Nokea
The community health nurse is conducting an awareness workshop on adolescent suicide. Which circumstances should the nurse discuss as risk factors?
- A. Family violence
- B. Use of alcohol or drugs
- C. Strong peer relationships
- D. Family history of depression
- E. Family has adequate financial resources
Correct Answer: A,B,D
Rationale: Risk factors for suicide among adolescents are depression; a family history of mental health disorders, especially depression and suicide; previous attempts at suicide; family violence or abuse; substance abuse; poor school performance; feelings of worthlessness or hopelessness; and homosexuality.
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Which reaction toward the physical symptom would the nurse observe in a client with conversion disorder?
- A. Anger
- B. Apathy
- C. Anxiety
- D. Agitation
Correct Answer: B
Rationale: In conversion disorder, the nurse would observe apathy toward the physical symptom. The development of the symptom serves as an unconscious method of reducing anxiety. The symptom is accepted passively, known as 'la belle indifférence.' There is no anger observed as symptoms are passively accepted. Similarly, there is no direct anxiety related to the physical symptom, as the conflict is resolved through the symptom development. While many individuals might experience agitation and seek to identify the cause of physical symptoms, in conversion disorder, there is an unusual calmness or indifference towards the physical manifestation, indicating apathy rather than other emotional responses.
A 37-year-old woman with a history of fibroids and menorrhagia that have not been responsive to hormonal treatments is admitted with severe menorrhagia resulting in anemia. She also has depression and pelvic pain. She is crying and states, 'I don't know what to do"?my primary health care provider is recommending a hysterectomy, but I haven't had children yet!' Which response would the nurse provide?
- A. There are so many children up for adoption, looking for a mother.'
- B. This must feel so difficult for you. Children are really important to you?'
- C. This must feel so difficult for you. Although Children should not be important to you.'
- D. Believe me when I tell you that kids are so difficult to raise"?you're better off without them.'
Correct Answer: B
Rationale: The correct response is to acknowledge the client's feelings and provide an open-ended question to encourage further expression. By expressing empathy and understanding, the nurse can create a supportive environment for the client. This approach allows the client to explore her emotions and concerns freely. Option A, suggesting adoption, may come across as dismissive of the client's current emotional state and may not address her immediate needs. Option D is insensitive and dismissive of the client's feelings and desires regarding having children. It is important to avoid making assumptions or judgments about the client's situation. Option C is a duplicate of Option B, and while it shows empathy, it lacks variety in communication, which may limit the depth of the conversation and the nurse's understanding of the client's needs.
A client who is in labor has human immunodeficiency virus (HIV) and states to the nurse, 'I know I will have a sick-looking baby.' Which appropriate therapeutic response should the nurse make?
- A. You are very sick, but your baby may not be.'
- B. All babies are beautiful. I am sure your baby will be too.'
- C. You have concerns about how HIV will affect your baby?'
- D. There is no reason to worry. Our neonatal unit offers the latest treatments available.'
Correct Answer: C
Rationale: Option 3 is the most therapeutic response, and it will elicit the best information. It addresses the therapeutic communication technique of paraphrasing. Option 3 also is an open-ended response that will provide an opportunity for the client to verbalize her concerns. Parents need to know that their baby will not look sick from HIV at birth and that there may be a period of uncertainty before it is known whether the baby has acquired the infection. Options 1 and 2 provide false reassurances. The client should not be told that there is no reason to worry.
A client recovering from an acute myocardial infarction will be discharged in 1 day. Which client action on the evening before discharge suggests that the client is in the denial about his medical condition?
- A. Requests a sedative for sleep at 10:00 pm
- B. Expresses a hesitancy to leave the hospital
- C. Consumes 25% of foods and fluids given for supper
- D. Walks up and down three flights of stairs unsupervised
Correct Answer: D
Rationale: Ignoring activity limitations and avoiding lifestyle changes are signs of the denial stage. Walking three flights of stairs should be a supervised activity during this phase of the recovery process. Option 1 is an appropriate client action on the evening before discharge. Option 2 may be a manifestation of anxiety or fear rather than denial. Option 3 is a manifestation of depression rather than denial.
Based on Maslow's hierarchy of needs, which client is demonstrating characteristics of self-actualization?
- A. Client is competent and esteemed by others for accomplishing work goals
- B. Client maintains a stable, loving, same-sex partnership for several years
- C. Client learns to sublimate aggressive impulses using physical exercises
- D. Client has an accurate perception of reality and is accepting of self and others
Correct Answer: D
Rationale: According to Maslow's hierarchy of needs, self-actualization is the highest level where individuals strive to reach their full potential and achieve personal growth. A self-actualized person, as per Maslow, has an accurate perception of reality and is accepting of themselves and others. This individual is characterized by traits such as fairness, independence, spontaneity, and creativity. While choices A, B, and C represent important aspects of human needs fulfillment, they align more closely with lower levels in Maslow's hierarchy. Choice A refers to meeting self-esteem needs, choice B relates to love and belonging needs, and choice C addresses safety needs, all of which are below self-actualization in the hierarchy of needs.