Core Concepts of Patient Family Care

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Andrew, a New York City firefighter, and his entire unit responded to the terrorist attacks at the World Trade Center. Working as a team, he and his best friend, Carlo, entered the area together. Carlo was killed when the building collapsed. Andrew was injured, but survived. Since that time, Andrew has had frequent nightmares and anxiety attacks. He says to the mental health worker, 'I don’t know why Carlo had to die and I didn’t!' This statement by Andrew suggests that he is experiencing:

  • A. Spiritual distress
  • B. Night terrors
  • C. Survivor’s guilt
  • D. Suicidal ideation
Correct Answer: C

Rationale: The correct answer is C: Survivor's guilt. Andrew's statement indicates feelings of guilt and confusion about why he survived while Carlo did not. Survivor's guilt is a common psychological response in individuals who have lived through a traumatic event where others did not. Andrew's frequent nightmares and anxiety attacks are also typical symptoms of survivor's guilt.

A: Spiritual distress is not the correct answer in this scenario as Andrew's statement does not specifically reference any spiritual or religious beliefs or conflicts.

B: Night terrors may be a symptom of Andrew's PTSD, but his statement about not understanding why he survived while Carlo did not suggests a deeper emotional struggle beyond just experiencing night terrors.

D: Suicidal ideation is not the correct answer as Andrew's statement does not indicate any desire or intention to harm himself. Rather, he is expressing confusion and guilt about surviving the traumatic event.

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Registered nurses care for clients in many settings and environments. These clients can be individual clients, couples, families, populations and communities. You have decided to use the Dimensions Model of Health model to assess, monitor and evaluate the health status of the community. Which of these dimensions is NOT an element of this Dimensions Model of Health model?

  • A. The Biophysical Dimension
  • B. The Psychological and Emotional Dimension
  • C. The Spiritual Dimension
  • D. The Health Systems Dimension
Correct Answer: D

Rationale: Health Systems (D) is not a core dimension; others are.

How might the perspectives of financially secure patients with respect to end-of-life care differ from those of disadvantaged patients?

  • A. Financially secure patients are more likely to insist that everything be done to keep them alive
  • B. Disadvantaged patients may interpret end-of-life care as an attempt to deny essential treatments
  • C. Disadvantaged patients are more likely to want to spend their last days outside the hospital
  • D. Financially secure patients are more likely to demand placement in assisted living facilities to avoid burdening their families
Correct Answer: B

Rationale: Disadvantaged patients may distrust end-of-life care due to historical inequities, perceiving it as withheld treatment.

Which of the following is a common ethical challenge for family practitioners?

  • A. Choosing to focus on the welfare of the individual or the family
  • B. Avoiding upsetting the family system through disclosure of therapist faith
  • C. Choosing which theoretical orientation to apply to an individual family
  • D. N/A
Correct Answer: A

Rationale: Balancing individual vs. family welfare is a frequent ethical dilemma in systemic therapy.

The focus of generic crisis intervention is to:

  • A. Introduce the nurse as a caring resource to those in crisis.
  • B. Assist as many in-crisis individuals as quickly as possible.
  • C. Remove the individual in crisis from immediate sources of stress.
  • D. Serve as a liaison between the individual in crisis and needed services.
Correct Answer: B

Rationale: The correct answer is B because generic crisis intervention aims to assist as many individuals in crisis as quickly as possible to minimize harm and provide immediate support. This approach focuses on rapidly addressing the crisis and ensuring the safety and well-being of those involved. Introducing the nurse as a caring resource (A) may be part of the intervention process, but it is not the primary focus. Removing the individual from immediate sources of stress (C) may be necessary in some situations but is not always feasible or effective as the first step. Serving as a liaison between the individual and needed services (D) is important, but it is not the primary goal of generic crisis intervention, which prioritizes immediate assistance and support.

What cardiovascular medication is often prescribed for persons suffering from opioid withdrawal, side effects of clozapine, or ADHD?

  • A. Clonidine (Catapres)
  • B. Valium
  • C. Thyroid function
  • D. Fatigue
Correct Answer: A

Rationale: The correct answer is A: Clonidine (Catapres). Clonidine is often prescribed for opioid withdrawal as it helps with symptoms like anxiety and agitation. It is also used for managing side effects of clozapine such as drooling and sedation. Additionally, Clonidine can be beneficial for individuals with ADHD by improving focus and impulsivity. Valium (B) is a benzodiazepine used for anxiety, not specifically for these conditions. Thyroid function (C) and fatigue (D) are not medications and are unrelated to the conditions mentioned.

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