Population Based Care

Population Based Care Related

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An individual accompanied by a sibling was brought by ambulance to the emergency room with suspected impaired cognitive function. The patient's aggressive behavior and attempts to get out of bed present a safety issue. The nurse should first consider:

  • A. applying four-point restraints.
  • B. using a calm tone to orient the patient.
  • C. leaving the patient alone with the sibling.
  • D. calling for security guards to hold the patient down.
Correct Answer: B

Rationale: The correct answer is B: using a calm tone to orient the patient. This is the most appropriate initial intervention because it aims to address the patient's aggressive behavior by providing reassurance and attempting to reorient them to their surroundings. Using a calm tone can help de-escalate the situation and improve communication with the patient. Applying four-point restraints (choice A) should be avoided as it is a restrictive measure that should only be used as a last resort to ensure patient safety. Leaving the patient alone with the sibling (choice C) may exacerbate the safety issue, as the sibling may not be equipped to manage the situation. Calling for security guards to hold the patient down (choice D) is a forceful approach that should be avoided until all other options have been exhausted.

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In DSM-IV-TR intellectual disabilities are divided into a number of degrees of severity, depending primarily on the range of IQ score provided by the sufferer. One of these is Mild Mental Retardation, corresponding to an IQ score between:

  • A. 60-65 to 80
  • B. 40-55 to 60
  • C. 50-55 to 70
  • D. 70-75 to 90
Correct Answer: C

Rationale: Mild Mental Retardation: Defined by DSM-IV-TR as an IQ score between 50-55 to 70.

An emergency department nurse prepares to assist with examination of a sexual assault victim. What equipment will be needed to collect and document forensic evidence? Select all that apply.

  • A. Body map.
  • B. DNA swabs.
  • C. Photographs.
  • D. Pulse oximeter.
Correct Answer: A

Rationale: The correct answer is A: Body map. In cases of sexual assault, a body map is essential to document and track injuries and evidence. It helps in accurately recording the location and nature of injuries on the victim's body. DNA swabs and photographs are also important for collecting forensic evidence. DNA swabs can help in identifying the perpetrator, while photographs can visually document injuries and evidence. However, a pulse oximeter is not typically needed for collecting forensic evidence in cases of sexual assault. It is used to measure oxygen saturation in the blood and is not directly relevant to documenting forensic evidence in this context.

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. evidence of risks for suicide
  • C. a call for sympathy
  • D. normal grieving
Correct Answer: B

Rationale: The patient describes loss of significant others, economic security, and health. He describes mood alteration and voices the thought that he has little to live for. Combined with his age, sex, and single status, each is a risk factor for suicide. Elderly white males have the highest risk for completed suicide.

Which of the following statements about attention deficit hyperactivity disorder (ADHD) are true? (Select one tha does not apply)

  • A. ADHD is more common in boys than in girls
  • B. Children with ADHD tend to be of below-average intelligence
  • C. Even though we think of ADHD as a disorder in children, adults can also have it
  • D. Children with ADHD are often treated with the use of stimulants
Correct Answer: B

Rationale: Children with ADHD tend to be of above normal intelligence but often dont function at those levels. The causes of ADHD are more associated with brain dysfunction and genetic factors. Correct statements are: A (more common in boys), D (treated with stimulants), E (benefit from behavior modification), F (can persist into adulthood).

The nurse is leading a group for women who have experienced interpersonal violence. A client asks what research statistics tell about the perpetrators of interpersonal violence. The nurse can accurately respond that perpetrators are:

  • A. Usually under the influence of drugs or alcohol
  • B. Most often someone the victim knows
  • C. A stranger to the victim in most cases
  • D. Often in a psychotic state during the act
Correct Answer: B

Rationale: The correct answer is B because research shows that perpetrators of interpersonal violence are most often someone the victim knows, such as a partner, family member, or acquaintance. This is supported by studies and data that indicate a significant majority of interpersonal violence cases involve perpetrators who have a prior relationship with the victim. Choice A is incorrect because while substance abuse can be a factor in some cases, it is not the primary characteristic of perpetrators. Choice C is incorrect as statistics show that perpetrators are usually known to the victim rather than being strangers. Choice D is also incorrect as psychotic states are not typically the primary cause of interpersonal violence, and most perpetrators are not in such a state during the act.

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