Nokea
The child's ability to understand consequences develops during
- A. Sensorimotor
- B. Preoperational
- C. Concrete operational
- D. Formal operational
Correct Answer: C
Rationale: Understanding consequences, tied to logical thinking, develops in the concrete operational stage (Piaget).
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Police bring a patient to the emergency department after an automobile accident. The patient is ataxic with slurred speech and mild confusion. The blood alcohol level is 400 mg/dl (0.4 mg %). Considering the relationship between behavior and blood alcohol level, which conclusion can the nurse draw? The patient:
- A. rarely drinks alcohol.
- B. has a high tolerance to alcohol.
- C. has been treated with disulfiram (Antabuse).
- D. has recently ingested both alcohol and sedative drugs.
Correct Answer: B
Rationale: The correct answer is B: the patient has a high tolerance to alcohol. At a blood alcohol level of 400 mg/dl, most individuals would exhibit severe symptoms such as unconsciousness or coma. However, this patient only shows mild symptoms of ataxia, slurred speech, and confusion, indicating a high tolerance to alcohol. This high tolerance suggests that the patient regularly consumes large amounts of alcohol, leading to an adaptation in the body's response to alcohol.
Choice A is incorrect because a blood alcohol level of 400 mg/dl is indicative of significant alcohol consumption, contradicting the statement that the patient rarely drinks alcohol. Choice C is incorrect as disulfiram is used to treat alcohol dependence, not tolerance. Choice D is incorrect since sedative drugs would exacerbate the effects of alcohol, causing more severe symptoms than what is observed in this case.
Mrs Wang is a retired teacher and used to take trips on cruise ships with her friends to gamble at the casino. She now goes to the local casino every other day by herself and is preoccupied with gambling. Her problem surfaced when she was caught on the closed circuit camera for trying to steal casino chips. Her husband was at a loss and reports that she keeps talking about gambling and boasts to her friends about the large amounts she places per bet. Her luck has turned for the worse, but she insists on going back to 'recoup' her losses. She has pawned most of her jewelry, stopped seeing her friends, and lies to her family about the amounts she has lost. Mrs Wang has features of a
- A. Social gambler.
- B. At risk gambler.
- C. Problem gambler.
- D. Pathological gambler.
Correct Answer: D
Rationale: Mrs. Wang's preoccupation, theft, financial loss, and deceit indicate pathological gambling, a severe disorder per DSM-5 criteria.
To support Level 1 families, a practitioner should first...
- A. Identify any mental health issues
- B. Mobilize support for the ineffective executive or parental system
- C. Develop a coalition of those in charge vs those needing control
- D. Case manage to meet basic needs for food, health, shelter, protection
Correct Answer: D
Rationale: Level 1 families often face immediate survival needs, so addressing basic requirements like food, shelter, and safety is the foundational step before other interventions can be effective.
Which nursing intervention best demonstrates an understanding of the effects of mental illness in the creation of secondary at-risk populations?
- A. Educating junior high school students concerning the dangers of drug and alcohol abuse
- B. Assessing the parenting skills of a father diagnosed with obsessive-compulsive disorder (OCD)
- C. Assessing the friends of a teenager who was recently hospitalized for an eating disorder for signs of the same disorder
- D. Providing the parents of a child diagnosed with obsessive-compulsive disorder (OCD) with information on behavior modification
Correct Answer: B
Rationale: Step-by-step rationale for why choice B is correct:
1. Mental illness can impact parenting skills.
2. Assessing parenting skills of a father with OCD is crucial to understand potential risks to the child.
3. OCD may affect parenting abilities, leading to neglect or inappropriate care.
4. By assessing parenting skills, nurses can identify and address risks to the child's well-being.
Summary of why other choices are incorrect:
A: Educating junior high students on drug abuse is important but does not directly address at-risk populations created by mental illness.
C: Assessing friends for signs of eating disorders is relevant but does not focus on understanding the impact of mental illness on caregiving roles.
D: Providing information on behavior modification to parents is helpful but does not directly assess the impact of mental illness on parenting skills.
The most appropriate nursing intervention with Marie (from question 9) would be to:
- A. Refer her to her family physician for a complete physical examination.
- B. Suggest she seek outside employment now that her children have left home.
- C. Identify convenient support systems for times when she is feeling particularly despondent.
- D. Begin grief work and assist her to recognize areas of self-worth separate and apart from her children.
Correct Answer: D
Rationale: The correct answer is D because Marie is experiencing empty nest syndrome, a common emotional response when children leave home. Grief work helps her process and cope with the loss, while recognizing self-worth beyond motherhood promotes self-identity. Referring her to a physician (A) may not address her emotional needs. Seeking outside employment (B) may not address her emotional concerns. Identifying support systems (C) is helpful but doesn't directly address her need for grief work and self-worth recognition.