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A patient undergoing alcohol rehabilitation decides to accept disulfiram (Antabuse) therapy to avoid impulsively responding to drinking cues. Which information should be included in the discharge teaching for this patient? Select all that apply.
- A. Avoid aged cheeses.
- B. Read labels of all liquid medications.
- C. Wear sunscreen and avoid bright sunlight.
- D. Maintain an adequate dietary intake of sodium.
Correct Answer: B
Rationale: Step 1: Disulfiram causes a severe adverse reaction when combined with alcohol.
Step 2: Liquid medications may contain alcohol, causing a disulfiram-alcohol reaction.
Step 3: Reading labels of all liquid medications helps the patient avoid alcohol-containing products.
Step 4: A, C, and D are incorrect as they are not directly related to disulfiram therapy or alcohol avoidance.
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An older adult with Lewy body dementia lives with family. After observing multiple bruises, the home health nurse talked with the daughter, who became defensive and said, My mother often wanders at night. Last night she fell down the stairs. Which nursing diagnosis has priority?
- A. Risk for injury related to poor judgment, cognitive impairments, and inadequate supervision
- B. Wandering related to confusion and disorientation as evidenced by sleepwalking and falls
- C. Chronic confusion related to degenerative changes in brain tissue as evidenced by nighttime wandering
- D. Insomnia related to sleep disruptions associated with cognitive impairment as evidenced by wandering at night
Correct Answer: A
Rationale: The patient is at high risk for injury because of her confusion. The risk increases when caregivers are unable to give constant supervision. Insomnia, chronic confusion, and wandering apply to this patient; however, the risk for injury is a higher priority.
What are the fundamental concepts of dialectical behavioral therapy (DBT)?
- A. Patients are doing the best they can
- B. Patients are motivated and willing to change
- C. Radical acceptance is essential in therapy
- D. Mindfulness is key to managing emotions
Correct Answer: A
Rationale: The correct answer is A because the fundamental concept of DBT is that patients are doing the best they can. This acknowledges that individuals are trying their best with the skills they currently have. Radical acceptance (C) is a core principle in DBT, but it is not the most fundamental concept. While mindfulness (D) is a key component of DBT, it is not the overarching fundamental concept. Motivation and willingness to change (B) are important in therapy, but the primary focus of DBT is on accepting where the patient is currently at in their journey.
Complementary and alternative medicine (CAM) therapies have been growing in popularity and surveys show that they are being used to treat several mental health conditions. With these statistics in mind the nurse is careful to assess which client for the possible use of CAM therapies?
- A. The teenager who is dealing with sexual identity issues
- B. The older adult who has developed early onset dementia
- C. The young adult who is experiencing chronic pain as a result of a knee injury
- D. The middle-aged adult who is experiencing depression after the death of a parent
Correct Answer: D
Rationale: Rationale: The correct answer is D. The nurse should assess the middle-aged adult experiencing depression after the death of a parent for possible use of CAM therapies because depression is a common mental health condition that CAM therapies can help alleviate. The client's emotional distress and grief may benefit from holistic approaches like mindfulness meditation or acupuncture. It is important to address mental health conditions with appropriate interventions, and CAM therapies can be a valuable supplement to traditional treatments.
Summary:
A: While sexual identity issues are important, they do not necessarily indicate a need for CAM therapies in this context.
B: Early onset dementia is a neurological condition, and CAM therapies may not be the primary focus for treatment.
C: Chronic pain from a knee injury may require more conventional medical interventions before exploring CAM therapies for pain management.
Joe, a Native American, goes to the emergency department (ED) because he has an oozing stasis ulcer on his leg. He is accompanied by the tribal shaman, who has been treating Joe on the reservation. As greeting, the physician extends his hand to the shaman, who lightly touches the physician's hand, then quickly moves away. How should the physician interpret this gesture?
- A. The shaman is snubbing the physician.
- B. The shaman is angry at Joe for wanting to go to the ED.
- C. The shaman does not believe in traditional medicine.
- D. The shaman does not feel comfortable with touch.
Correct Answer: D
Rationale: The shaman's brief touch and quick withdrawal likely reflect cultural discomfort or unfamiliarity with physical touch, common in some Native American cultures, aligning with option d.
Which of the following is not a component of Bandura's theory
- A. Self-efficacy
- B. Reciprocal determinism
- C. Classical conditioning
- D. Behavioral capability
Correct Answer: C
Rationale: Classical conditioning is Pavlov's, not Bandura's; Bandura focused on social and cognitive factors.