Nokea
Confidentiality should be discussed with all adolescents and parents before the consult. Confidentiality may be breached in all situations below EXCEPT:
- A. Disclosure of sexual abuse
- B. Disclosure of drug abuse
- C. Disclosure of suicidality
- D. Disclosure of dropping grades
Correct Answer: D
Rationale: Confidentiality can be breached for safety concerns (abuse, drug use, suicidality), but dropping grades is not a direct threat to safety or health, so it does not warrant breaching confidentiality.
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What is not the primary evidence-based approach to managing oppositional behaviour in children?
- A. Cognitive-behavioural intervention
- B. Psychosocial intervention
- C. Pharmacological intervention
- D. Family therapy
Correct Answer: C
Rationale: Pharmacological intervention is not a primary approach for oppositional behavior; psychosocial interventions like parent training are first-line.
A patient with schizophrenia repeatedly asks for directions and the time of day. The nurse should:
- A. repeat the information in a kind, matter-of-fact manner.
- B. write out the information so the patient can easily refer to it.
- C. tell the patient that the habit of frequent questioning is annoying.
- D. provide the information once and then remind the patient that the question was already asked.
Correct Answer: A
Rationale: The correct answer is A because patients with schizophrenia may have cognitive impairments affecting memory and orientation, leading to repetitive questioning. By repeating information in a kind, matter-of-fact manner, the nurse can address the patient's needs without causing distress.
Choice B may be helpful, but verbal reinforcement is essential for immediate clarification. Choice C is incorrect as it may exacerbate the patient's distress and worsen the therapeutic relationship. Choice D does not address the underlying cognitive issue and may come across as dismissive.
Which theme is most likely during family therapy with parents, siblings, and a teen patient with anorexia nervosa who engages in provocative behavior?
- A. Stable coalitions between family members
- B. Interpreting negative messages as positive
- C. Competition between the patient and father
- D. Lack of trust in the patient by family members
Correct Answer: C
Rationale: The correct answer is C: Competition between the patient and father. In family therapy with a teen patient with anorexia nervosa, the theme of competition between the patient and a parental figure, often the father, can be prominent. The rationale is that the father's influence and expectations can contribute to the teen's feelings of inadequacy and drive for control through anorexic behaviors. This dynamic can be explored and addressed in therapy to improve family relationships and support the patient's recovery.
A: Stable coalitions between family members - This is less likely as anorexia nervosa often disrupts family dynamics.
B: Interpreting negative messages as positive - While this can be a relevant theme, it is not as central to the specific scenario described.
D: Lack of trust in the patient by family members - While trust issues may exist, the theme of competition is more relevant in this context.
A patient with an eating disorder states, 'I heard people laughing behind me in the check-out line at the department store. I bet they thought it was hysterically funny that I gained a pound in the last few days.' The nurse documents that the patient is exhibiting which cognitive distortion related to maladaptive eating regulation responses?
- A. Magnification
- B. Personalization
- C. Overgeneralization
- D. Dichotomous thinking
Correct Answer: B
Rationale: The correct answer is B: Personalization. Personalization is a cognitive distortion where an individual attributes external events to themselves without any evidence. In this case, the patient is assuming that people laughing were directed at them and related to their weight gain, which is a distorted belief.
A: Magnification involves blowing things out of proportion, which is not evident in this scenario.
C: Overgeneralization involves drawing broad conclusions based on a single incident, which is not happening here.
D: Dichotomous thinking involves seeing things in black and white terms, which is not demonstrated in the patient's statement.
In summary, the patient's attribution of others' laughter to their weight gain without evidence aligns with the cognitive distortion of personalization, making it the correct choice.
Sleep disorders that are characterized by abnormal behavioral or physical events during sleep are called:
- A. insomnia.
- B. dyssomnias.
- C. hypersomnia.
- D. parasomnias.
Correct Answer: D
Rationale: The correct answer is D: parasomnias. Parasomnias are sleep disorders involving abnormal behaviors or physical events during sleep, such as sleepwalking or night terrors. This is the correct choice because it specifically addresses the description provided in the question.
A: Insomnia is characterized by difficulty falling or staying asleep, not abnormal behaviors during sleep.
B: Dyssomnias are a broad category of sleep disorders affecting the timing, quality, or amount of sleep, not necessarily involving abnormal behaviors during sleep.
C: Hypersomnia is a sleep disorder characterized by excessive daytime sleepiness, not abnormal behaviors during sleep.
In summary, the other choices do not align with the description of sleep disorders involving abnormal behavioral or physical events during sleep, making D the correct answer.