Nokea
During the first family therapy session, the mother of a child being treated for truancy and emotional outbursts asks the nurse, “Why are you bothering to ask the rest of us questions? My son is the one with the problems.” The best response for the nurse would be:
- A. “We’ll get more accurate information if the entire family is involved.”
- B. “It may seem strange to you, but we’ll get better results doing it this way.”
- C. “When one family member is sick, the whole family system is sick as well.”
- D. “Every family member’s perceptions are very important to the total picture.”
Correct Answer: A
Rationale: The correct answer is A because involving the entire family in therapy sessions allows for a more comprehensive understanding of the family dynamics and how they may be contributing to the child's issues. By including all family members, the nurse can gather diverse perspectives and insights that can inform the treatment plan. This approach also promotes family unity and collaboration in addressing the child's problems.
Option B is not the best response as it lacks a clear rationale for involving the whole family. Option C, while partially true, does not directly address the question raised by the mother. Option D emphasizes the importance of every family member's perceptions but does not specifically address the benefits of involving the entire family in therapy sessions.
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A teenage boy has lost his best friend as a result of a hunting accident. His parents report that he is eating and sleeping very little and expresses little interest in school. They are concerned that he talks about the accident repeatedly. These behaviors are generally seen as:
- A. Expressing responsibility for his friends death
- B. Attempts to avoid dealing with his pain
- C. Expressions of a normal grief reaction
- D. Indications of a risk for self-harm
Correct Answer: C
Rationale: The correct answer is C: Expressions of a normal grief reaction. The teenage boy's behaviors of poor appetite, insomnia, lack of interest in school, and repetitive discussions about the accident are common manifestations of grief. This grief reaction is a normal response to losing a close friend in a traumatic manner like a hunting accident. It is important to acknowledge and validate his emotions during this difficult time.
Incorrect Choices:
A: Expressing responsibility for his friend's death - This choice suggests guilt or blame on the part of the boy, which is not evident in the scenario.
B: Attempts to avoid dealing with his pain - The boy's behaviors indicate he is processing his grief rather than avoiding it.
D: Indications of a risk for self-harm - While it is important to monitor for signs of self-harm, the behaviors described are more indicative of grief rather than immediate self-harm risk.
Which response demonstrates both empathy and understanding of the relationship genetics has to the development of schizophrenia in twins?
- A. In fraternal twins, the chance of the other twin developing the disorder is quite small.
- B. No one can say what will happen, so we will hope for the best for you and both of your sons.
- C. You poor woman! I wish I could tell you that your other son will be free of the disorder
- D. Studies show that 50% of twins develop schizophrenia when it is present in the other twin.
Correct Answer: D
Rationale: The correct answer is D because it provides an empathetic response by acknowledging the concern of the parent and demonstrating an understanding of the genetic link between twins and schizophrenia. By citing a specific statistic (50%), it shows knowledge of the relationship between genetics and the development of schizophrenia in twins.
Choice A is incorrect because it downplays the genetic influence by suggesting a small chance, which is not accurate.
Choice B is incorrect because it dismisses the seriousness of the situation and does not address the genetics aspect of the disorder.
Choice C is incorrect because it is not based on factual information and offers sympathy without addressing the genetic component of schizophrenia in twins.
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.
A 70-year-old male has the nursing diagnosis of situational low self-esteem related to forced retirement. Using Maslow’s hierarchy, the nurse is confident the patient is meeting self-worth outcomes when the patient:
- A. Moves to a secure apartment building
- B. Exercises regularly with friends at the gym
- C. Attends his grandchildren’s school functions
- D. Volunteers at the local homeless shelter weekly
Correct Answer: D
Rationale: The correct answer is D because volunteering at the local homeless shelter fulfills the self-actualization need in Maslow's hierarchy. By helping others and contributing to the community, the patient gains a sense of purpose and fulfillment, boosting self-esteem.
A: Moving to a secure apartment building addresses safety needs, not self-esteem.
B: Exercising with friends promotes social belonging but does not directly address self-esteem.
C: Attending grandchildren's functions fosters social connections, but it may not directly impact self-esteem like volunteering does.
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.