Nokea
An adult who had been abused as a child is discussing the group therapy program. Which statement indicates that the client has gained insight?
- A. I think I was a lonely child because I could not tell anyone about my abuse.'
- B. I am now aware of how deep-seated my anger is. Before I did not realize I was angry.'
- C. The program has given me the courage to tell my mother how I felt about her role in my hurt.'
- D. There are so many people just like me, who are just normal people that had bad things happen to them.'
Correct Answer: B
Rationale: Children who are abused learn to cope with the painful experiences by ignoring painful feelings and avoiding getting close to people. As adults, victims of abuse usually continue to repress feelings, avoid close interpersonal relationships, and frequently use alcohol or drugs to block painful memories. Long-term effects in adults might include criminal/violent behavior (for adult males), substance abuse, and a variety of social and emotional problems (including suicidal thoughts, anxiety, hostility, dissociation, and interpersonal difficulties).
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When discussing the patterns of use of alcohol and other drugs, the nurse should include which piece of information?
- A. Lifetime prevalence and intensity of alcohol use is greater in women than men
- B. Hispanics and African Americans have higher levels of alcohol use than Caucasians
- C. Overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age
- D. Heavy use is more common in higher socioeconomic groups because they can afford to buy the drugs
Correct Answer: C
Rationale: Alcohol and drug use peaks in the mid-20s and decreases with age. Men have higher prevalence, Caucasians report more alcohol use, and heavy use is more common among less educated or unemployed groups.
A nurse observes a client sitting alone and talking. When asked, the client reports that he is 'talking to the voices.' The nurse's next action should be:
- A. touching the client to help him return to reality
- B. leaving the client alone until reality returns
- C. asking the client to describe what is happening
- D. telling the client there are no voices
Correct Answer: C
Rationale: Asking the client to describe the hallucinations validates their experience and provides insight into their condition, aiding therapeutic communication. Touching may be intrusive, leaving them alone is non-therapeutic, and denying the voices dismisses their reality.
Social support systems include of the following except:
- A. call-in help lines.
- B. emotional assistance provided by others.
- C. community support groups.
- D. use of coping skills and verbalization for anger management.
Correct Answer: D
Rationale: Use of coping skills and verbalization for anger management are personal strategies, not examples of social support systems. Choices 1, 2, and 3 are all social support systems.
A nurse is planning a brief treatment program for a client who was raped. A realistic, short-term goal is to:
- A. identify all psychosocial problems.
- B. eliminate the client's enticing behaviors.
- C. resolve feelings of trauma and fear.
- D. verbalize feeling about the event.
Correct Answer: D
Rationale: A realistic short-term goal is for the client to verbalize feelings about the event. A brief treatment program is not designed to identify or resolve problems. The focus is on managing acute symptoms. If in-depth psychological problems are identified, the nurse might make referrals for treatment.
A client admitted to the medical nursing unit has classic symptoms of tuberculosis (TB) and tests positive on the purified protein derivative (PPD) skin test. Several months later, the nurse who cared for the client also tests positive on an annual TB skin test for work. The most likely course of treatment if the chest X-ray (CXR) is negative is to:
- A. repeat a TB skin test in six months.
- B. treat the nurse with an anti-infective agent for six months.
- C. monitor for signs and symptoms within the next year.
- D. follow up in one year at the next annual physical with CXR only.
Correct Answer: B
Rationale: Exposure with a positive TB skin test usually requires six months of prophylactic treatment unless contraindicated.