Nokea
A young woman had just learned of the accidental death of her husband. She begins to cry
and states, Its not fair! How could he do this to me? This remark is assessed as:
- A. A plea for help
- B. An explosive episode
- C. An expression of anger
- D. Fear of making decisions alone
Correct Answer: C
Rationale: The correct answer is C, an expression of anger. The woman's statement "It's not fair! How could he do this to me?" indicates feelings of anger and resentment towards her husband for leaving her unexpectedly. This response does not show a plea for help (A), as she is expressing her emotions rather than seeking assistance. It is also not an explosive episode (B) as there is no indication of sudden outbursts or intense emotional reactions. Similarly, it is not about fear of making decisions alone (D) as her statement focuses on her feelings of unfairness and betrayal. In summary, the woman's remark reflects her anger and sense of injustice following her husband's accidental death.
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A teen is grieving the loss of her pet dog. She states to her mother, “I miss my dog so much, but I know that if I start crying, I will never stop.” The teen is expressing a fear of:
- A. Appearing emotionally immature
- B. Embarrassing herself by crying in public
- C. Losing the support of her friends and family.
- D. Losing control over her emotions.
Correct Answer: D
Rationale: The correct answer is D: Losing control over her emotions. The teen's statement indicates a fear of losing control if she starts crying. This fear suggests that she believes crying will lead to an inability to stop, indicating a concern about managing her emotions. This fear of losing control over her emotions aligns with the teen's hesitance to express her grief through tears.
A: Appearing emotionally immature - This choice is incorrect as the teen's statement does not directly suggest a fear of appearing emotionally immature.
B: Embarrassing herself by crying in public - This choice is incorrect as the teen's statement does not mention a fear of embarrassment.
C: Losing the support of her friends and family - This choice is incorrect as the teen's statement does not indicate a fear of losing support from others.
A patient is scheduled to attend an occupational therapy group to work on the identified goal of “recognizing and using more effective coping techniques.” What measure can the nurse use to continue to support the patient’s attainment of this goal after he returns to the unit?
- A. Praising him for positive behavioral changes
- B. Avoiding setting limits that would increase his anxiety level
- C. Isolating him from more seriously ill patients
- D. Recommending that he avoid group activities for a while
Correct Answer: A
Rationale: The correct answer is A: Praising him for positive behavioral changes. This measure reinforces the patient's use of effective coping techniques, providing positive feedback and motivation. This positive reinforcement encourages the patient to continue utilizing these strategies.
Choices B, C, and D are incorrect:
B: Avoiding setting limits that would increase his anxiety level - This does not actively support the patient's goal of recognizing and using more effective coping techniques.
C: Isolating him from more seriously ill patients - Isolation does not promote the practice of coping techniques and may hinder the patient's social interaction and progress.
D: Recommending that he avoid group activities for a while - Avoiding group activities contradicts the goal of attending occupational therapy groups and working towards improved coping techniques.
The nurse is assessing a child with autism. Which of the following behaviors would the nurse expect to observe?
- A. Referring to their imaginary friend, Skipper
- B. Asking to telephone my friends on the weekends
- C. Repeating, milk, milk, milk, milk until given a drink.
- D. Is insistent that a dim light be left on in the bedroom at night
Correct Answer: C
Rationale: The correct answer is C: Repeating, milk, milk, milk, milk until given a drink. This behavior is a characteristic of children with autism, known as echolalia. Echolalia is the repetition of words or phrases spoken by others, often used by individuals with autism to communicate or self-soothe. This behavior is a common feature of autism spectrum disorder and is indicative of language difficulties and communication challenges.
Choices A, B, and D are incorrect because they do not specifically relate to behaviors typically observed in children with autism. Referring to an imaginary friend (A) is not exclusive to autism, asking to telephone friends on weekends (B) is a social behavior that can be seen in children without autism, and insisting on a dim light in the bedroom (D) is a preference that does not directly relate to the core characteristics of autism.
Which description is characteristic of an impulsive child?
- A. Running out into the street regardless of frequent instruction to look both ways first.
- B. Pacing and speaking in a very loud, disruptive voice
- C. Frequently talking about hearing voices telling him what to do
- D. Having a difficult time concentrating on reading since his attention is easily diverted
Correct Answer: A
Rationale: The correct answer is A. An impulsive child typically acts without thinking or considering consequences, such as running into the street without looking. This behavior is impulsive, risky, and disregards safety instructions. Choices B and C describe behaviors that are more indicative of other issues like hyperactivity or hallucinations. Choice D suggests difficulty concentrating, which is not directly related to impulsivity. In summary, the key characteristic of an impulsive child is acting quickly without considering potential dangers or instructions.
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. The patient’s level of motor activity
- C. Medications the patient has recently taken
- D. Level of preoccupation with somatic symptoms
Correct Answer: C
Rationale: The correct answer is C: Medications the patient has recently taken. This information is crucial because certain medications can cause symptoms of delirium or exacerbate confusion in elderly patients. By reviewing the patient's recent medications, healthcare providers can identify potential drug-induced causes of confusion and adjust the treatment accordingly.
Choice A (Evidence of spasticity or flaccidity) is incorrect because these symptoms are more related to neurological conditions such as stroke or spinal cord injury, not specifically delirium.
Choice B (The patient’s level of motor activity) is not as relevant in distinguishing delirium from other problems as medication history, as motor activity can be influenced by various factors.
Choice D (Level of preoccupation with somatic symptoms) is also less relevant compared to medication history in differentiating delirium, as somatic symptoms may not always directly indicate the underlying cause of confusion in elderly patients.