A victim of a sexual assault sits in the emergency department rocking back and forth. This behavior is characteristic of:
- A. The acute phase reaction.
- B. The angry stage of rape.
- C. Trauma syndrome.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: The acute phase reaction. This behavior is common in the immediate aftermath of a traumatic event like sexual assault. The victim may exhibit physical and emotional symptoms such as rocking back and forth, confusion, disorientation, and numbness. This reaction is a natural response to the overwhelming stress and trauma experienced. Choice B, the angry stage of rape, is incorrect as it does not capture the immediate post-assault response. Choice C, trauma syndrome, is too vague and does not specifically address the behavior described. Choice D, None of the above, is incorrect as the victim's behavior aligns with the acute phase reaction typically seen in trauma survivors.
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A 63-year-old female has been admitted to the hospital for cholecystitis. She is accompanied by her sister, who provides all the assessment data while the client sits and stares somewhat vacantly. You determine that the client is single, lives alone, and lost her job as a secretary last year when she was unable to learn a new computer system. The sister states she has recently had to manage the client's shopping, meal preparation, and finances. Which of the following are appropriate nursing diagnoses?
- A. Pain, self-care deficits, situational low self-esteem
- B. Anxiety, self-care deficits, disturbed thought processes
- C. Impaired home maintenance, disturbed thought process, impaired verbal communication
- D. Disturbed body image, anxiety, pain
Correct Answer: C
Rationale: The correct answer is C: Impaired home maintenance, disturbed thought process, impaired verbal communication.
Rationale:
1. Impaired home maintenance: The client is unable to take care of herself and her living environment due to the need for assistance in shopping, meal preparation, and finances.
2. Disturbed thought process: The client's vacant stare and inability to learn new tasks suggest cognitive impairment or confusion.
3. Impaired verbal communication: The client's lack of verbal interaction and reliance on her sister for assessment data indicate difficulties in expressing herself.
Summary:
A: Pain, self-care deficits, situational low self-esteem - Pain is not mentioned in the scenario, and the client's issues go beyond self-care deficits and low self-esteem.
B: Anxiety, self-care deficits, disturbed thought processes - While anxiety and disturbed thought processes may be present, impaired home maintenance and impaired verbal communication are more appropriate diagnoses based on the scenario.
D: Disturbed body image, anxiety, pain - Disturbed
The antisocial personality is one who
- A. is irresponsible and seems to lack remorse
- B. is frequently dangerous and out of contact with reality
- C. is always a delinquent or criminal
- D. benefits greatly from humanistic and psychoanalytic therapies
Correct Answer: A
Rationale: Antisocial personality features irresponsibility and lack of remorse, not necessarily overt danger.
What is the correct assessment for a patient with bulimia nervosa who frequently engages in purging behaviors?
- A. Observe for parotid gland enlargement and dehydration.
- B. Assess for fluid retention and leg swelling.
- C. Perform regular weight checks to assess for weight loss.
- D. Evaluate for signs of hyperactivity and poor sleep.
Correct Answer: A
Rationale: The correct assessment for a patient with bulimia nervosa who frequently engages in purging behaviors is to observe for parotid gland enlargement and dehydration. Parotid gland enlargement is a common physical manifestation due to repeated vomiting, and dehydration can result from purging behaviors. This assessment is crucial in monitoring the patient's physical health and identifying potential complications. Assessing for fluid retention and leg swelling (Choice B) is more typical in conditions like heart failure. Performing weight checks (Choice C) may not accurately reflect the patient's health status due to fluid shifts. Evaluating for signs of hyperactivity and poor sleep (Choice D) are not directly related to the immediate physical consequences of purging behaviors.
Which of the following is the first-line treatment for Anorexia Nervosa?
- A. Family-Based Therapy
- B. Cognitive Behavioural Therapy
- C. Psychodynamic therapy
- D. Humanistic therapy
Correct Answer: A
Rationale: Family-Based Therapy (FBT) is the evidence-based first-line treatment for Anorexia Nervosa in adolescents, per NICE and APA guidelines.
An advance directive gives legally binding direction for health care interventions when a patient:
- A. has a new diagnosis of cancer
- B. is diagnosed with Parkinsons disease
- C. is unable to make decisions for self because of illness
- D. diagnosed with amyotrophic lateral sclerosis is unable to speak
Correct Answer: C
Rationale: Advance directives are invoked when patients are unable to make their own health care decisions. The correct response is the most global answer. A diagnosis of cancer or Parkinsons disease does not mean the patient is unable to make a decision. For a patient with amyotrophic lateral sclerosis, there are other ways to communicate beyond speaking.