Nokea
The extreme reaction known as fugue refers to
- A. physical flight to escape conflict
- B. severe depression
- C. hallucinations
- D. obsessive behavior
Correct Answer: A
Rationale: Fugue is a dissociative state involving sudden travel or flight, often to escape stress.
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A rape victim tells the nurse, "I should not have been out on the street alone."Â Select the nurse's most helpful response.
- A. Rape can happen anywhere.
- B. Blaming yourself increases your anxiety and discomfort.
- C. You are right. You should not have been alone on the street at night.
- D. You feel as though this would not have happened if you had not been alone.
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the victim's feelings without placing blame or judgment. By reflecting the victim's feelings back to them, the nurse validates their experience and shows empathy. This response encourages the victim to express their emotions and helps in building trust with the nurse.
Other choices are incorrect:
A: This choice does not address the victim's feelings of self-blame and does not provide the needed support.
B: While this choice acknowledges the negative impact of self-blame, it does not directly address the victim's statement.
C: This choice may be perceived as dismissive or blaming, which can further harm the victim's emotional well-being.
The Omnibus Budget Reconciliation Act (OBRA) provides standards of care for which of the following:
- A. Very young
- B. Older adults
- C. Those who have certain intellectual communication difficulties
- D. Those without medical insurance
Correct Answer: B
Rationale: OBRA provides regulations for proper assessment of the elderly (B); for this reason, registered nurses have to provide the initial physical assessment.
The psychiatric-mental health nurse knows that the patient's spouse clearly understands the adverse effects of lithium carbonate (Eskalith), when they say:
- A. I should call the doctor if my spouse shakes badly'
- B. I should make sure my spouse drinks as much water as possible'
- C. My spouse must remain on a salt-free diet'
- D. When the lithium level is 1.6mEq\L, my spouse can go back to work'
Correct Answer: A
Rationale: Tremors are a common lithium side effect requiring medical attention; other options reflect misunderstanding (e.g., salt-free diet increases toxicity risk, 1.6mEq\L is toxic).
In Massachusetts, which year contained the highest level of days exceeding the 8-hour average ground-level ozone standard?
- A. 1983
- B. 1984
- C. 2007
- D. 1999
Correct Answer: A
Rationale: 1983 likely had higher ozone exceedances due to less stringent regulations and higher industrial emissions at that time.
A male patient diagnosed with paranoid schizophrenia typically relates effectively with female staff but angrily tells the male nurse, 'You act like a homosexual. None of the men trust you or want to be around you.' The nurse, who is heterosexual, is perplexed by the patient's statements and discusses the event with his mentor. Which explanation most likely underlies the patient's behavior?
- A. The patient was unleashing unconscious, hostile feelings toward the nurse.
- B. The patient feared the nurse would reject him, so he coped by rejecting the nurse first.
- C. It was the patient's way of distancing himself from potential emotional intimacy.
- D. The patient was coping with homosexual urges by projecting them onto the nurse.
Correct Answer: D
Rationale: The correct answer is D because the patient is exhibiting the defense mechanism of projection by attributing his own uncomfortable feelings (homosexual urges) to the nurse. This defense mechanism allows the patient to disown his feelings and project them onto others. This behavior is common in individuals struggling with their own conflicting desires or impulses.
Incorrect choices:
A: Unconscious hostile feelings are not necessarily the root cause in this scenario.
B: The patient's behavior is not about preemptively rejecting the nurse due to fear of rejection.
C: While emotional intimacy may play a role, the patient's behavior is more about projection of his own feelings onto the nurse rather than distancing himself.