Nokea
After taking the medical history of a patient, which of the following approaches would be most effective in eliciting the need to address personal health issues?
- A. Warn the patient of long-term consequences
- B. Implement a plan of action immediately
- C. Share opinions about the patient's ability to problem solve
- D. Consult family members in the decision-making process
Correct Answer: C
Rationale: Sharing opinions invites patient reflection and engagement.
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Which statement most accurately describes substance dependence?
- A. It is a lack of control over use. Tolerance and withdrawal symptoms occur when intake is reduced or stopped.
- B. It occurs when psychoactive drug use interferes with the work of competing neurotransmitters.
- C. Symptoms occur when two or more drugs that affect the central nervous system (CNS) have additive effects.
- D. It involves taking a combination of substances to weaken or inhibit the effect of another drug.
Correct Answer: A
Rationale: Rationale for Answer A:
1. Substance dependence involves a lack of control over use, leading to compulsive drug-seeking behavior.
2. Tolerance and withdrawal symptoms are key indicators of substance dependence when intake is reduced or stopped.
3. These symptoms result from physiological changes in the body due to chronic drug use.
4. The cycle of tolerance and withdrawal reinforces the dependence on the substance.
Summary of why other choices are incorrect:
B. Interference with neurotransmitters is more related to the pharmacological effects of drugs, not a defining feature of substance dependence.
C. Additive effects of drugs do not necessarily indicate substance dependence but rather interactions between different substances.
D. Combining substances to weaken effects does not define substance dependence; it is more about the compulsive use and physical dependence on a substance.
What is the role of the physician when the patient lacks decisionmaking capacity and someone other than a family member has been designated as the surrogate decision maker?
- A. Follow the instructions of the family and ignore the surrogate
- B. Ignore the family and talk only to the surrogate
- C. Serve as a mediator between parties and encourage all groups to work together in the best interest of the patient, consistent with the patient's wishes
- D. Consult legal affairs to determine who should be the decisionmaker
Correct Answer: C
Rationale: Mediation ensures collaboration and honors the patient's designated surrogate.
The focus of generic crisis intervention is to:
- A. Introduce the nurse as a caring resource to those in crisis.
- B. Assist as many in-crisis individuals as quickly as possible.
- C. Remove the individual in crisis from immediate sources of stress.
- D. Serve as a liaison between the individual in crisis and needed services.
Correct Answer: B
Rationale: The correct answer is B because generic crisis intervention aims to assist as many individuals in crisis as quickly as possible to minimize harm and provide immediate support. This approach focuses on rapidly addressing the crisis and ensuring the safety and well-being of those involved. Introducing the nurse as a caring resource (A) may be part of the intervention process, but it is not the primary focus. Removing the individual from immediate sources of stress (C) may be necessary in some situations but is not always feasible or effective as the first step. Serving as a liaison between the individual and needed services (D) is important, but it is not the primary goal of generic crisis intervention, which prioritizes immediate assistance and support.
Why are patients advised not to abruptly discontinue a benzodiazepine regimen?
- A. Potential for seizures
- B. Have many side effects
- C. Serotonin syndrome
- D. but do not abruptly stop taking medication - can cause withdrawal symptom
Correct Answer: A
Rationale: The correct answer is A: Potential for seizures. Abruptly discontinuing benzodiazepines can lead to withdrawal symptoms, including seizures, due to the sudden decrease in GABA activity in the brain. This can result in serious health risks. Option B is incorrect as side effects are not the primary reason for gradual tapering. Option C is unrelated, as serotonin syndrome is associated with other types of medications. Option D is incorrect because withdrawal symptoms, not side effects, are the main concern when stopping benzodiazepines abruptly.
When diet is affected by cultural factors, which in turn significantly impact a patient's health care, which of the following approaches is appropriate?
- A. Recommend immediate cessation of the usual diet and provide a list of prohibited foods
- B. Allow the patient to continue his/her usual diet and adjust medications accordingly
- C. Discuss the underlying cultural factors related to the usual diet and explore options within that paradigm that might be better suited to the patient's health
- D. Suggest that the patient instead see a physician who shares his/her cultural background
Correct Answer: C
Rationale: Discussing cultural factors and options respects traditions while promoting health.