Nokea
During a bereavement group, one of the members states, “I should have been the one to die. My husband had so much to offer.” The member was expressing:
- A. Ambivalence and low self-esteem
- B. Unresolved anger toward her husband
- C. A need for attention from group members
- D. Depression
Correct Answer: A
Rationale: The correct answer is A: Ambivalence and low self-esteem. The member's statement reflects conflicting emotions (ambivalence) about her worth compared to her husband's. This indicates low self-esteem, as she believes she is less valuable. Unresolved anger (B) would involve blaming her husband, not herself. A need for attention (C) is not evident, as she is sharing personal feelings. Depression (D) may be present, but the statement specifically points to self-deprecation, not just a general feeling of sadness.
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Which intervention best reflects the nursing role regarding effective implementation of behavioral therapy goals?
- A. Administering the prescribed medications accurately
- B. Interacting effectively with members of the health care team
- C. Being aware of all the patient related therapeutic modalities
- D. Evaluating patient behaviors to reward economic tokens appropriately
Correct Answer: D
Rationale: The correct answer is D because evaluating patient behaviors to reward economic tokens appropriately is a key aspect of behavioral therapy. By assessing and reinforcing positive behaviors with rewards, nurses can encourage patients to continue working towards their therapy goals. Administering medications accurately (choice A) is important but not directly related to behavioral therapy goals. Interacting effectively with the health care team (choice B) is important for overall patient care but does not specifically address behavioral therapy. Being aware of therapeutic modalities (choice C) is important but does not directly contribute to implementing behavioral therapy goals like choice D does.
After undergoing two of nine electroconvulsive therapy (ECT) procedures, a client states, "I can’t even remember eating breakfast, so I want to stop the ECT." Which is the most appropriate nursing reply?
- A. After you begin the course of treatments, you must complete all of them.
- B. You’ll need to talk with your doctor about what you’re thinking
- C. It is within your right to discontinue the treatments, but let’s talk about your concerns.
- D. Memory loss is a rare side effect of the treatment. I don’t think it should be a concern.
Correct Answer: C
Rationale: The correct answer is C. It acknowledges the client's autonomy while also addressing their concerns. First, it recognizes the client's right to discontinue treatment. Second, it opens the door for a discussion to explore the client's worries and provide support. This response shows empathy and respects the client's decision-making.
Choice A is incorrect because it dismisses the client's autonomy and fails to address their concerns. Choice B is not as appropriate as it suggests only talking to the doctor, missing the opportunity for the nurse to provide immediate support. Choice D is incorrect as it invalidates the client's experience of memory loss and fails to address their concerns.
A grief support group is held at the local community center to assist persons who are dealing with issues of loss. Which remark by one of the members would the nurse interpret as indicating unresolved feelings of guilt?
- A. “I know that my husband had a good life.”
- B. “It seems I miss my son more as time goes on.”
- C. “I am still wishing I had gotten help to him sooner.”
- D. "The holidays are always so hard for me now."
Correct Answer: C
Rationale: The correct answer is C because the statement indicates feelings of guilt about not getting help sooner, suggesting the member may blame themselves for the loss. This remark reflects a sense of responsibility and regret, common in unresolved guilt. Choice A expresses acceptance, B reflects natural grief progression, and D highlights difficulty during specific times, not necessarily linked to guilt. By analyzing the content of each statement, the nurse can identify cues related to unresolved feelings of guilt.
How can the nurse encourage an extremely shy patient to participate therapeutically in a dance activity group?
- A. Offer to dance with the patient.
- B. Ask the patient if this is the first dance he has attended.
- C. Sit with the patient away from the group.
- D. Encourage another patient to ask him to dance.
Correct Answer: A
Rationale: The correct answer is A because offering to dance with the patient shows support, builds trust, and models behavior. This approach can help the shy patient feel more comfortable and encouraged to participate. Choice B focuses on the patient's past experience, which may not directly address the current issue. Choice C isolates the patient, potentially increasing feelings of shyness. Choice D involves a third party, which may not be as effective in building a direct connection with the shy patient. Overall, option A is the most effective in directly engaging and encouraging the shy patient to participate therapeutically in the dance activity group.
The patient states, "Everybody picks on me. They frobitz me." The patient’s communication exhibits:
- A. A neologism
- B. Loose associations
- C. Delusional thinking
- D. Circumstantial speech
Correct Answer: A
Rationale: The correct answer is A: A neologism. A neologism is a made-up word or phrase that only has meaning to the individual. In this case, "frobitz" is not a known word in the English language, indicating a neologism. This suggests possible language or thought disorder. B: Loose associations involve disconnected or tangential thoughts. C: Delusional thinking involves fixed false beliefs. D: Circumstantial speech includes excessive, irrelevant detail before reaching the main point.