Nokea
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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A nurse assesses that which of the following individuals is most likely to engage in eating behaviors characteristic of bulimia?
- A. A person who weighs 225 pounds and is 5 feet 4 inches tall.
- B. A person who is 5 pounds overweight and cannot stick to a diet.
- C. A person who lost up to 40 pounds but gained it back within 1 year.
- D. None of the above.
Correct Answer: A
Rationale: Step 1: Individuals with bulimia often engage in episodes of binge eating followed by purging behaviors.
Step 2: Choice A, a person who is significantly overweight, is more likely to engage in binge eating behavior.
Step 3: Being overweight can be a risk factor for bulimia due to body image concerns.
Step 4: Choices B and C do not provide as strong indicators for bulimia as choice A.
Summary: Choice A is correct as being significantly overweight is a common characteristic of individuals with bulimia. Choices B and C lack the same level of risk factors for engaging in eating behaviors characteristic of bulimia.
Which patient is at greatest risk for physical abuse by a family member?
- A. An 8-year-old who is mentally challenged and living with a foster family
- B. A 15-year-old who lives with a single parent in an inner city apartment complex
- C. A 30-year-old adult who shares a home with a homosexual partner
- D. A 79-year-old with chronic depression who lives with a grandchild
Correct Answer: D
Rationale: The correct answer is D because the 79-year-old with chronic depression who lives with a grandchild is vulnerable due to age, health condition, and dependency on the grandchild. Older adults with mental health issues are at a higher risk of abuse, especially when living with family members. The other choices are less likely to be at greatest risk for physical abuse. A, B, and C do not have the same level of vulnerability due to age, health condition, or dependency as the 79-year-old with chronic depression living with a grandchild.
A 32-year-old client with an admitting diagnosis of catatonic schizophrenia has been mute and motionless for 2 days. The priority nursing diagnosis is:
- A. Risk for deficient fluid volume
- B. Impaired physical mobility
- C. Impaired social interaction
- D. Ineffective coping
Correct Answer: A
Rationale: The correct answer is A: Risk for deficient fluid volume. The priority nursing diagnosis in this case is to address the client's physical needs to ensure their safety and well-being. The client's mutism and immobility put them at risk for dehydration and malnutrition. By prioritizing the risk for deficient fluid volume, the nurse can address the immediate physiological needs of the client.
Choice B: Impaired physical mobility is incorrect because while the client is motionless, the immediate concern is addressing the risk of dehydration.
Choice C: Impaired social interaction is incorrect as addressing social interaction is not the priority when the client's physical needs are not being met.
Choice D: Ineffective coping is incorrect because the client's presentation is indicative of a more urgent physical need for hydration and nutrition.
Serious mental illness is characterized as:
- A. any mental illness of more than 2 weeks duration
- B. a major long-term mental illness marked by significant functional impairments
- C. a mental illness accompanied by physical impairment and severe social problems
- D. a major mental illness that cannot be treated to prevent deterioration of cognitive and social abilities
Correct Answer: B
Rationale: Serious mental illness has replaced the term chronic mental illness. Global impairments in function are evident particularly social. Physical impairments may be present. Serious mental illness can be treated, but remissions and exacerbations are part of the course of the illness.
A patient with borderline personality disorder has been making steady progress but one day gets a phone call from her boyfriend, who breaks off their relationship. Although she has not self-injured in over 2 months, she makes repeated lacerations on her forearm. Which statement about this and most maladaptive behaviors seen in personality disorders is most accurate?
- A. People with personality disorders rarely achieve lasting improvement.
- B. However dysfunctional, most behavior is the person's best effort to cope.
- C. People with personality disorders are at the mercy of others' actions.
- D. What appears to be improvement can be manipulation instead.
Correct Answer: B
Rationale: The correct answer is B: However dysfunctional, most behavior is the person's best effort to cope.
Rationale:
1. People with borderline personality disorder often struggle with intense emotions and unstable relationships.
2. Self-injury is a maladaptive coping mechanism used to manage overwhelming emotions or distress.
3. In this scenario, the patient resorts to self-injury as a coping strategy after the breakup triggers intense emotional pain.
4. Despite being maladaptive, the behavior serves as a coping mechanism to regulate emotions.
5. Understanding that maladaptive behaviors are often the individual's best attempt to cope helps in providing non-judgmental support and promoting healthier coping strategies.
Summary:
A: Incorrect. People with personality disorders can make progress with appropriate treatment and support.
C: Incorrect. While external factors may trigger behaviors, individuals with personality disorders have agency in their actions.
D: Incorrect. Improvement in behavior should not always be viewed as manipulation; it can indicate genuine progress in coping skills.