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During a counseling session, the mother of one of the clients with an eating disorder states to the nurse, 'I feel like such a failure. How can I be sure my daughter has no more problems like this?' Which response is the most therapeutic?
- A. You are not responsible for your daughter's behavior.'
- B. Avoid giving advice and engaging in power struggles with your daughter.'
- C. It sounds like you are blaming yourself for your daughter's problems.'
- D. Try to ignore any problems your daughter has related to her eating disorder.'
Correct Answer: C
Rationale: Rationale:
C is the correct answer because it demonstrates empathy and reflects active listening. It acknowledges the mother's feelings without judgment and helps her explore her emotions. A: Blames the mother. B: Avoids addressing the mother's emotions. D: Dismisses the daughter's issues.
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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.
A woman was bound, taken to a remote location, and raped at gunpoint. When found, she was examined and treated in the emergency department. Which aspect of this crisis produced the greatest amount of psychological trauma?
- A. The threat to her life
- B. Collection of evidence
- C. Physical pain experienced
- D. Being in a remote location
Correct Answer: A
Rationale: The correct answer is A: The threat to her life. This aspect produced the greatest psychological trauma as the fear of losing one's life triggers intense emotional distress and long-lasting psychological effects such as anxiety and PTSD. The threat of death during a traumatic event can lead to profound feelings of helplessness and vulnerability. In comparison, while the other aspects (B: Collection of evidence, C: Physical pain experienced, D: Being in a remote location) also contribute to the trauma experienced, they do not elicit the same level of fear and existential threat as the possibility of losing one's life.
A 45-year-old man develops weakness and wasting of the right hand. Which one of the following is least likely to be the cause?
- A. Old injury to the elbow joint.
- B. Bronchogenic carcinoma of the right upper lobe.
- C. Multiple sclerosis.
- D. Syringomyelia.
Correct Answer: C
Rationale: Multiple sclerosis (C) typically causes sensory and motor symptoms but rarely isolated hand wasting, which is more characteristic of peripheral nerve or motor neuron issues. Old injury (A), lung cancer (B, via brachial plexus), syringomyelia (D), and motor neurone disease (E) are more directly linked to such symptoms.
Which information is most important to obtain during assessment of an older adult diagnosed with a mental disorder?
- A. Functional ability and emotional status
- B. Chronological age and sexual function
- C. Economic status and sources of income
- D. Developmental history, interests, and activities
Correct Answer: A
Rationale: Information related to functional ability and emotional status provides an overview of patient problems and abilities. It guides selection of interventions and services to meet identified needs. The distracters reflect information of relevance, but are not of highest priority.
In clinical supervision, the nurse caring for the patient with a paranoid personality disorder tells the advanced practice nurse, 'I tried being caring and empathetic, but the patient just kept telling me to stay away.' Which response by the advanced practice nurse would be best?
- A. Acting somewhat cynical and aloof, like they do, will make it easier for paranoid persons to bond with you over time. That, plus humor.'
- B. You may be trying too hard too soon. Back off, give him some time to get used to you, then try your caring and empathetic approach again.'
- C. Mistrustful people do not bond as others do, so first it's important to be realistic. Second, a neutral yet courteous approach will work better.'
- D. You are on the right track, but give it more time. Actively conveying empathy and care will work, but paranoid persons respond more slowly.'
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the unique challenges of working with individuals with paranoid personality disorder. The response emphasizes the importance of being realistic about the patient's mistrust and suggests a neutral yet courteous approach. This approach recognizes the need to build trust gradually and not rush into being overly caring or empathetic, which could further trigger the patient's paranoia.
Choice A is incorrect because adopting a cynical and aloof attitude is not conducive to building rapport with individuals with paranoid personality disorder. Humor may also be perceived as mocking or dismissive.
Choice B is incorrect because it suggests backing off completely before trying a caring and empathetic approach again. This approach may not effectively address the patient's needs for support and may reinforce their feelings of isolation.
Choice D is incorrect because it suggests continuing with the caring and empathetic approach without acknowledging the need for a more cautious and neutral approach with individuals who are mistrustful. This approach may not effectively address the patient's specific needs and could potentially worsen the