Nokea
An adult patient shares that, When my mother died when we were children, I never saw my
father show any emotion. What do you think will happen with those unexpressed feelings?
Which response is most appropriate?
- A. Pent-up emotions may lead to depression or other disorders.
- B. Your father probably has worked through his grief by this time.
- C. Maybe you can teach him how to best express his own feelings.
- D. If feelings are not effectively expressed, the person can become suicidal.
Correct Answer: A
Rationale: Step 1: Pent-up emotions are emotions that are suppressed or not expressed.
Step 2: Unexpressed feelings, especially from past traumatic events, can lead to emotional distress.
Step 3: Long-term suppression can manifest as depression or other mental health disorders.
Step 4: Therefore, choice A is the most appropriate response as it highlights the potential negative consequences of unexpressed emotions.
Summary:
- Choice B assumes the father has processed his grief, which may not be the case.
- Choice C oversimplifies the complexity of emotional expression and may not address the root issue.
- Choice D jumps to an extreme outcome without considering the range of possible consequences.
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The highest priority for assessment by nurses caring for older adults who self-administer medications is:
- A. Use of multiple drugs with anticholinergic effects.
- B. Overuse of medications for erectile dysfunction.
- C. Missed doses of medications for arthritis.
- D. Trading medications with acquaintances.
Correct Answer: A
Rationale: The correct answer is A: Use of multiple drugs with anticholinergic effects. This is the highest priority as anticholinergic medications can have severe side effects in older adults, including confusion, constipation, and increased risk of falls. Nurses need to assess for potential harm caused by these medications.
Choice B (Overuse of medications for erectile dysfunction) is not the highest priority as it may not pose an immediate threat to the health and safety of older adults compared to anticholinergic effects.
Choice C (Missed doses of medications for arthritis) is important but not as critical as assessing for the potential harm caused by anticholinergic medications.
Choice D (Trading medications with acquaintances) is concerning but not as urgent as assessing for the harmful effects of anticholinergic medications, which can lead to serious health complications.
The patient’s daughter was murdered while they were customers in a local bank. Which statements would support the patient’s diagnosis of posttraumatic stress disorder (PTSD)? Select all that apply:
- A. “I feel numb, like a robot going through the motions of existing.”
- B. “I’m so nervous and jump at the slightest noise.”
- C. “I have not slept very well at all since I lost her.”
- D. “I can’t stop reliving the last time I saw her alive.”
Correct Answer: A
Rationale: The correct answer is A because feeling numb and detached from emotions is a common symptom of PTSD known as emotional numbing. This symptom is often seen in individuals who have experienced a traumatic event, such as the murder of a loved one. It is a defense mechanism that helps the person cope with overwhelming emotions.
The other choices are incorrect:
B: Being nervous and easily startled (hypervigilance) is more indicative of the hyperarousal symptom of PTSD, not emotional numbing.
C: Difficulty sleeping is a common symptom of PTSD, known as insomnia, but it does not directly relate to emotional numbing.
D: Reliving the traumatic event through flashbacks or intrusive memories is a symptom of PTSD, but it is not directly related to emotional numbing.
Which behavior best supports the diagnosis of attention-deficit/hyperactivity disorder in an 8-year-old child?
- A. Cries when separated from his mother or father
- B. Refuses to pick up toys as instructed by his parents
- C. Is fascinated with spinning and moving toys and objects
- D. Can concentrate on schoolwork for only very short periods of time.
Correct Answer: D
Rationale: The correct answer is D because the inability to concentrate for extended periods is a key characteristic of ADHD. This behavior aligns with the inattention aspect of the disorder. Choice A is incorrect as separation anxiety does not directly relate to ADHD. Choice B could indicate oppositional behavior rather than ADHD. Choice C suggests sensory-seeking behavior, which is not a defining feature of ADHD.
The nurse determines that the most effective point of intervention for bereavement is:
- A. Promotion of mental and spiritual health across the life spa
- B. At the time a newly discovered loss is impending
- C. Immediately after the loss has occurred
- D. When requested by the patient
Correct Answer: C
Rationale: The correct answer is C because intervening immediately after the loss has occurred allows for timely support and processing of emotions. This is crucial for healthy grieving and preventing complications. Choice A is too broad and not specific to the immediate need post-loss. Choice B focuses on pre-loss, which is not the most effective time for intervention. Choice D puts the responsibility on the patient, which may delay necessary support.
When a novice nurse asks why the unit has a multidisciplinary approach to therapeutic activities, the nurse should explain that multidisciplinary collaboration:
- A. Reduces the incidence of aggressive behavior by patients
- B. Produces quicker results and earlier discharge to the community
- C. Produces better outcomes than when only one perspective is used
- D. Helps to improve staffing efficiency and resource allocation.
Correct Answer: C
Rationale: Rationale for Correct Answer (C): Multidisciplinary collaboration in therapeutic activities involves the input of professionals from various disciplines, leading to a holistic approach that considers all aspects of a patient's condition. This approach is more likely to result in better outcomes because it combines diverse perspectives, expertise, and skills to address complex patient needs comprehensively.
Summary of Incorrect Choices:
A: Reducing aggressive behavior is not the primary goal of multidisciplinary collaboration in therapeutic activities.
B: While multidisciplinary collaboration may lead to efficient care, the primary focus is on achieving better outcomes rather than quicker discharge.
D: Although improving staffing efficiency and resource allocation may be benefits of multidisciplinary collaboration, the main purpose is to enhance patient care outcomes through diverse perspectives and expertise.