Nokea
A patient newly diagnosed with pancreatic cancer says, My father also died of pancreatic cancer. I took care of him during his illness. I can't go through that. Select the highest priority nursing diagnosis.
- A. Anticipatory grieving
- B. Ineffective coping
- C. Ineffective denial
- D. Risk for suicide
Correct Answer: D
Rationale: The patients statement has a subtle message of suicide. Suicide is a risk for people with major losses, including terminal disease. The nurse will need to monitor the suicide risk vigilantly. The other diagnoses may apply but are lower priority.
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What type of antidepressant medication is not frequently used due to its lethality in overdose?
- A. Tricyclic antidepressants (TCAs)
- B. Selective serotonin reuptake inhibitors (SSRIs)
- C. GI upset
- D. Divalproex (Depakote)
Correct Answer: A
Rationale: The correct answer is A: Tricyclic antidepressants (TCAs). TCAs are not frequently used due to their high lethality in overdose. They have a narrow therapeutic index, leading to severe toxicity even at slightly higher doses. In overdose, TCAs can cause life-threatening cardiovascular and central nervous system effects. SSRIs (B) are safer in overdose compared to TCAs. GI upset (C) is a common side effect of many medications, not specifically antidepressants. Divalproex (D) is not an antidepressant medication, but rather a mood stabilizer primarily used in bipolar disorder.
Which of the following may be the most effective approach to ensure good communication with a large family of a hospitalized patient?
- A. Ask the family to choose an individual to be the point of contact with the health care team
- B. Appoint the person who spends the most time at the patient's bedside to be the point of contact with the health care team
- C. Listen to each family member's individual concerns
- D. Arrange a daily meeting with the entire family to discuss the patient's health care
Correct Answer: A
Rationale: A single point of contact streamlines communication while respecting family involvement.
The most appropriate crisis intervention with Amanda (from question 3) would be to:
- A. Encourage her to recognize how lucky she is to be alive.
- B. Discuss stages of grief and feelings associated with each.
- C. Identify community resources that can help Amanda.
- D. Suggest that she find a place to live that provides a storm shelter.
Correct Answer: C
Rationale: The correct answer is C because identifying community resources can provide immediate support and assistance to Amanda during the crisis. This approach focuses on practical help and solutions tailored to her specific needs. Encouraging her to recognize her luck (A) may invalidate her feelings, discussing grief stages (B) may not address her immediate needs, and suggesting finding a place with a storm shelter (D) does not directly address her current crisis.
The belief stated in the previous question is more common among which of the following ethnic groups?
- A. Hispanic
- B. Caucasian
- C. Asian
- D. African American
Correct Answer: D
Rationale: This belief is notably prevalent among African Americans, per cultural studies.
Which of the following personnel do has the “right to know†medical information?
- A. The facility's Performance Improvement Director who is not a healthcare person and who has no direct contact with clients
- B. A nursing student who is caring for a client under the supervision of the nursing instructor
- C. The facility's Safety Officer who is not a healthcare person and who has no direct contact with clients
- D. A department supervisor with no direct or indirect care duties
Correct Answer: B
Rationale: Personnel without direct client contact generally do not have the 'right to know'.