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The client is in the maintenance stage based on the transtheoretical model of health behavior change. Which stage is the client in?
- A. Action
- B. Preparation
- C. Maintenance
- D. Contemplation
Correct Answer: C
Rationale: The client is in the maintenance stage of human behavior change. During this stage, the client has successfully incorporated the changes into their lifestyle. The maintenance stage typically begins 6 months after the action stage and continues indefinitely. The action stage lasts for 6 months from when the client initially incorporates the changes. In the preparation stage, the client starts realizing that the benefits of change outweigh the disadvantages and starts making small changes to prepare for major changes in the following month. The contemplation stage involves the client considering whether to make changes in the next 6 months. Therefore, in this scenario, the client's consistent adherence to the diet and exercise program for 8 months places them in the maintenance stage of behavior change.
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What initial treatment would the nurse expect for a preschool-aged child experiencing severe fear of the dark?
- A. Prescription medication
- B. Mental health counseling
- C. Cognitive behavioral therapy
- D. Repetition of brave statements
Correct Answer: D
Rationale: Repetition of brave statements is an effective initial treatment for preschool-aged children with severe fear of the dark. This technique involves encouraging the child to repeat positive and reassuring statements to themselves to build confidence and reduce fear. Prescription medication is not typically the first-line approach for this type of fear in children due to potential side effects and safety concerns. Mental health counseling and cognitive behavioral therapy may be considered if the fear persists or is severe, but they are usually not the initial treatments for preschool-aged children with fear of the dark.
What initial response would the nurse give to a husband who is upset that his wife's alcohol withdrawal delirium has persisted for a second day?
- A. "I see that you're worried. We're using medication to ease your wife's discomfort."?
- B. "This is expected. I suggest that you go home because there's nothing you can do to help."?
- C. "If you're afraid that she will die, I assure you, very few alcoholics die during detoxification."?
- D. "If you are concerned that she is uncomfortable, I'm sure that she's not in pain."?
Correct Answer: A
Rationale: The correct response is to acknowledge the husband's feelings and provide information on the treatment plan to alleviate his concerns. This approach validates his emotions and educates him on the steps being taken to help his wife, promoting understanding and reducing anxiety. Choice B is incorrect as it dismisses the husband's worries and implies helplessness, potentially increasing his distress. Choice C is inappropriate as it introduces the concept of death, which can heighten fear and anxiety in the husband. Choice D is not recommended as it provides reassurance about the wife's pain without accurate knowledge of her discomfort, which could undermine trust and communication between the nurse and the husband.
Which term or description would the nurse use for a client who repeatedly performs ritualistic behaviors throughout the day to limit anxious feelings?
- A. Obsessions
- B. Compulsions
- C. Under personal control
- D. Related to rebelliousness
Correct Answer: B
Rationale: The correct answer is 'Compulsions.' A compulsion is an uncontrollable, persistent urge to perform an act repetitively to relieve anxiety. In this scenario, the client's repetitive ritualistic behaviors are indicative of compulsions. Obsessions, on the other hand, are persistent ideas, thoughts, or impulses that cannot be eliminated with logical reasoning. The behavior is not under personal control because avoiding it increases anxiety, making it a defense mechanism. It is not related to rebelliousness; instead, clients engage in these behaviors to reduce anxiety.
After being medicated for anxiety, the client says to the nurse, 'I guess you are too busy to stay with me.' Which response by the nurse is correct?
- A. I'm so sorry, but I need to see other clients.'
- B. 'I have to go now, but I will come back in 10 minutes.'
- C. You'll be able to rest after the medicine starts working.'
- D. You'll feel better after I've made you more comfortable.'
Correct Answer: B
Rationale: The nurse should respond with empathy and reassurance to address the client's emotional needs. The correct response, 'I have to go now, but I will come back in 10 minutes,' acknowledges the client's feelings while providing a timeframe for the nurse's return, showing care and concern. Choice A, 'I'm so sorry, but I need to see other clients,' prioritizes other tasks over the client's emotional needs, which can increase anxiety. Choice C, 'You'll be able to rest after the medicine starts working,' offers false reassurance and does not address the client's immediate emotional distress. Choice D, 'You'll feel better after I've made you more comfortable,' does not acknowledge the client's concerns and fails to establish a supportive connection with the client.
Which consideration is the most accurate when applying the principles of mental health?
- A. Emotionally ill individuals may initially reject psychological support from family or others.
- B. People with emotional illnesses may experience challenges in problem-solving.
- C. Mental illness is not solely characterized by signs and symptoms of socially inappropriate behavior.
- D. Emotional health is promoted when there is a sense of mastery of self and the environment.
Correct Answer: D
Rationale: Emotional health is enhanced when an individual feels a sense of control over themselves and their surroundings, fostering security, reducing anxiety, and promoting optimal functioning. While some emotionally ill individuals may reject help initially, many are in distress and acknowledge the need for psychological support. Some seek care based on positive past experiences or the attention received. Additionally, individuals with excellent cognitive function may face challenges in problem-solving due to emotional or psychological barriers. Not all individuals with mental illness exhibit socially inappropriate behavior; it is a misconception that mental illness is solely characterized by such signs and symptoms. Therefore, the most accurate consideration among the choices is that emotional health thrives when there is a feeling of mastery over oneself and the environment.