Nokea
Inappropriate, life-threatening or challenging behaviours may be inadvertently maintained by reinforcement from others in the environment. Which of the following is a process that can be carried out in order to help identify the factors maintaining the behaviour?
- A. Functional analysis
- B. Statistical analysis
- C. Behavioural analysis
- D. Procedural analysis
Correct Answer: A
Rationale: Functional Analysis: Using operant conditioning principles to identify rewarding or reinforcing factors maintaining behavior.
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Which of the following can potentially be diagnostic at the clinic?
- A. The Ages & Stages questionnaire
- B. The Vanderbilt Rating Scale
- C. The MCHAT R/F
- D. The Goodenough Draw a Man test
Correct Answer: C
Rationale: The MCHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-up) is a validated diagnostic screening tool for autism that can be used in a clinic setting, unlike the others which are more general developmental or cognitive assessments.
A child, age 5, was admitted to the children's unit, having been sexually abused by an acquaintance of her family. The child refuses to talk and participate in unit activities, choosing to stay in her room with her stuffed animals. Which therapeutic intervention will best help the child release pent-up feelings about the abuse?
- A. Individual communication with the nurse
- B. Play therapy
- C. Family therapy
- D. Role-play with other children on the unit
Correct Answer: B
Rationale: The correct answer is B: Play therapy. Play therapy is the most suitable therapeutic intervention for a child in this scenario because it allows the child to express their feelings and experiences through play, which is a natural form of communication for children. Through play therapy, the child can act out their experiences using toys and create a safe space to process their emotions without having to verbally communicate. It helps the child release pent-up feelings and trauma in a non-threatening environment.
Summary of other choices:
A: Individual communication with the nurse may not be as effective as play therapy in this case as the child is not yet comfortable verbalizing their feelings.
C: Family therapy may not be appropriate at this stage as the child is not ready to engage with family members about the abuse.
D: Role-play with other children on the unit may not be beneficial as it can potentially trigger more anxiety and discomfort for the abused child.
A client with catatonic schizophrenia has been posturing, standing with his left arm upraised and his right foot off the floor. For the most part, he ignores attempts at nursing intervention but will occasionally walk, sit, or lie down for a few minutes. The client eats standing up if the nurse brings a tray to the room. The priority nursing order would be to:
- A. Insist that client sit or lie down for 30 minutes hourly
- B. Assess for lower extremity edema bid
- C. Provide high-calorie drinks hourly
- D. Take client to activities therapy once daily
Correct Answer: B
Rationale: The correct answer is B: Assess for lower extremity edema bid. It is important to assess for lower extremity edema in this client with catatonic schizophrenia as posturing in a standing position for prolonged periods can lead to decreased circulation and potential development of edema. This assessment is crucial to monitor the client's physical health and prevent complications such as deep vein thrombosis.
Choice A is incorrect as insisting the client sit or lie down for 30 minutes hourly may not address the underlying issue of potential lower extremity edema and could potentially worsen the client's condition by causing distress.
Choice C is incorrect as providing high-calorie drinks hourly does not address the immediate physical health concern of lower extremity edema and may not be appropriate without a comprehensive assessment of the client's nutritional needs.
Choice D is incorrect as taking the client to activities therapy once daily does not address the immediate need for assessing lower extremity edema and may not be suitable if the client's physical health
After a rape victim visited a rape crisis counselor weekly for 8 weeks, which finding best demonstrates that reorganization was successful?
- A. Absence of signs or symptoms of posttraumatic stress disorder
- B. Presence of mild somatic reactions
- C. Moderate doubts about self-worth
- D. Occasional episodic nightmares
Correct Answer: A
Rationale: The correct answer is A because the absence of signs or symptoms of posttraumatic stress disorder indicates successful reorganization after therapy. This demonstrates that the victim has effectively processed and coped with the trauma. Choice B indicates lingering somatic reactions, C suggests ongoing self-esteem issues, and D implies unresolved trauma manifesting in nightmares, all of which do not reflect successful reorganization.
A patient with mania has not eaten or slept for 3 days. Which nursing diagnosis has priority?
- A. Risk for injury
- B. Ineffective coping
- C. Ineffective management of therapeutic regime
- D. Imbalanced nutrition
Correct Answer: D
Rationale: The correct answer is D: Imbalanced nutrition. Priority is given to physiological needs. The patient not eating for 3 days can lead to serious health complications. This nursing diagnosis addresses the immediate risk to the patient's physical well-being. Choices A, B, and C are important but addressing the patient's nutritional needs is the priority to prevent further deterioration in their condition.