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The nurse determines that the most effective point of intervention for bereavement is:
- A. Promotion of mental and spiritual health across the life span
- B. At the time a newly discovered loss is impending
- C. Immediately after the loss has occurred
- D. When requested by the patient
Correct Answer: A
Rationale: The correct answer is A because promoting mental and spiritual health across the lifespan addresses bereavement proactively by providing support and resources before, during, and after losses occur. This approach allows individuals to build resilience and cope effectively with grief. Choice B is incorrect as it focuses on impending loss, missing the opportunity for early intervention. Choice C is incorrect as immediate intervention may not be suitable for everyone and may overlook the importance of ongoing support. Choice D is incorrect as waiting for the patient to request intervention may delay support and hinder the healing process.
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The nurse is assessing a child with autism. Which of the following behaviors would the nurse expect to observe?
- A. Referring to their imaginary friend, Skipper
- B. Asking to telephone my friends on the weekends
- C. Repeating, milk, milk, milk, milk until given a drink.
- D. Is insistent that a dim light be left on in the bedroom at night
Correct Answer: C
Rationale: The correct answer is C: Repeating, milk, milk, milk, milk until given a drink. This behavior is a characteristic of children with autism, known as echolalia. Echolalia is the repetition of words or phrases spoken by others, often used by individuals with autism to communicate or self-soothe. This behavior is a common feature of autism spectrum disorder and is indicative of language difficulties and communication challenges.
Choices A, B, and D are incorrect because they do not specifically relate to behaviors typically observed in children with autism. Referring to an imaginary friend (A) is not exclusive to autism, asking to telephone friends on weekends (B) is a social behavior that can be seen in children without autism, and insisting on a dim light in the bedroom (D) is a preference that does not directly relate to the core characteristics of autism.
Discharge planning begins for an elderly patient hospitalized for 2 weeks diagnosed with major depression. The patient needs ongoing assessment and socialization opportunities as well as education about medication and relapse prevention. The patient lives with a daughter, who works during the week. Select the best referral for this patient.
- A. Behavioral health home care
- B. Partial hospitalization
- C. A skilled nursing facility
- D. A halfway house
Correct Answer: A
Rationale: The correct answer is A: Behavioral health home care. This option provides ongoing assessment, socialization opportunities, and education about medication and relapse prevention, which are all essential for the elderly patient with major depression. Additionally, it allows the patient to stay in their own home environment, promoting comfort and familiarity.
Option B: Partial hospitalization may not provide the ongoing support and socialization opportunities needed for the patient.
Option C: A skilled nursing facility may offer medical care but may not focus on mental health needs or socialization.
Option D: A halfway house is typically for individuals transitioning from addiction treatment and may not address the specific needs of an elderly patient with major depression.
A nurse is using Piaget’s model to assess a child’s developmental stage. Which behaviors would determine that a child is successfully achieving the skills required of the formal operations level of development? (Select all that apply.)
- A. Becomes sad when the family pet dies.
- B. Plans a trip to attend a basketball game.
- C. Identifies two different bowls that hold 1 cup.
- D. Selects the appropriate clothing for a ski trip.
Correct Answer: B, D
Rationale: In Piaget's formal operations stage, children develop abstract thinking, planning abilities, and logical reasoning. Planning a trip and selecting appropriate clothing demonstrate these skills. Becoming sad over the pet's death and identifying objects by capacity are more related to emotional and concrete operational stages.
When differentiating between bereavement symptoms and depression, the nurse will base the formulation on knowledge that in bereavement:
- A. Symptoms remit and exacerbate.
- B. Guilt feelings are overwhelming.
- C. Suicide thoughts are common.
- D. Psychomotor retardation is obvious.
Correct Answer: A
Rationale: The correct answer is A because in bereavement, symptoms of grief and sadness tend to come and go, known as remitting and exacerbating, as the individual processes the loss over time. This is a normal part of the grieving process. On the other hand, in depression, symptoms are persistent and may not improve without intervention. Guilt feelings being overwhelming (B) is common in both bereavement and depression. Suicide thoughts being common (C) can occur in severe depression but are not a distinguishing factor between bereavement and depression. Psychomotor retardation being obvious (D) is a symptom more commonly associated with severe depression rather than bereavement.
The best response to the patient’s statement, "They frobitz me," would be:
- A. "That’s really too bad that you are being treated that way."
- B. "Who do you mean when you say everybody?"
- C. "What difference does frobitzing make?"
- D. "Why do they frobitz?"
Correct Answer: B
Rationale: The correct answer is B because it seeks clarification and prompts the patient to specify who they are referring to when they say "everybody." This response shows active listening and encourages deeper communication. Choice A offers sympathy but doesn't address the issue directly. Choice C dismisses the significance of "frobitzing." Choice D asks for the reason behind "frobitzing" without seeking clarification on the people involved.