. Persons with serious mental illness die an average of 25 years prematurely. Contributing factors include failing to provide for their own health needs (e.g forgetting to take medicine), inability to access or pay for care, higher rates of smoking, poor diet, criminal victimization, and stigma. The most accurate answer indicates that seriously mentally ill people are at much higher risk of premature death for a variety of reasons. Staff would not have been surprised that the patient died prematurely, and they would not attribute his death to random, undetected medical problems. Although the cause of death will not be reliably established until the autopsy, this response fails to address the familys need for information.
A client, age 34, has been physically abused by her husband five times during the past 2 years. During her last discussion with the nurse, the client stated, 'I probably should not keep going back to him.' The nurse is aware that the final decision to leave a batterer:
- A. Is complex and may take time.
- B. Should be made immediately.
- C. Is the responsibility of the nurse.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Is complex and may take time. The nurse understands that leaving an abusive relationship is a complex process that may take time. The client's statement of awareness indicates progress, but making the final decision to leave a batterer involves various factors such as safety planning, emotional readiness, and support systems. Choice B is incorrect as immediate decision-making can be dangerous without proper planning. Choice C is incorrect as the nurse's role is to support and empower the client but not make decisions for them. Choice D is incorrect as leaving an abuser is a personal decision that requires careful consideration.
A couple in counseling reports fighting with their child when they are angry with each other. This behavior typifies:
- A. coalition
- B. indirect communication
- C. transference
- D. triangulation
Correct Answer: D
Rationale: Triangulation occurs when a third party (the child) is drawn into a conflict between two others, redirecting tension.