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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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What is an important aspect of managing refeeding syndrome in patients with anorexia nervosa?
- A. Refeeding the patient with high-calorie foods immediately.
- B. Monitoring electrolytes closely during the refeeding process.
- C. Allowing the patient to eat whatever they want without restrictions.
- D. Restricting fluid intake to avoid water retention.
Correct Answer: B
Rationale: The correct answer is B because monitoring electrolytes closely during refeeding is crucial to prevent life-threatening complications such as electrolyte imbalances. Refeeding syndrome can lead to shifts in electrolytes, particularly phosphorus, potassium, and magnesium, which may result in cardiac arrhythmias, respiratory failure, or even death. Close monitoring allows for timely interventions to maintain electrolyte balance.
Choice A is incorrect because refeeding a patient with high-calorie foods immediately can actually exacerbate refeeding syndrome by overwhelming the body's metabolic and electrolyte regulation processes. Choice C is incorrect because allowing the patient to eat whatever they want without restrictions can lead to rapid and uncontrolled weight gain, which may worsen medical complications. Choice D is incorrect because restricting fluid intake can also contribute to electrolyte imbalances and dehydration during refeeding.
The nurse has been working with a patient diagnosed with schizophrenia who experiences auditory hallucinations. The patient relates, 'When I first heard the voices they said nice things about me. Lately, they've changed and they say bad things.' What information has the least impact on therapeutic patient care at this point in the hospitalization?
- A. Do you trust me to help you with the voices?'
- B. Are the voices commanding you to do something?'
- C. How often during 24 hours do you hear the voices?'
- D. Do you hear the voices if you're busy in noisy environment?'
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
A: Asking about trust in the nurse is not immediately relevant as the patient's primary concern is the change in voice content. Building trust is important but addressing the content of hallucinations takes priority.
B: This is relevant as commanding voices could pose a safety risk.
C: Monitoring frequency helps assess severity and response to treatment.
D: Understanding triggers for hallucinations is important for managing symptoms.
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.
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.
An appropriate outcome for a patient with a personality disorder and a nursing diagnosis of Ineffective coping as evidenced by use of manipulation would be that the patient will:
- A. refrain from manipulative behavior at all times
- B. use manipulation only to get legitimate needs met
- C. acknowledge manipulative behavior when it is pointed out
- D. identify when he is experiencing feelings of anger
Correct Answer: C
Rationale: Rationale: Choice C is correct as it focuses on the patient acknowledging manipulative behavior when pointed out. This is important for growth and self-awareness in handling emotions and behaviors effectively. Choices A and B are extreme and unrealistic expectations, as complete cessation or selective use of manipulation may not be achievable. Choice D is irrelevant to the nursing diagnosis and does not address the core issue of ineffective coping through manipulation.