Nokea
The nurse is leading a group for women who have experienced interpersonal violence. A client asks what research statistics tell about the perpetrators of interpersonal violence. The nurse can accurately respond that perpetrators are:
- A. Usually under the influence of drugs or alcohol
- B. Most often someone the victim knows
- C. A stranger to the victim in most cases
- D. Often in a psychotic state during the act
Correct Answer: B
Rationale: The correct answer is B because research shows that perpetrators of interpersonal violence are most often someone the victim knows, such as a partner, family member, or acquaintance. This is supported by studies and data that indicate a significant majority of interpersonal violence cases involve perpetrators who have a prior relationship with the victim. Choice A is incorrect because while substance abuse can be a factor in some cases, it is not the primary characteristic of perpetrators. Choice C is incorrect as statistics show that perpetrators are usually known to the victim rather than being strangers. Choice D is also incorrect as psychotic states are not typically the primary cause of interpersonal violence, and most perpetrators are not in such a state during the act.
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The patient tells his primary nurse 'I get into trouble because I have hair-trigger responses. I shoot from the hip. Lots of times that gets me into a mess.' Which response would be most therapeutic?
- A. Let's look at ways to help you slow it down and think before acting.'
- B. It might help to explore how you came to be that way"“any ideas?'
- C. I'll bet you have some interesting stories to share about overreacting.'
- D. It's good that you're showing readiness and motivation to change.'
Correct Answer: A
Rationale: The correct answer is A because it demonstrates empathy and offers a therapeutic approach to help the patient manage their hair-trigger responses. By suggesting ways to slow down and think before acting, the nurse is providing practical strategies for the patient to work on self-regulation and impulse control. This response shows active listening and a commitment to supporting the patient in developing coping mechanisms.
Option B is incorrect as it focuses on exploring the root cause rather than offering immediate support. Option C is incorrect as it may encourage dwelling on past mistakes rather than focusing on problem-solving. Option D is incorrect as it praises the patient without addressing the need for behavior change.
A patient tells a nurse, 'The others won't give me my pain meds early, but you are more understanding, you know what it's like to be in pain, and you don't want to see your patients suffer. Could you find a way to get me my pill now? I won't tell anyone.' Which response by the nurse would be most therapeutic?
- A. I'm not comfortable doing that,' then ignore subsequent requests for early meds.
- B. I'll have to check with your doctor about that; I will get back to you after I do.'
- C. It would be unsafe to give the medicine early; none of us will do that.'
- D. I understand that you have pain, but giving medicine too soon would not be safe.'
Correct Answer: D
Rationale: Step 1: Acknowledge the patient's pain and show understanding.
Step 2: Emphasize the importance of safety in medication administration.
Step 3: Set clear boundaries by explaining why giving medicine too soon is unsafe.
Step 4: Reiterate empathy for the patient's pain while prioritizing safety.
Summary: Answer D is correct as it acknowledges the patient's pain, emphasizes safety, sets clear boundaries, and maintains empathy. Other choices either ignore the patient's request, defer responsibility, or solely focus on safety without empathy.
Which outcome is realistic for a client with stage 1 Alzheimer's disease?
- A. Appropriate long-term placement will be arranged to maintain caregiver's health and well-being.
- B. The client will maintain the highest possible functional level within his or her capacity.
- C. All day-to-day decisions will be made by the caregiver to relieve client of stress.
- D. The client will remain fully functional physically, since Alzheimer's affects only the brain.
Correct Answer: B
Rationale: The correct answer is B because in stage 1 Alzheimer's, individuals can still maintain a relatively high level of functionality. This is because in the early stages, the cognitive decline is mild and individuals can still perform daily tasks independently. It is important to focus on maximizing the client's functional abilities through cognitive exercises and support services.
Choice A is incorrect because long-term placement may not be necessary in stage 1 and should only be considered if the caregiver's health is at risk. Choice C is incorrect because individuals with Alzheimer's should be encouraged to make decisions to maintain their sense of autonomy. Choice D is incorrect because Alzheimer's is a progressive disease that affects both cognitive and physical functions over time.
A highly suspicious patient who has delusions of persecution about being poisoned has refused all hospital meals for 3 days. Which of the following interventions would be most appropriate under these circumstances?
- A. Feed the patient via tube, involuntarily via court order if needed.
- B. Offer to taste each food item on the tray yourself while he watches.
- C. Allow the patient to contact a local restaurant to deliver his meals.
- D. Allow him supervised access to use food vending machines in the hospital lobby.
Correct Answer: D
Rationale: Step 1: In this scenario, the patient is refusing hospital meals due to delusions of being poisoned, indicating a lack of trust.
Step 2: By allowing supervised access to food vending machines in the hospital lobby, the patient can choose his own food, promoting autonomy and trust-building.
Step 3: This intervention respects the patient's autonomy while ensuring access to food.
Step 4: In contrast, feeding via tube involuntarily (Option A) violates autonomy, tasting food yourself (Option B) doesn't address the issue of trust, and ordering from a restaurant (Option C) may not be feasible or safe in a hospital setting.
Summary: Option D is the most appropriate as it balances patient autonomy and safety, addressing the refusal of hospital meals effectively.
A person diagnosed with a serious mental illness enters a shelter for the homeless. Which intervention should be the nurses initial priority?
- A. Find supported employment
- B. Develop a trusting relationship
- C. Administer prescribed medication
- D. Teach appropriate health care practices
Correct Answer: B
Rationale: Basic psychosocial needs do not change because a person is homeless. The first step in caring for health care needs is establishing rapport. Once a trusting relationship is established, the nurse pursues other interventions.