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A patient tells a nurse, 'The others won't give me my pain meds early, but you are more understanding, you know what it's like to be in pain, and you don't want to see your patients suffer. Could you find a way to get me my pill now? I won't tell anyone.' Which response by the nurse would be most therapeutic?
- A. I'm not comfortable doing that,' then ignore subsequent requests for early meds.
- B. I'll have to check with your doctor about that; I will get back to you after I do.'
- C. It would be unsafe to give the medicine early; none of us will do that.'
- D. I understand that you have pain, but giving medicine too soon would not be safe.'
Correct Answer: D
Rationale: Step 1: Acknowledge the patient's pain and show understanding.
Step 2: Emphasize the importance of safety in medication administration.
Step 3: Set clear boundaries by explaining why giving medicine too soon is unsafe.
Step 4: Reiterate empathy for the patient's pain while prioritizing safety.
Summary: Answer D is correct as it acknowledges the patient's pain, emphasizes safety, sets clear boundaries, and maintains empathy. Other choices either ignore the patient's request, defer responsibility, or solely focus on safety without empathy.
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Which theme is most likely during family therapy with parents, siblings, and a teen patient with anorexia nervosa who engages in provocative behavior?
- A. Stable coalitions between family members
- B. Interpreting negative messages as positive
- C. Competition between the patient and father
- D. Lack of trust in the patient by family members
Correct Answer: C
Rationale: The correct answer is C: Competition between the patient and father. In family therapy with a teen patient with anorexia nervosa, the theme of competition between the patient and a parental figure, often the father, can be prominent. The rationale is that the father's influence and expectations can contribute to the teen's feelings of inadequacy and drive for control through anorexic behaviors. This dynamic can be explored and addressed in therapy to improve family relationships and support the patient's recovery.
A: Stable coalitions between family members - This is less likely as anorexia nervosa often disrupts family dynamics.
B: Interpreting negative messages as positive - While this can be a relevant theme, it is not as central to the specific scenario described.
D: Lack of trust in the patient by family members - While trust issues may exist, the theme of competition is more relevant in this context.
A client experiences intrusive, insulting auditory hallucinations. Which independent behavioral technique can the nurse teach the client to employ when the voices are troublesome?
- A. Take additional antipsychotic medication
- B. Lie down in bed and try to sleep
- C. Sing or whistle to compete with the voices
- D. Eat a large portion of chocolate
Correct Answer: C
Rationale: The correct answer is C: Sing or whistle to compete with the voices. This technique is effective as it can help distract the client from the intrusive auditory hallucinations. By engaging in singing or whistling, the client can shift their focus away from the voices, making them less bothersome. This method can also empower the client by giving them a sense of control over the situation.
Other choices are incorrect:
A: Taking additional antipsychotic medication may not be necessary in this situation and should be prescribed by a healthcare provider.
B: Lying down and trying to sleep may not address the immediate distress caused by the hallucinations.
D: Eating a large portion of chocolate is not a valid behavioral technique for managing auditory hallucinations.
What is the primary source of mental stimulation in early childhood?
- A. Television
- B. Parental interaction
- C. Toys
- D. School lessons
Correct Answer: B
Rationale: Parental interaction (B) provides responsive, tailored stimulation critical for early mental development. TV (A) and toys (C) are less interactive, and school lessons (D) come later.
A client who has been diagnosed as having bulimia nervosa is hospitalized for treatment of electrolyte imbalance. Just before lunch is finished, the client leaves the table and walks quickly in the direction of the bathroom. The nurse should say:
- A. No one is allowed to leave the dining room during meals.'
- B. I must accompany you when you go to the bathroom.'
- C. I think I understand your plan, and I cannot permit you to carry it out.'
- D. Wouldn't it be preferable to exercise rather than vomit?'
Correct Answer: B
Rationale: The correct answer is B because accompanying the client to the bathroom is essential to prevent purging behavior associated with bulimia nervosa. By doing so, the nurse can provide support, monitor the client, and intervene if necessary to ensure the client's safety. Choice A is incorrect as it may come across as punitive and restrictive. Choice C is incorrect as it may escalate the situation and lead to confrontation. Choice D is incorrect as it suggests an alternative behavior without addressing the immediate concern of potential purging. Accompanying the client to the bathroom is the most appropriate and therapeutic response in this situation.
A man who reports frequently experiencing premature ejaculation tells the nurse, 'I feel like such a failure. It's so awful for both me and my partner. Can you help me?' Select the nurse's best response.
- A. Have you discussed this problem with your partner?
- B. I can refer you to a practitioner who can help you with this problem.
- C. Have you asked your health care provider for prescription medication?
- D. There are several techniques described in this pamphlet that might be helpful.
Correct Answer: B
Rationale: The correct answer is B because the nurse should refer the patient to a practitioner who specializes in treating premature ejaculation. This is the best response as it ensures the patient receives specialized care and treatment tailored to his needs. Referring to a specialist increases the likelihood of successful intervention and addresses the patient's concerns effectively.
Choices A, C, and D are incorrect. Choice A focuses on communication with the partner, which is important but not the primary intervention for premature ejaculation. Choice C suggests prescription medication without exploring other treatment options or assessing the patient's individual situation. Choice D provides general information without addressing the patient's emotional distress or offering specific help from a professional.