Nokea
A teen states, "I miss my dog so much, but if I start crying, I will never stop." This reflects a fear of:
- A. Losing control over her emotions
- B. Losing the support of her friends and family
- C. Embarrassing herself by crying in public
- D. Appearing emotionally immature
Correct Answer: A
Rationale: The correct answer is A because the teen is expressing a fear of losing control over her emotions if she starts crying. This is evident from her belief that she will never stop crying once she starts. Option B (Losing the support of her friends and family) is incorrect as the statement does not suggest concern about losing support. Option C (Embarrassing herself by crying in public) is incorrect as the fear expressed is more about not being able to stop crying rather than embarrassment. Option D (Appearing emotionally immature) is incorrect as there is no indication that the teen is worried about how others perceive her emotional maturity.
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When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value?
- A. Evidence of spasticity or flaccidity
- B. Medications the patient has recently taken.
- C. Level of preoccupation with somatic symptoms
- D. The patient’s level of motor activity
Correct Answer: B
Rationale: The correct answer is B: Medications the patient has recently taken. This is crucial because certain medications can cause delirium in elderly patients. Step 1: Evaluate recent medication history. Step 2: Identify medications known to cause delirium. Step 3: Determine if the patient has taken any of these medications. Other choices are incorrect because: A: Evidence of spasticity or flaccidity is more related to neuromuscular conditions. C: Level of preoccupation with somatic symptoms is not specific to delirium assessment. D: The patient’s level of motor activity is not a key factor in distinguishing delirium from other problems.
Family and friends rush to offer support to a friend who has lost her teenage son. Which of these persons, through an intended act of kindness, may contribute to prolonging the woman’s grief?
- A. The physician who prescribed antianxiety agents
- B. The nurse who offered to spend the night at her home
- C. The next-door teenager who provided care for the son’s pet
- D. The accountant who assisted with stabilizing financial affairs.
Correct Answer: A
Rationale: The correct answer is A because prescribing antianxiety agents may mask the woman's grief instead of allowing her to process and work through it naturally. This could potentially prolong her grief by avoiding the necessary emotional processing. The other choices, B, C, and D, all involve support that can help the woman cope with her loss in a healthy way. B offers emotional support and companionship, C helps with practical tasks, and D provides assistance in managing practical matters, all of which can facilitate the grieving process rather than prolong it.
Which patient would the nurse determine to be at highest risk for dysfunctional grief? The patient:
- A. Whose 16-year-old daughter was raped and killed while going on an errand for the patient
- B. Whose 86-year-old mother, with whom she has shared her home, died after a long illness.
- C. Who attended a support group and had been assisted by hospice to care for her terminally
- D. Who attended a bereavement group, where she learned to express feelings after the deaths of her twin daughters
Correct Answer: A
Rationale: The correct answer is A because the patient whose 16-year-old daughter was raped and killed while going on an errand for the patient is at highest risk for dysfunctional grief. This traumatic and unexpected loss of a child to a violent act can lead to complicated or prolonged grief reactions. The sudden and violent nature of the death, along with the added trauma of rape, can significantly impact the grieving process. The intense emotions and feelings of guilt, anger, and helplessness may complicate the bereavement process and lead to dysfunctional grief reactions.
Summary:
Choice B is incorrect because the death of an 86-year-old mother after a long illness, although sad, does not necessarily indicate a higher risk of dysfunctional grief. Choice C is incorrect as attending a support group and receiving assistance from hospice are positive factors that can support healthy grieving. Choice D is incorrect as attending a bereavement group and learning to express feelings after the deaths of twin daughters indicate active engagement in the grieving process, which is
Planning safety interventions for a teenager with a history of self-injurious behavior is based on what research-based information?
- A. Teenagers rarely entertain the idea of suicide.
- B. Self-injury is always viewed as a risk factor for future suicidal attempts.
- C. Assessment for suicidal ideations is a vital component of this child's care.
- D. Suicides can occur accidentally as a result of self-injurious behaviors.
Correct Answer: D
Rationale: The correct answer is D because research indicates that suicides can occur accidentally as a result of self-injurious behaviors. This is known as an unintentional suicide, where the individual did not intend to die but died due to the severity of their self-injurious behavior. This information is crucial for planning safety interventions for the teenager, as it highlights the potential seriousness of self-injury.
Choice A is incorrect because research shows that suicidal ideation is not uncommon among teenagers, so it cannot be assumed that they rarely entertain the idea of suicide. Choice B is also incorrect because while self-injury can be a risk factor for future suicidal attempts, it is not always the case. Choice C is relevant but not the most specific to the scenario presented in the question, as it focuses solely on suicidal ideations rather than the potential accidental outcomes of self-injury.
Which person would the nurse assess as experiencing chronic sorrow?
- A. The mother of a child diagnosed with asthma
- B. The father of an adult son who is a schizophrenic
- C. The daughter whose father experienced a hip replacement
- D. The wife whose husband has recently requested a trial separation
Correct Answer: B
Rationale: The correct answer is B because chronic sorrow is a continuous feeling of grief or sadness that occurs when there is a discrepancy between the reality of a situation and the individual's expectations or hopes. In this case, the father of an adult son who is schizophrenic is likely to experience chronic sorrow due to the ongoing challenges and difficulties associated with his son's mental illness. This long-term impact on his emotional well-being aligns with the concept of chronic sorrow.
Choices A, C, and D do not necessarily imply a long-term or continuous feeling of grief. The mother of a child with asthma may experience anxiety or distress during asthma attacks, but it may not necessarily lead to chronic sorrow. The daughter whose father had a hip replacement may experience temporary worry or concern but not chronic sorrow. The wife whose husband requested a trial separation may experience sadness and distress, but it is not a situation that inherently leads to chronic sorrow.