Population Specific Care

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After being raped, a woman was told by her aunt, 'I'm not surprised that happened to you. You were asking for it.' A few days later, a friend told her, 'Well after all, he took you to dinner. He expected something in return.' The victim states, 'I can't believe that people can think that way.' The rape crisis nurse correctly hypothesizes that the client is:

  • A. Experiencing cognitive dissonance.
  • B. In denial about the rape.
  • C. Seeking validation from others.
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A: Experiencing cognitive dissonance. Cognitive dissonance refers to the mental discomfort or conflict that occurs when a person's beliefs or attitudes are inconsistent with their actions or experiences. In this scenario, the woman is facing conflicting beliefs - she knows she did not ask for or deserve to be raped, yet the comments from her aunt and friend suggest otherwise. This leads to the woman feeling disbelief and distress.

Summary:
B: In denial about the rape - This choice does not address the conflicting beliefs the woman is experiencing.
C: Seeking validation from others - While seeking validation may be a natural response, it does not capture the essence of cognitive dissonance in this context.

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Stuttering is a disturbance in the normal fluency and time patterning of speech that is inappropriate for the individual's age. It involves which of the following?

  • A. Frequent repetitions or prolongations of sounds
  • B. Pauses within words
  • C. Filled or unfilled pauses in speech
  • D. All of the above
Correct Answer: D

Rationale: Stuttering: A disturbance in the normal fluency and time patterning of speech that includes frequent repetitions, prolongations, and pauses.

A patient's medical record documents sexual masochism. This patient derives sexual pleasure

  • A. from inanimate objects.
  • B. by inflicting pain on a partner.
  • C. when sexually humiliated by a partner.
  • D. from touching a nonconsenting person.
Correct Answer: C

Rationale: The correct answer is C because sexual masochism involves deriving sexual pleasure from being humiliated or degraded by a partner. This behavior is characterized by finding arousal in receiving physical or emotional pain or humiliation during sexual activities. Choices A, B, and D are incorrect because they do not align with the specific behavior associated with sexual masochism. Choice A refers to objectophilia, choice B describes sadism, and choice D pertains to non-consensual sexual behavior, none of which are indicative of sexual masochism.

Irrational and very specific fears that persist even when there is no real danger to a person are called

  • A. anxieties
  • B. dissociation's
  • C. phobias
  • D. obsessions
Correct Answer: C

Rationale: Phobias are specific, irrational fears persisting despite no real threat, distinct from general anxiety.

A history reveals that a patient virtually stopped eating 5 months ago and lost 25% of body weight. The nurse says, "Describe what you think about your present weight and how you look." Which response would be most consistent with anorexia nervosa?

  • A. "I'm fat and ugly."
  • B. "What I think about myself is my business."
  • C. "I'm grossly underweight, but I cover it well."
  • D. "I'm a few pounds overweight, but I can live with it."
Correct Answer: A

Rationale: The correct answer is A because the response indicates a distorted body image, a common characteristic of anorexia nervosa. Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted perception of body image, leading individuals to see themselves as overweight despite being underweight. In this case, the patient's response of "I'm fat and ugly" demonstrates a negative perception of their weight and appearance, which aligns with the distorted body image seen in anorexia nervosa.

Choices B, C, and D are incorrect:
B: "What I think about myself is my business" - This response does not indicate a distorted body image or negative perception of weight and appearance, which are key features of anorexia nervosa.
C: "I'm grossly underweight, but I cover it well" - While this response acknowledges being underweight, it does not reflect the distorted body image commonly seen in anorexia nervosa.
D: "I'm a

The physician prescribes haloperidol (Haldol), a first-generation antipsychotic drug, for a patient with schizophrenia who displays delusions, hallucinations, apathy, and social isolation. Which symptoms should most be monitored to evaluate the expected improvement from this medication?

  • A. Talking to himself, belief that others will harm him
  • B. Flat affect, avoidance of social activities, poor hygiene
  • C. Loss of interest in recreational activities, alogia
  • D. Impaired eye contact, needs help to complete tasks
Correct Answer: A

Rationale: The correct answer is A because the symptoms of delusions and hallucinations are key indicators of improvement in schizophrenia with antipsychotic treatment. These symptoms directly relate to the patient's perception of reality and are core features of the disorder. Monitoring these symptoms provides objective evidence of the medication's effectiveness in addressing the patient's psychotic symptoms.

Choices B, C, and D are incorrect because they mainly indicate negative symptoms of schizophrenia, such as flat affect, social withdrawal, and cognitive deficits. While monitoring these symptoms is important for assessing overall functioning and quality of life, they are not the primary target of improvement with antipsychotic medications. Symptoms like delusions and hallucinations are considered primary targets for evaluating the efficacy of antipsychotic treatment in schizophrenia.

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