Population Based Health Care

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According to Freud, an individual who experiences problems during the phallic stage of development may have a poorly developed superego. This construct is most relevant to planning care for a client who has the DSM-IV-TR diagnosis of:

  • A. Obsessive-compulsive personality disorder
  • B. Schizoid personality
  • C. Borderline personality disorder
  • D. Antisocial personality disorder
Correct Answer: D

Rationale: Step 1: Freud's phallic stage is when the superego develops.
Step 2: Antisocial personality disorder is associated with a poorly developed superego.
Step 3: Individuals with antisocial personality disorder often lack empathy and have a disregard for rules.
Step 4: This behavior aligns with Freud's concept of a weak superego.
Step 5: Therefore, the correct answer is D, Antisocial personality disorder.
Summary: A: Obsessive-compulsive personality disorder is characterized by perfectionism, not related to a weak superego. B: Schizoid personality is marked by social detachment, not directly linked to superego development. C: Borderline personality disorder involves instability in relationships and self-image, not specifically tied to superego development.

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An outpatient diagnosed with schizophrenia tells the nurse, I am here to save the world. I threw away the pills because they make God go away. The nurse identifies the patients reason for medication nonadherence as:

  • A. poor alliance with clinicians.
  • B. inadequate discharge planning.
  • C. dislike of medication side effects.
  • D. lack of insight associated with the illness.
Correct Answer: D

Rationale: The patient's belief in an exalted role and rejection of medication due to hallucinations (God's voice) reflect lack of insight (D) into their illness, the primary reason for nonadherence here.

The federal act that establishes the standards of care for older adults is known as the Omnibus Budget Act.

  • A. Reconciliation
  • B. Budget
  • C. Care
  • D. Standards
Correct Answer: A

Rationale: The Omnibus Budget Reconciliation Act (OBRA) (A) ensures that proper assessment of elderly people will be provided in the health care facility and in the home, as per its full name.

Which would be the best initial approach for a nurse to select when managing the care of an individual with two children who works full-time and has been abused by a partner?

  • A. Teach the individual how to avoid provoking the abuser.
  • B. Assist the individual in filing a police report describing the abuse.
  • C. Help the individual to identify needs in order to best obtain support.
  • D. Facilitate the individual's move into a safe house located near the current workplace.
Correct Answer: C

Rationale: The correct answer is C: Help the individual to identify needs in order to best obtain support. This is the best initial approach because it focuses on understanding the individual's specific needs and circumstances before taking any further action. By identifying needs, the nurse can create a tailored plan to provide appropriate support and resources.

Option A is incorrect because teaching the individual to avoid provoking the abuser places the responsibility on the victim rather than addressing the root cause of the abuse. Option B, filing a police report, may not be the best initial step as it may not take into consideration the individual's safety concerns or emotional well-being. Option D, moving the individual to a safe house, may not be feasible or desired by the individual without first understanding their needs and preferences.

How does peer interaction influence mental development?

  • A. Increases stress
  • B. Enhances problem-solving
  • C. Limits creativity
  • D. Reduces attention span
Correct Answer: B

Rationale: Peer interaction enhances problem-solving (B) by encouraging collaboration and critical thinking, a key aspect of mental development. It doesn't inherently increase stress (A), limit creativity (C), or reduce attention (D).

The client is describing her trip to town. She tells the nurse, 'I cold town yellow water girl outside below ground.' This speech disturbance is called:

  • A. Neologism
  • B. Word salad
  • C. Flight of ideas
  • D. Verbigeration
Correct Answer: B

Rationale: The correct answer is B: Word salad. This speech disturbance is characterized by a jumble of words that lack coherent meaning or connection. In this case, the client's words are disorganized and nonsensical. Neologism (A) is the creation of new words, not a jumble of existing words. Flight of ideas (C) involves rapid shifts in thoughts without a clear connection, not a jumble of words. Verbigeration (D) is the constant repetition of words or phrases, not a jumble of unrelated words.

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