Population Specific Care

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The head nurse on a unit that serves persons with cognitive impairment is concerned about her staff, many of whom seem to be becoming 'burned out' by their challenging work. Which response by the head nurse is most likely to minimize staff frustration and burnout on the unit? Select all that apply.

  • A. Educate staff regarding realistic expectations for this patient population.
  • B. Arrange for 12-hour shifts so that staff can have more days off per week.
  • C. Guide staff to use small, realistic goals as their measure of patient progress.
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A because educating staff about realistic expectations for working with persons with cognitive impairment can help them understand the challenges they may face and develop appropriate coping strategies. This knowledge can reduce frustration and burnout by promoting a better understanding of the patients' needs and behaviors.

Choice B, arranging for 12-hour shifts, may actually increase staff burnout as longer shifts can be physically and mentally taxing. Choice C, guiding staff to use small, realistic goals, while helpful in patient care, may not directly address staff burnout. Therefore, the most effective approach to minimize staff frustration and burnout in this scenario is education on realistic expectations.

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Which is the most appropriate initial goal for a nurse when attempting to overcome personal negative attitudes about a patient who has a history of returning to an abusive spouse?

  • A. Exploring own attitudes and values toward survivors of violence
  • B. Identifying the dysfunctional behaviors exhibited by the violent family
  • C. Concentrating on identifying any possible personal abusive relationships
  • D. Attending seminars on the psychological impact of being the victim of abuse
Correct Answer: A

Rationale: The correct answer is A because exploring one's own attitudes and values towards survivors of violence is crucial in overcoming personal negative attitudes. By reflecting on personal biases, the nurse can gain self-awareness and empathy, enabling better care for the patient. Choice B is incorrect as it focuses on the abuser's behaviors, not the nurse's attitudes. Choice C is incorrect as it shifts the focus to the nurse's personal relationships. Choice D is incorrect as attending seminars does not directly address the nurse's personal attitudes.

A nurse is caring for a patient who is confused, disoriented in all three spheres, and experiencing visual hallucinations. While preparing to provide personal care, the nurse should:

  • A. ask the patient, "Do you remember who I am?"
  • B. speak minimally so as not to disturb the patient.
  • C. pat the patient on the forearm and say, "Let's get started."
  • D. explain to the patient what will happen during the care.
Correct Answer: D

Rationale: The correct answer is D because explaining to the patient what will happen during care is essential to provide a sense of orientation and reduce anxiety in a confused patient. This approach helps the patient understand the situation and feel more in control, which can decrease agitation. Choice A is incorrect as the patient's memory deficit may lead to further confusion. Choice B is incorrect as minimal communication may not address the patient's needs. Choice C is incorrect as physical touch without explanation may escalate the patient's hallucinations.

In refeeding syndrome that develops during nutritional rehabilitation of a patient with eating disorder, what is the most important biochemical change?

  • A. Hypomagnesemia
  • B. Hypophosphatemia
  • C. Hypokalaemia
  • D. Hypoglycaemia
Correct Answer: B

Rationale: Hypophosphatemia is the most critical biochemical change in refeeding syndrome, as it can lead to severe complications like cardiac arrest.

Schizophrenia is usually diagnosed in:

  • A. Infancy
  • B. Childhood
  • C. Early adulthood
  • D. Old age
Correct Answer: C

Rationale: Schizophrenia typically emerges in early adulthood (late teens to early 20s), though symptoms may appear earlier or later in rare cases.

A patient's medical record documents sexual masochism. This patient derives sexual pleasure

  • A. from inanimate objects.
  • B. by inflicting pain on a partner.
  • C. when sexually humiliated by a partner.
  • D. from touching a nonconsenting person.
Correct Answer: C

Rationale: The correct answer is C because sexual masochism involves deriving sexual pleasure from being humiliated or degraded by a partner. This behavior is characterized by finding arousal in receiving physical or emotional pain or humiliation during sexual activities. Choices A, B, and D are incorrect because they do not align with the specific behavior associated with sexual masochism. Choice A refers to objectophilia, choice B describes sadism, and choice D pertains to non-consensual sexual behavior, none of which are indicative of sexual masochism.

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