Nokea
An older adult patient was diagnosed with schizophrenia at age 18. A nurse at the outpatient medication clinic interviews this patient. Which communication strategy will be most helpful?
- A. Ask questions that can be answered with yes or no.
- B. Use silence often and let the patient take the lead.
- C. Use open-ended, indirect questions.
- D. Ask clear, simple questions using concrete language.
Correct Answer: D
Rationale: The correct answer is D: Ask clear, simple questions using concrete language. This strategy is most helpful because older adults with schizophrenia may have cognitive impairments that affect their ability to process complex information. Clear and simple questions using concrete language can help the patient understand and respond effectively.
Choice A (Ask questions that can be answered with yes or no) limits communication and may not provide enough information for the nurse to assess the patient's condition comprehensively. Choice B (Use silence often and let the patient take the lead) may not be effective as the patient may struggle to communicate effectively due to cognitive impairments. Choice C (Use open-ended, indirect questions) may lead to confusion or misinterpretation for a patient with cognitive challenges.
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Which developmental level would be characterized by a child being able to focus, coordinate, and imagine a series of events?
.
- A. Preoperational
- B. Concrete operational
- C. Formal operational
- D. Postoperational
Correct Answer: B
Rationale: The correct answer is B: Concrete operational. At this developmental level, children typically exhibit the ability to focus, coordinate, and imagine a series of events. This stage, according to Piaget's theory, usually occurs around ages 7 to 11. Children at this stage can perform logical operations, understand conservation, and think more systematically.
A: Preoperational - Children at this stage (ages 2-7) lack the ability to perform logical operations and struggle with understanding conservation and cause-and-effect relationships.
C: Formal operational - This stage (typically starting around age 11) involves abstract thinking, hypothetical reasoning, and problem-solving beyond the concrete level.
D: Postoperational - This term is not a recognized developmental stage in Piaget's theory.
By the end of the orientation phase, which outcome can be identified for a newly admittedpatient? The patient will demonstrate:
- A. Positive transference with a staff member
- B. Ability to ask for help in meeting needs
- C. Commitment to long-term therapy
- D. Ability to manage symptoms independently
Correct Answer: A
Rationale: The correct answer is A because positive transference with a staff member in the orientation phase indicates a developing therapeutic relationship, which is crucial for effective treatment. This outcome shows the patient is beginning to trust and feel safe with a staff member, enhancing their engagement in therapy.
Choice B is incorrect because the ability to ask for help in meeting needs may not be fully developed by the end of the orientation phase. Choice C is incorrect as commitment to long-term therapy is usually not established this early in the process. Choice D is incorrect because the ability to manage symptoms independently typically requires more time and therapy progress.
Which patient would the nurse determine to be at highest risk for dysfunctional grief? The patient:
- A. Whose 16-year-old daughter was raped and killed while going on an errand for the patient
- B. Whose 86-year-old mother, with whom she has shared her home, died after a long illness.
- C. Who attended a support group and had been assisted by hospice to care for her terminally
- D. Who attended a bereavement group, where she learned to express feelings after the deaths of her twin daughters
Correct Answer: A
Rationale: The correct answer is A because the patient whose 16-year-old daughter was raped and killed while going on an errand for the patient is at highest risk for dysfunctional grief. This traumatic and unexpected loss of a child to a violent act can lead to complicated or prolonged grief reactions. The sudden and violent nature of the death, along with the added trauma of rape, can significantly impact the grieving process. The intense emotions and feelings of guilt, anger, and helplessness may complicate the bereavement process and lead to dysfunctional grief reactions.
Summary:
Choice B is incorrect because the death of an 86-year-old mother after a long illness, although sad, does not necessarily indicate a higher risk of dysfunctional grief. Choice C is incorrect as attending a support group and receiving assistance from hospice are positive factors that can support healthy grieving. Choice D is incorrect as attending a bereavement group and learning to express feelings after the deaths of twin daughters indicate active engagement in the grieving process, which is
Family and friends rush to offer support to a friend who has lost her teenage son. Which of these persons, through an intended act of kindness, may contribute to prolonging the woman’s grief?
- A. The physician who prescribed antianxiety agents
- B. The nurse who offered to spend the night at her home
- C. The next-door teenager who provided care for the son’s pet
- D. The accountant who assisted with stabilizing financial affairs.
Correct Answer: A
Rationale: The correct answer is A because prescribing antianxiety agents may mask the woman's grief instead of allowing her to process and work through it naturally. This could potentially prolong her grief by avoiding the necessary emotional processing. The other choices, B, C, and D, all involve support that can help the woman cope with her loss in a healthy way. B offers emotional support and companionship, C helps with practical tasks, and D provides assistance in managing practical matters, all of which can facilitate the grieving process rather than prolong it.
Which person would the nurse assess as experiencing chronic sorrow?
- A. The mother of a child diagnosed with asthma
- B. The father of an adult son who is a schizophrenic
- C. The daughter whose father experienced a hip replacement
- D. The wife whose husband has recently requested a trial separation
Correct Answer: B
Rationale: The correct answer is B because chronic sorrow is a continuous feeling of grief or sadness that occurs when there is a discrepancy between the reality of a situation and the individual's expectations or hopes. In this case, the father of an adult son who is schizophrenic is likely to experience chronic sorrow due to the ongoing challenges and difficulties associated with his son's mental illness. This long-term impact on his emotional well-being aligns with the concept of chronic sorrow.
Choices A, C, and D do not necessarily imply a long-term or continuous feeling of grief. The mother of a child with asthma may experience anxiety or distress during asthma attacks, but it may not necessarily lead to chronic sorrow. The daughter whose father had a hip replacement may experience temporary worry or concern but not chronic sorrow. The wife whose husband requested a trial separation may experience sadness and distress, but it is not a situation that inherently leads to chronic sorrow.