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A young, newly married adult says, 'My spouse never lets me out of sight. I'm not allowed to do anything on my own, and I'm constantly accused of cheating.' Which nursing communication is most therapeutic for this patient?
- A. Have you discussed the behavior with your spouse?'
- B. How does your spouse's behavior make you feel?'
- C. Are there other examples of controlling behaviors on your spouse's part?'
- D. Do you feel that your spouse has anything to be upset or suspicious about?'
Correct Answer: B
Rationale: The correct answer is B: "How does your spouse's behavior make you feel?" This question focuses on the patient's emotions, allowing them to express their feelings and validating their experiences. It shows empathy and encourages the patient to explore and understand their own emotional responses to the situation.
Choice A focuses on addressing the behavior directly without acknowledging the patient's emotions. Choice C asks for more examples of controlling behavior, which may feel judgmental. Choice D suggests that the spouse's behavior is justified, which can further invalidate the patient's feelings. Overall, choice B is the most therapeutic as it promotes emotional exploration and support.
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A physically frail elderly patient with mild cognitive impairments needs services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this patient during the evening and night. Which type of facility should the nurse suggest to meet this patient's needs?
- A. Adult day care program
- B. Skilled nursing facility
- C. Partial hospitalization
- D. Group home
Correct Answer: A
Rationale: The correct answer is A: Adult day care program. This option is suitable as it provides supervision, safety, recreation, and social interaction during the day while allowing the family to care for the patient in the evening and night. Adult day care programs offer a structured environment with trained staff to ensure the patient's safety and provide social engagement.
- Option B, Skilled nursing facility, is not the best choice as it usually provides round-the-clock care, which may not be necessary in this case.
- Option C, Partial hospitalization, is more focused on intensive psychiatric treatment and therapy, which may not align with the patient's needs.
- Option D, Group home, is designed for individuals who need 24-hour care and supervision, which exceeds the patient's current requirements.
Which instruction has priority when teaching a patient taking clozapine (Clozaril)?
- A. Avoid unprotected sex.
- B. Report sore throat and fever immediately.
- C. Reduce foods high in polyunsaturated fats.
- D. Use over-the-counter preparations for rashes.
Correct Answer: B
Rationale: The correct answer is B: Report sore throat and fever immediately. This is because clozapine can cause a serious condition called agranulocytosis, which is characterized by a dangerously low white blood cell count. Sore throat and fever can be early signs of this condition, so it is crucial to report them immediately to prevent serious complications.
Avoiding unprotected sex (choice A) is important for overall health but is not directly related to clozapine use. Reducing foods high in polyunsaturated fats (choice C) is not a priority as it does not impact the safety or effectiveness of clozapine. Using over-the-counter preparations for rashes (choice D) is not advised as rashes can be a side effect of clozapine, and professional medical advice should be sought.
A patient remanded by the court after his wife had him jailed for battery told the judge how sorry he was and suggested he needed psychiatric help. His history reveals acting-out behaviors as an adolescent and several adult arrests. The nurse interviews him about his relationship with his wife. Which statement by the patient is most consistent with a diagnosis of antisocial personality disorder?
- A. I've done some stupid things in my life, but I've learned a lesson.'
- B. I'm feeling terrible about the way my behavior has hurt my family.'
- C. I have a quick temper, but I can usually keep it under control.'
- D. I hit her because she nags at me. She deserves it when I beat her up.'
Correct Answer: D
Rationale: The correct answer is D. This statement reflects a lack of remorse, empathy, and justification for violent behavior, which are key characteristics of antisocial personality disorder. The patient blames his wife for his violent actions and shows a sense of entitlement.
A: This statement shows acknowledgment of mistakes and a willingness to learn from them, which is not consistent with antisocial personality disorder.
B: Expressing feeling terrible about hurting family members demonstrates some level of empathy and remorse, which is not typical of individuals with antisocial personality disorder.
C: Acknowledging a quick temper but being able to control it does not align with the impulsivity and lack of control often seen in individuals with antisocial personality disorder.
What is the most effective strategy for preventing relapse in a patient with anorexia nervosa?
- A. Providing a rigid, inflexible meal plan with strict weight goals.
- B. Offering therapy to address both physical and emotional factors.
- C. Encouraging the patient to lose weight to maintain control.
- D. Focusing on body image improvement before addressing nutrition.
Correct Answer: B
Rationale: The correct answer is B because offering therapy to address both physical and emotional factors is the most effective strategy for preventing relapse in a patient with anorexia nervosa. This approach helps the patient develop coping skills, explore underlying issues, and learn healthier ways to manage emotions and stress. By addressing both physical and emotional factors, the patient can build a strong support system, improve self-esteem, and work towards a sustainable recovery.
Choice A is incorrect because providing a rigid, inflexible meal plan with strict weight goals may increase anxiety and reinforce harmful behaviors associated with anorexia nervosa. Choice C is incorrect as encouraging the patient to lose weight to maintain control can perpetuate the disorder and increase the risk of relapse. Choice D is incorrect because focusing on body image improvement before addressing nutrition neglects the essential aspect of nutrition in recovery and may lead to distorted perceptions of health.
A nurse is working with a patient diagnosed with bulimia nervosa. Which of the following would indicate the need for further education?
- A. I know that purging is harmful to my health, but I continue to do it.
- B. I feel better after purging, but I realize it is not a long-term solution.
- C. I can control my eating and purging behaviors without help from others.
- D. I am working with my healthcare team to improve my eating habits and emotional health.
Correct Answer: C
Rationale: The correct answer is C because it indicates a lack of awareness about the severity of the disorder. Choice A acknowledges the harm of purging but struggles to stop, showing insight. Choice B recognizes the temporary relief of purging but understands the need for a better solution. Choice D demonstrates active engagement with healthcare professionals for support. In contrast, choice C suggests overconfidence in managing the disorder independently, which can hinder recovery progress. It is crucial for individuals with bulimia nervosa to acknowledge the need for professional help and support.