Nokea
During a grief-processing group, an elderly patient stated, “For the first time since my husband died, I’m having more good days than bad.” This statement suggests that the patient has:
- A. Reached the phase of reestablishment
- B. Determined she is ready to terminate the support group
- C. Completed her “grief work” successfully
- D. Replaced old memories with new ones.
Correct Answer: C
Rationale: The correct answer is C: Completed her "grief work" successfully. This statement indicates progress in the grieving process, moving towards acceptance and healing. The patient acknowledging having more good days than bad reflects a positive shift in coping with the loss, indicating that she has processed her grief and is beginning to adapt to life without her husband. This suggests that the patient has worked through her emotions, memories, and adjustments related to the loss, reaching a point where she is experiencing more peace and acceptance.
Summary:
A: Reestablishment is not the correct choice as it does not specifically address the completion of the grief work.
B: Determining readiness to terminate the support group is premature, as the patient may still benefit from continued support.
D: Replacing old memories with new ones is not supported by the patient's statement and does not necessarily indicate successful grief processing.
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A child who has been physically abused becomes emotionally distressed when told that the parent will no longer be allowed to visit. Which principle of social learning theory explains the child’s response?
- A. The child views the abuse as more desirable than the parent leaving
- B. The parent has fostered a fear in the child that increases when they are apart.
- C. The child believes they are responsible for the parent being punished.
- D.
The parent has likely told the child that they deserved the abuse as punishment.
Correct Answer: C
Rationale: The correct answer is C: The child believes they are responsible for the parent being punished. According to social learning theory, individuals learn behaviors through observation and modeling. In this scenario, the child has internalized the belief that they are the cause of the parent's punishment due to the abuse. This leads to feelings of guilt and distress when the parent is no longer allowed to visit.
A: The child does not view abuse as desirable; it is a harmful behavior.
B: While fear may be present, the core issue lies in the child's belief of responsibility.
D: The parent blaming the child for the abuse does not align with the principles of social learning theory.
Which of the following meets the DSM-IV-TR criteria for moderate mental retardation?
- A. Requires constant one-on-one supervision and total physical care
- B. Advanced as far as the second grade and provides her own personal care with supervision
- C. Attends the local community college for developmental English and math courses
- D. Advanced as far as the sixth grade and works at a warehouse every day and supports himself.
Correct Answer: D
Rationale: The correct answer is D because the DSM-IV-TR criteria for moderate mental retardation includes an IQ range of 35-49, which typically corresponds to functioning at around the level of a 6 to 9-year-old. Choice D best fits this criteria as the individual has advanced to the sixth grade level academically, indicating a level of functioning consistent with moderate mental retardation. Choices A, B, and C do not meet the criteria as they suggest a higher level of functioning and independence than what is typically associated with moderate mental retardation.
The Omnibus Budget Reconciliation Act (OBRA) provides standards of care for which of the following?
- A. Very young
- B. Older adults
- C. Those who have certain intellectual communication difficulties Those who have certain intellectual communication difficulties
- D. Those without medical insurance
Correct Answer: B
Rationale: The correct answer is B: Older adults. OBRA primarily focuses on setting standards of care for older adults in long-term care facilities, ensuring their safety and well-being. This is because older adults are a vulnerable population requiring specialized care and attention. Choices A, C, and D are incorrect because OBRA does not specifically address very young individuals, those with intellectual communication difficulties, or individuals without medical insurance. The Act mainly pertains to the care and rights of older adults in long-term care settings.
When sharing her feelings about separating from a therapy group, the patient stated, “I feel a bit sad and empty that I won’t be seeing you folks again.” What is the most accurate evaluation of the patient’s statement?
- A. It indicates regression and her lack of readiness to terminate.
- B. Unconsciously, she is hoping she will be permitted to continue the group.
- C. She is demonstrating normal feelings associated with termination of therapy.
- D. She needs further evaluation by her therapist to determine readiness to
Correct Answer: C
Rationale: The correct answer is C because the patient expressing feeling sad and empty about leaving the therapy group is a normal response to the termination of therapy. This indicates that the patient has developed attachments and a sense of belonging within the group, which is a common aspect of group therapy. It shows emotional investment in the therapeutic process and signifies progress in the patient's emotional awareness and ability to express feelings.
Choice A is incorrect because the statement does not necessarily indicate regression but rather a normal emotional response. Choice B is incorrect as it assumes unconscious motivations without evidence. Choice D is incorrect as it is not necessary to question the patient's readiness based on the provided statement.
Select the best outcome for a patient with the nursing diagnosis: "Impaired social interaction related to sociocultural dissonance as evidenced by stating, 'Although I’d like to, I don’t join in because I don’t speak the language very well.'” Patient will:
- A. Show improved use of language.
- B. Demonstrate improved social skills.
- C. Become more independent in decision-making.
- D. Select and participate in one group activity per day.
Correct Answer: D
Rationale: The correct answer is D: Select and participate in one group activity per day. This outcome directly addresses the nursing diagnosis of impaired social interaction by encouraging the patient to engage in a specific social activity daily. This goal promotes social interaction, helps the patient overcome language barriers, and gradually enhances their social skills. It provides a structured approach to improve the patient's sociocultural integration.
A: Show improved use of language - This choice focuses solely on language skills but does not directly address the social interaction issue.
B: Demonstrate improved social skills - While this choice is related to the nursing diagnosis, it is too broad and lacks specificity compared to choice D.
C: Become more independent in decision-making - This choice is not directly related to addressing impaired social interaction caused by language barriers.