Nokea
Joe, a Native American, appears at the community health clinic with an oozing stasis ulcer on his lower right leg. It is obviously infected, and he tells the nurse that the shaman has been treating it with herbs. The nurse determines that Joe needs emergency care, but Joe states he will not go to the emergency department (ED) unless the shaman is allowed to help treat him. How should the nurse handle this situation?
- A. Contact the shaman and have him meet them at the ED to consult with the attending physician.
- B. Tell Joe that the shaman is not allowed in the ED.
- C. Explain to Joe that the shaman is at fault for his leg being in the condition it is in now.
- D. Have the shaman try to talk Joe into going to the ED without him.
Correct Answer: A
Rationale: Joe's cultural reliance on the shaman for treatment requires the nurse to respect this belief by allowing the shaman's involvement in the ED, ensuring cultural sensitivity and compliance with treatment, aligning with option a.
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Which treatment has been identified as a best practice for persons with borderline personality disorder?
- A. Dialectical behavioral therapy (DBT)
- B. Cognitive Behavioral Therapy (CBT)
- C. Mindfulness-Based Cognitive Therapy (MBCT)
- D. Exposure and Response Prevention (ERP)
Correct Answer: A
Rationale: The correct answer is A: Dialectical Behavioral Therapy (DBT). DBT is specifically designed for individuals with borderline personality disorder, focusing on emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness. It has shown to be effective in reducing self-harm behaviors and improving overall functioning. CBT (B) may be helpful for some symptoms but lacks the comprehensive approach of DBT. MBCT (C) is primarily used for depression and may not address the specific needs of individuals with borderline personality disorder. ERP (D) is used for anxiety disorders, not BPD.
A therapeutic milieu is:
- A. A safe environment of care that is conducive to the prevention of medical errors.
- B. A client care area that provides personal privacy and the confidentiality of medical information.
- C. A European method of design and color to promote health and wellness.
- D. The provision of a therapeutic environment of consistency to promote health.
Correct Answer: D
Rationale: A therapeutic milieu (D) promotes health through consistency.
he Montessori approach believes that discipline is
- A. Imposed
- B. Self-imposed
- C. Punitive
- D. External
Correct Answer: B
Rationale: Montessori fosters self-imposed discipline through independence and responsibility.
A patient is admitted in a comatose state after ingesting 30 capsules of pentobarbital sodium. A friend of the patient says, 'Often my friend drinks, along with taking more of the drug than is ordered.' What is the effect of the use of alcohol with this drug?
- A. The drug’s metabolism is stimulated.
- B. The drug’s effect is diminished.
- C. A synergistic effect occurs.
- D. There is no effect.
Correct Answer: C
Rationale: The correct answer is C: A synergistic effect occurs. When alcohol is consumed with pentobarbital sodium, both substances depress the central nervous system. This results in an enhanced sedative effect, leading to respiratory depression, coma, and potentially death. The combined effect of the two substances is greater than the sum of their individual effects. Choices A and B are incorrect as alcohol does not stimulate the metabolism of pentobarbital sodium nor diminish its effect. Choice D is also incorrect as there is a significant effect when alcohol is combined with this drug.
Which question asked by the nurse best serves as a screening tool for the assessment of a possible problem with alcohol abuse?
- A. When was the last time you drank alcohol?'
- B. Is there a history of alcohol abuse in your immediate family?'
- C. How old were you when you had your first drink of alcohol?'
- D. In the last year, did you ever drink more alcohol than you intended to?'
Correct Answer: D
Rationale: The correct answer is D because it directly assesses the individual's control over alcohol consumption, a key indicator of potential alcohol abuse. By asking if the person has ever consumed more alcohol than intended in the last year, the nurse can gauge if there are issues with self-regulation and potential abuse. Choices A, B, and C focus on past behaviors or family history, which are important but do not directly address current patterns of alcohol consumption and potential abuse.