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During the first interview with a parent whose child died in a car accident, the nurse feels empathic and reaches out to take the patient’s hand. Select the correct analysis of the nurse’s behavior.
- A. It shows empathy and compassion. It will encourage the patient to continue to express feelings.
- B. The gesture is premature. The patient’s cultural and individual interpretation of touch is unknown.
- C. The patient will perceive the gesture as intrusive and overstepping boundaries.
- D. The action is inappropriate. Psychiatric patients should not be touched.
Correct Answer: B
Rationale: Touch requires cultural and individual assessment, as in Option B, to avoid misinterpretation. Options A, C, and D assume outcomes or overgeneralize without evidence.
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A malpractice lawsuit was filed after a nurse restrained the client for screaming at and attempting to strike anyone who was within striking distance. The nurse followed agency procedures that were consistent with Joint Commission Standards. For which reason is this malpractice lawsuit most likely to be unsuccessful?
- A. The nurse did not have a duty.
- B. The nurse did not breach duty.
- C. The client did not suffer some type of loss, damage, or injury.
- D. There was no evidence that a breach of duty was a direct cause of the loss, damage, or injury.
Correct Answer: B
Rationale: For a malpractice suit to be successful, the client or family needs to prove the following four elements: (1) Duty: a legally recognized relationship (i.e., physician to client, nurse to client) existed. The nurse had a duty to the client, meaning that the nurse was acting in the capacity of a nurse. (2) Breach of duty: the nurse (or physician) failed to conform to standards of care, thereby breaching or failing the existing duty. The nurse did not act as a reasonable, prudent nurse would have acted in similar circumstances. (3) Injury or damage: the client suffered some type of loss, damage, or injury. (4) Causation: the breach of duty was the direct cause of the loss, damage, or injury. In other words, the loss, damage, or injury would not have occurred if the nurse had acted in a reasonable, prudent manner. The nurse did have a duty to the client. The nurse did not breach this duty by the nursing actions. The client did experience loss of autonomy from being restrained. Since there was no breach of duty, there was no evidence that a breach of duty was a direct cause of the loss, damage, or injury.
A nurse is caring for a patient diagnosed with schizophrenia. The patient is exhibiting negative symptoms, such as lack of motivation and limited speech. Which of the following is an appropriate intervention?
- A. Encourage the patient to engage in social activities and talk about their feelings.
- B. Provide the patient with a structured routine and encourage participation in small tasks.
- C. Allow the patient to rest and avoid any demands or expectations.
- D. Tell the patient to try harder to communicate and participate in activities.
Correct Answer: B
Rationale: Providing a structured routine and encouraging small tasks can help engage the patient, even when they have limited motivation or speech.
Spirituality is especially important in helping people cope primarily for which of the following reasons?
- A. Spirituality helps people set personal goals.
- B. Spirituality gives people meaningful daily activities in which to participate.
- C. Spirituality provides a reliable support network.
- D. Spirituality guides beliefs about the meaning of life events.
Correct Answer: D
Rationale: Spirituality offers a framework for understanding life’s meaning (D), aiding coping in mental illness. Goals (A) link to self-efficacy, activities (B) to hardiness, and networks (C) are secondary benefits.
Which of the following are common aspects of co-morbidity in anxiety disorders?
- A. Physiological symptoms of panic are found not only in panic disorder, but also in the reactions to phobic stimuli in specific phobias.
- B. Cognitive biases - such as information processing biases that tend anxious people to selectively attending to threatening stimuli (Mathews & McLeod, 1994) - are common to almost all anxiety disorders.
- C. Certain specific early experiences can be found in the aetiology of a number of different anxiety disorders (e.g. physical or sexual abuse during childhood), and experiences such as these may increase an individual's risk of developing several anxiety-based problems.
- D. All of the above.
Correct Answer: D
Rationale: Co-morbidity refers to the co-occurrence of multiple disorders. Option D includes all listed aspects: physiological overlap (A) between panic and phobia responses, shared cognitive biases (B) across anxiety disorders (Mathews & McLeod, 1994), and common early risk factors (C) like trauma. Each is a well-documented feature of anxiety disorder co-morbidity, making 'all of the above' correct.
A patient in a group therapy session listens to others and then remarks, "I used to think I was the only one who felt afraid. I guess I'm not as alone as I thought." This comment is an example of
- A. altruism.
- B. ventilation.
- C. universality.
- D. group cohesiveness.
Correct Answer: C
Rationale: Realizing that one is not alone and that others share the same problems and feelings is called universality. Ventilation refers to expressing emotions. Altruism refers to benefitting by being of help to others. Group cohesiveness refers to the degree of bonding among members of the group.