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In the care plan of a male patient diagnosed with a dissociative disorder, the nursing diagnosis of ineffective coping is included. Which behavior demonstrated by the patient supports this nursing diagnosis?
- A. Has no memory of the physical abuse he endured.
- B. Using both alcohol and marijuana.
- C. Often reports being unaware of surroundings.
- D. Reports feelings of 'not really being here.'
Correct Answer: B
Rationale: The correct answer is B because using substances like alcohol and marijuana can be a sign of ineffective coping mechanisms in patients with dissociative disorders. Substance abuse is often used as a maladaptive way to cope with stress, trauma, or other underlying issues. Choices A, C, and D may be related to dissociative symptoms but do not directly reflect ineffective coping behaviors as substance abuse does.
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Which intervention should the nurse implement when caring for a patient demonstrating manic behavior? Select one that doesn't apply.
- A. Monitor the patient's vital signs frequently.
- B. Keep the patient distracted with group-oriented activities.
- C. Provide the patient with frequent milkshakes and protein drinks.
- D. Reduce the volume on the television and dim bright lights in the environment.
Correct Answer: B
Rationale: When caring for a patient demonstrating manic behavior, it is crucial to monitor vital signs frequently to ensure the patient's physical health is stable. Providing nutrition, such as milkshakes and protein drinks, is essential to meet the patient's dietary needs. Diminishing environmental stimuli by reducing the volume on the television and dimming bright lights can help create a calmer environment. However, keeping the patient distracted with group-oriented activities may not be the most appropriate intervention as it could potentially exacerbate the manic behavior by overstimulating the patient. Therefore, this choice is the one that doesn't apply in managing manic behavior effectively.
In a client's history, a significant indicator suggesting marginal coping skills and the need for careful risk assessment for violence is a history of
- A. childhood trauma.
- B. family involvement.
- C. academic problems.
- D. chemical dependence.
Correct Answer: D
Rationale: A history of chemical dependence is a critical factor indicating marginal coping skills and the need for assessing the risk of violence. Substance abuse can impair judgment, increase impulsivity, and escalate the likelihood of violent behavior. It is essential to thoroughly evaluate and address substance abuse issues in clients to enhance treatment outcomes and ensure safety.
What assessment question will provide information to the healthcare provider regarding the effects of a woman's circadian rhythms on her quality of life?
- A. How much sleep do you usually get each night?
- B. Does your heart ever seem to skip a beat?
- C. When was the last time you had a fever?
- D. Do you have problems urinating?
Correct Answer: A
Rationale: The correct assessment question to understand the effects of a woman's circadian rhythms on her quality of life is to inquire about her sleep duration. Circadian rhythms significantly influence sleep patterns, so knowing how much sleep she usually gets each night can provide valuable insight into potential circadian rhythm disturbances and their impact on her overall well-being.
When should healthcare professionals be most alert to the possibility of communication errors resulting in harm to the patient?
- A. Change of shift reports
- B. Admission interviews
- C. One-to-one conversations with patients
- D. Conversations with patient families
Correct Answer: A
Rationale: Healthcare professionals should be most alert to the possibility of communication errors resulting in harm to the patient during change of shift reports. This is a critical time when information is transferred between healthcare providers, and any errors in communication during this handover can lead to adverse outcomes for the patient.
A client displays signs and symptoms indicative of hypochondriasis. The nurse would initially expect to see:
- A. Self-preoccupation
- B. La belle indifference
- C. Fear of physicians
- D. Insight into the source of their fears
Correct Answer: A
Rationale: In hypochondriasis, individuals are excessively preoccupied with and worried about having a serious illness, despite reassurance from medical professionals. This self-preoccupation is a key characteristic of hypochondriasis. 'La belle indifference' refers to a lack of concern or distress about symptoms, which is not typically seen in hypochondriasis. Fear of physicians may be present due to the individual's persistent belief in their illness despite medical reassurance. Insight into the source of their fears is usually lacking in hypochondriasis, as individuals often believe their physical symptoms are evidence of a serious illness.