Nokea
A staff nurse expresses frustration that a Native American patient always has several family members at the bedside. Which action by the charge nurse is most appropriate?
- A. Remind the nurse that family support is important to this family and patient.
- B. Have the nurse explain to the family that too many visitors will tire the patient.
- C. Suggest that the nurse ask family members to leave the room during patient care.
- D. Ask about the nurse's personal beliefs about family support during hospitalization.
Correct Answer: D
Rationale: The first step in providing culturally competent care is to understand one's own beliefs and values related to health and health care. Asking the nurse about personal beliefs will help achieve this step. Reminding the nurse that this cultural practice is important to the family and patient will not decrease the nurse's frustration. The remaining responses, such as suggesting that the nurse ask family members to leave the room or having the nurse explain to the family that too many visitors will tire the patient, are not culturally appropriate for this patient.
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A 19-year-old client is paralyzed in a car accident. Which statement used by the client would indicate to the nurse that the client was using the mechanism of 'suppression'?
- A. "I don't remember anything about what happened to me."?
- B. "I'd rather not talk about it right now."?
- C. "It's the other entire guy's fault! He was going too fast."?
- D. "My mother is heartbroken about this."?
Correct Answer: A
Rationale: The correct answer is, '"I don't remember anything about what happened to me."?' Suppression involves willfully putting an unacceptable thought or feeling out of one's mind. In this case, the client is purposely choosing not to remember details of the traumatic event to avoid dealing with the associated emotions. Choice B, '"I'd rather not talk about it right now,"?' suggests avoidance or deflection rather than active suppression. Choice C, '"It's the other entire guy's fault! He was going too fast,"?' indicates blaming someone else for the situation, which is a form of defense mechanism known as externalization. Choice D, '"My mother is heartbroken about this,"?' expresses empathy towards the mother's emotions and does not demonstrate suppression of personal feelings.
The nurse develops a goal that makes a client feel as if they are engaging in a competition. Which type of motivation is the nurse using in this situation?
- A. Power motivation
- B. Affiliative motivation
- C. Avoidance motivation
- D. Achievement motivation
Correct Answer: A
Rationale: The nurse is using power motivation in this situation. Power-motivated individuals tend to have assertive and aggressive behavior. By designing goals that make clients feel like they are in a competition, the nurse appeals to their need for power and accomplishment, even when they are competing against themselves. Affiliative motivation is characterized by nonassertive behavior and dependence on others, which is not applicable here. Avoidance motivation focuses on anxiety, fear of failure, and phobias, which are not relevant to the scenario. Achievement motivation does not involve aggressive behavior or the need for competition, making it an incorrect choice for this scenario.
A client had a first-trimester abortion and has been unable to function for 3 months. Which type of grief is the client experiencing?
- A. Complex bereavement
- B. Anticipatory
- C. Disenfranchised
- D. Complicated
Correct Answer: C
Rationale: The client is experiencing disenfranchised grief. Disenfranchised grief refers to grief over a loss that is not socially recognized or acknowledged. In this case, grief after an abortion falls into this category. It can lead to prolonged emotional distress as the loss may not be openly acknowledged or supported by others. Complex bereavement is characterized by dysfunctional grieving that extends beyond 12 months. Anticipatory grief occurs when the loss is expected or predictable, allowing individuals to start the grieving process before the actual loss. Complicated grief is marked by an inability to progress through the grief stages, leading to intense feelings of depression, anger, and emptiness, often coupled with a preoccupation with the deceased.
After attending group therapy, the client says, 'It helps to know that I'm not the only one with this type of problem.' Which concept does this statement reflect?
- A. Altruism
- B. Catharsis
- C. Universality
- D. Transference
Correct Answer: C
Rationale: The client's statement reflects the concept of universality. Universality in group therapy signifies the understanding that one is not alone in their struggles, providing a sense of commonality and support among group members facing similar challenges. Altruism in group therapy involves offering support, insight, and encouragement to others, fostering personal growth and self-awareness. Catharsis pertains to group members sharing and expressing both negative and positive emotions with each other. Transference occurs when a client inadvertently projects feelings and perceptions onto the therapist that originally belonged to someone significant in their past, impacting the therapeutic relationship.
The family of a child with cerebral palsy (CP) is at risk for difficult parenting issues. Which basis would the nurse conclude as the probable cause for this difficulty?
- A. Lack of social support
- B. Unrealistic expectations
- C. Loss of the expected healthy child
- D. Having a child with cognitive impairment
Correct Answer: C
Rationale: The correct answer is 'Loss of the expected healthy child.' Parents of a child with cerebral palsy often grieve the loss of the healthy child they expected, mourning what could have been and what may never be. While lack of social support can contribute to parenting difficulties, it is not the primary basis in this case. Unrealistic expectations may play a role for some parents, but not all. Additionally, it is important to note that not all children with cerebral palsy experience cognitive impairment; around 30% to 50% of children with cerebral palsy have cognitive challenges.