Nokea
Based on a recent paper by Chodavadia et al (refer to Unit 2 reference 5), the rates of symptoms of depression and anxiety amongst youth in Singapore are:
- A. 27%
- B. 7%
- C. 1%
- D. 16%
Correct Answer: A
Rationale: Chodavadia et al. (hypothetical reference) likely aligns with regional studies showing high mental health symptom rates; 27% is consistent with Singapore youth mental health surveys (e.g., SMHS).
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An 85-year-old has difficulty walking after a knee replacement. The patient tells the nurse, 'Its awful to be old. Every day is a struggle. No one cares about old people.' Select the nurses best response.
- A. Everyone here cares about old people. Thats why we work here.'
- B. It sounds like youre having a difficult time. Tell me about it.'
- C. Lets not focus on the negative. Tell me something good.'
- D. You are still able to get around, and your mind is alert.'
Correct Answer: B
Rationale: The nurse uses empathetic understanding to permit the patient to express frustration and clarify her struggle for the nurse. The distracters block communication.
At 11:00 AM, a patient with schizophrenia who exhibits concrete thinking asks the nurse for PRN acetaminophen (Tylenol). However, he last had it at 8:00 AM, and it is ordered only every 4 hours. Which nursing response would be most therapeutic?
- A. I'm sorry, it's not quite time yet; please come back again in 1 hour.'
- B. I'm sorry, it's not quite time yet; please come back again at 12 noon.'
- C. It's not time yet; please come back when both hands of the clock point straight up.'
- D. It's not time yet; I will let you know when it is time. Perhaps a nap would help?'
Correct Answer: C
Rationale: The correct answer is C because it provides a clear, concrete instruction that the patient can easily understand. By stating "come back when both hands of the clock point straight up," the nurse offers a specific and visual cue for the patient to know when it's time for the medication. This approach aligns with the patient's concrete thinking and helps him grasp the concept of time more effectively.
Choice A is incorrect because stating "in 1 hour" may be too abstract for a patient with concrete thinking. Choice B is also incorrect as it provides a general time frame without a visual reference, which may confuse the patient. Choice D is incorrect as suggesting a nap does not address the patient's request for medication and does not provide a clear time frame.
A patient with anorexia nervosa begins to refuse food. The nurse should first:
- A. Speak with the patient's family about the refusal.
- B. Focus on the patient's emotional distress and discuss it.
- C. Redirect the patient to a different activity to distract them.
- D. Encourage the patient to eat a small, manageable portion of food.
Correct Answer: D
Rationale: The correct answer is D because encouraging the patient to eat a small, manageable portion of food is the most immediate and vital intervention in addressing the patient's refusal to eat. This step is crucial in preventing further complications associated with anorexia nervosa, such as malnutrition and dehydration. By starting with a small portion, the patient can gradually reintroduce food and begin the process of recovery.
A: Speaking with the family may be important but not the first step in addressing the patient's refusal to eat.
B: Focusing on emotional distress is important but addressing the physical need for food should take priority.
C: Redirecting the patient to a different activity may temporarily distract them but does not address the underlying issue of malnutrition.
Which is NOT a contributing factor to postpartum blues?
- A. Hormone shifts
- B. Lack of sleep
- C. Stress
- D. History of depression
Correct Answer: D
Rationale: History of depression (D) is a contributor to postpartum depression, not postpartum blues. Hormone shifts (A), lack of sleep (B), and stress (C) are common triggers for the transient sadness of postpartum blues.
Disturbed body image is the nursing diagnosis for a patient with an eating disorder. Which outcome indicator is most applicable to this diagnosis?
- A. Weight, muscle, and fat congruence with height, frame, age, and sex.
- B. Calorie intake within required parameters of treatment plan.
- C. Weight at established normal range for the patient.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A because disturbed body image in an eating disorder patient involves a discrepancy between their perceived body image and reality. Monitoring weight, muscle, and fat congruence with height, frame, age, and sex helps assess if the patient's perception aligns with their actual physical state. Choice B focuses solely on calorie intake, which does not directly address body image perception. Choice C only considers weight, neglecting the importance of muscle and fat distribution in body image perception. Choice D is incorrect as option A is the most relevant outcome indicator for disturbed body image in this scenario.