Health Care Utilization by Age Group

Health Care Utilization by Age Group Related

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A victim of partner abuse, parent of one child, describes the partner as someone who is easily frustrated and more likely to be abusive after experiencing an event in which self-esteem is challenged. The most recent episodes of violence were related to feeling "upset" over a job loss. What type of therapy would provide the greatest help to the abuser?

  • A. Voluntary individual or group therapy
  • B. Court-ordered individual or group therapy
  • C. Voluntary couples or family therapy
  • D. Court-ordered couples or family therapy
Correct Answer: A

Rationale: The correct answer is A: Voluntary individual or group therapy. This type of therapy would provide the greatest help to the abuser because it focuses on addressing the underlying issues of frustration, self-esteem challenges, and abusive behavior. The key here is that the therapy is voluntary, which means the abuser is more likely to engage and actively participate in the process. In individual or group therapy, the abuser can explore and work on managing emotions, coping strategies, and developing healthier communication skills. Court-ordered therapy (choices B and D) may not be as effective because it could be seen as a punishment rather than a genuine effort to seek help. Couples or family therapy (choice C) may not be appropriate initially as the focus should be on the abuser's personal growth and behavior change.

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Which of the following combines the best treatments for postpartum blues?

  • A. Antidepressants, sleep, crisis intervention
  • B. Rest, support, compassion
  • C. Mother-baby bonding session, family education, antidepressants
  • D. Analgesics for post-delivery pain, rest, longer hospital stay
Correct Answer: B

Rationale: Antidepressants have no use in postpartum blues (A, C). Rest, support, and compassion (B) are the main interventions for this self-limiting condition, unlike analgesics or extended hospital stays (D).

A nurse assessing an elderly patient for depression and suicide potential should include questions about mood as well as: (Select one tha does not apply)

  • A. anhedonia.
  • B. increased appetite.
  • C. sleep pattern changes.
  • D. increased concerns with bodily functions.
Correct Answer: B

Rationale: The correct responses (A, C, E) relate to symptoms often noted in elderly patients with depression: anhedonia (loss of pleasure), sleep changes, and somatic concerns. Increased appetite (B) is less typical than anorexia, and grandiosity (D) relates to bipolar disorder, not depression.

A disorder that interrupts normal sleep patterns and is characterized by repeated, brief jerks of the arms and legs that occur every 20 to 60 seconds during the beginning of sleep is called:

  • A. Insomnia.
  • B. Narcolepsy.
  • C. Hypersomnia.
  • D. None of the above.
Correct Answer: D

Rationale: The correct answer is D: None of the above. The disorder described in the question is Periodic Limb Movement Disorder (PLMD), not any of the options provided. PLMD involves involuntary movements during sleep, which are different from the symptoms of insomnia, narcolepsy, or hypersomnia. Insomnia is difficulty falling or staying asleep, narcolepsy is a neurological disorder characterized by excessive daytime sleepiness, and hypersomnia is excessive daytime sleepiness despite getting enough sleep. Therefore, the correct answer is D as none of the provided options accurately describe the specific disorder mentioned in the question.

A nurse is caring for a patient with bulimia nervosa. What should the nurse do to promote a healthy eating pattern?

  • A. Provide a strict, rigid eating schedule without flexibility.
  • B. Allow the patient to choose meals without any guidelines.
  • C. Encourage regular meals and snacks with a focus on nutrition.
  • D. Promote food restriction to avoid feelings of guilt after eating.
Correct Answer: C

Rationale: The correct answer is C because encouraging regular meals and snacks with a focus on nutrition helps stabilize blood sugar levels, reduce binge eating episodes, and promote overall health. This approach also supports the patient in developing a balanced relationship with food.

A: Providing a strict, rigid eating schedule may increase anxiety and reinforce unhealthy behaviors.
B: Allowing the patient to choose meals without guidelines may lead to erratic eating patterns and poor nutrition.
D: Promoting food restriction can exacerbate feelings of guilt and perpetuate the cycle of binge eating.

The client tells the nurse, 'I thought my psychiatrist was the best doctor in the world. I thought he understood me completely. Now, I hate him! He doesn't understand me at all. He's just dumping me to go on a 2-week vacation.' The nurse assesses the client's description of feelings about the physician as evidence of the use of:

  • A. Splitting
  • B. Projective identification
  • C. Isolation of affect
  • D. Dissociation
Correct Answer: A

Rationale: The correct answer is A: Splitting. Splitting is a defense mechanism where a person sees things as all good or all bad, leading to extreme shifts in perception. In this case, the client initially viewed the psychiatrist as the best doctor but now hates him completely due to feeling abandoned. This sudden shift from idealization to devaluation is characteristic of splitting.

Choice B: Projective identification involves attributing one's own unacceptable feelings or traits onto another. This is not evident in the client's description.

Choice C: Isolation of affect refers to separating emotions from their source. The client is expressing strong emotions towards the psychiatrist, not isolating them.

Choice D: Dissociation involves a disruption in consciousness, memory, identity, or perception. The client is not displaying symptoms of dissociation in this scenario.

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