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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A nurse plans care based upon the fact that anticipatory grief:
- A. Is associated with fewer expressions of guilt
- B. Prevents development of symptoms of depression
- C. Requires a longer period of time to effect resolution
- D. Prevents development of symptoms of depression
Correct Answer: A
Rationale: The correct answer is A because anticipatory grief allows individuals to gradually accept the impending loss, leading to fewer feelings of guilt. This process helps the individual prepare emotionally and psychologically for the eventual loss, reducing guilt related to not being able to prevent it. Choice B is incorrect because anticipatory grief does not prevent symptoms of depression, but rather helps individuals cope with them. Choice C is incorrect as anticipatory grief does not necessarily require a longer period of time for resolution; it varies for each individual. Choice D is incorrect, as mentioned earlier, because anticipatory grief does not prevent symptoms of depression but helps individuals navigate through them.
The mother of a child describes her child's annoying behavior as not being able to sit still or to stop jerking his arms when told to. Which disorder does the nurse suspect?
- A. Oppositional-defiant disorder
- B. Tourette’s disorder
- C. Oppositional-defiant disorder
- D. What makes you think he is doing that out of defiance?
Correct Answer: B
Rationale: The correct answer is B: Tourette’s disorder. The child's inability to sit still and jerking arms suggest motor tics, which are common in Tourette's disorder. Tourette's is characterized by involuntary repetitive movements or sounds. Choice A is incorrect as oppositional-defiant disorder does not involve physical tics. Choice C is a duplicate. Choice D is incorrect as it assumes defiance rather than considering a neurological explanation for the behavior.
A 79-year-old white male tells a nurse, “I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing.” The nurse should analyze this comment as:
- A. Normal pessimism of the elderly.
- B. A call for sympathy
- C. Evidence of risks for suicide.
- D. Normal grieving.
Correct Answer: C
Rationale: The correct answer is C: Evidence of risks for suicide. The statement contains indicators such as feeling very sad, lack of purpose, isolation, and declining health, which are red flags for suicide risk in older adults. It is crucial for healthcare providers to assess and intervene promptly in such cases to prevent harm. Choices A, B, and D are incorrect because they do not address the seriousness of the situation or the potential risk for self-harm.
A patient presents to the emergency department with mixed psychiatric symptoms. The admission nurse suspects the symptoms may be the result of a medical problem. Lab results show elevated BUN (blood urea nitrogen) and creatinine. What is the nurse’s next best action?
- A. Report the findings to the health care provider.
- B. Assess the patient for a history of renal problems.
- C. Assess the patient’s family history for cardiac problems.
- D. Arrange for the patient’s hospitalization on the psychiatric unit.
Correct Answer: A
Rationale: Rationale for Correct Answer (A): Reporting the findings to the health care provider is the next best action because elevated BUN and creatinine levels indicate possible renal dysfunction, which could be causing the psychiatric symptoms. The health care provider needs this information to determine appropriate treatment and further evaluation.
Summary of Incorrect Choices:
B: Assessing the patient for a history of renal problems is not the next best action because the lab results already indicate potential renal issues.
C: Assessing the patient’s family history for cardiac problems is irrelevant to the elevated BUN and creatinine levels and the psychiatric symptoms.
D: Arranging for the patient’s hospitalization on the psychiatric unit is premature without addressing the underlying medical issue indicated by the lab results.
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.