Nokea
The lack of necessary supplies and equipment to adequately and safely care for patients is an example of a (n):
- A. Sentinel event.
- B. System variance.
- C. Adverse effect.
- D. Provider variance.
Correct Answer: B
Rationale: System variances involve deficiencies in resources or processes.
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Which of the following may be the most effective approach to ensure good communication with a large family of a hospitalized patient?
- A. Ask the family to choose an individual to be the point of contact with the health care team
- B. Appoint the person who spends the most time at the patient's bedside to be the point of contact with the health care team
- C. Listen to each family member's individual concerns
- D. Arrange a daily meeting with the entire family to discuss the patient's health care
Correct Answer: A
Rationale: A single point of contact streamlines communication while respecting family involvement.
The psychosexual stage associated with sexual maturity is
- A. Oral
- B. Anal
- C. Phallic
- D. Genital
Correct Answer: D
Rationale: The genital stage (puberty onward, Freud) focuses on mature sexuality.
A patient was admitted 48 hours ago for injuries sustained while intoxicated. The patient is shaky, irritable, anxious, and diaphoretic. The pulse rate is 130 beats per minute. The patient shouts, 'Bugs are crawling on my bed. I’ve got to get out of here.' What is the most accurate assessment of the situation? The patient:
- A. is attempting to obtain attention by manipulating staff.
- B. may have sustained a head injury before admission.
- C. has symptoms of alcohol withdrawal delirium.
- D. is having a recurrence of an acute psychosis.
Correct Answer: C
Rationale: The correct answer is C: The patient has symptoms of alcohol withdrawal delirium. The presentation of shakiness, irritability, anxiety, diaphoresis, elevated heart rate, and hallucinations ('bugs are crawling on my bed') are classic signs of alcohol withdrawal delirium. Delirium tremens, a severe form of alcohol withdrawal, typically occurs 48-72 hours after the last drink and can be life-threatening. This patient's symptoms are consistent with the timeline and manifestations of alcohol withdrawal, requiring immediate medical intervention.
Incorrect answers:
A: Manipulating staff for attention is unlikely given the severity of the symptoms and the potential life-threatening nature of alcohol withdrawal delirium.
B: Head injury would not typically present with these specific symptoms and timeline.
D: Acute psychosis would not typically manifest with these specific symptoms in the context of alcohol intoxication and withdrawal.
Which documentation indicates that the treatment plan for a patient in an alcohol rehabilitation program was effective?
- A. Is abstinent for 10 days and states, 'I can maintain sobriety 1 day at a time.' Spoke with employer, who is willing to allow the patient to return to work in 3 weeks.
- B. Is abstinent for 15 days and states, 'My problems are under control.' Plans to seek a new job where co-workers will not know history.
- C. Attends AA daily; states many of the members are 'real' alcoholics and states, 'I may be able to help some of them find jobs at my company.'
- D. Is abstinent for 21 days and says, 'I know I can’t handle more than one or two drinks in a social setting.'
Correct Answer: A
Rationale: The correct answer is A because it demonstrates a positive change in behavior and mindset. The patient has been abstinent for 10 days, shows commitment to sobriety, and has a supportive employer. This indicates progress and readiness to reintegrate into work.
Choice B shows longer abstinence but still relies on external factors for control. Choice C focuses on helping others rather than personal progress. Choice D mentions limitations on alcohol consumption, which may not reflect true recovery.
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.