Nokea
The nurse is using a theory which includes positive reinforcement with rewarding client behavior in group participation activities. From which theorist is the nurse deriving these strategies?
- A. Sigmund Freud
- B. Erik Erikson
- C. Harry Sullivan
- D. B.F. Skinner
Correct Answer: D
Rationale: B.F. Skinner proposed the theory that adaptive and maladaptive behavior are learned and repeated because of rewarding reinforcement. The other theorists listed did not propose such a theory.
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The nurse is caring for a client who has recently lost a spouse. Which question asked by the nurse is essential in guarding the client's immune system?
- A. Do you have friends and family to support you?
- B. Do you live alone in a one-story house?
- C. Are you able to prepare nutritious meals?
- D. Are your neighbors able to check on you?
Correct Answer: A
Rationale: When a client has very intense stress, such as the loss of a spouse, stress can lower the number of white blood cells impacting the immune system. There is also a connection between poorer immune function and loneliness. Asking the client about friends and family who are available to provide support is most helpful. Friends and family allow the client to share emotions and immune function improves. The other questions provide helpful data but not as pertinent to the immune system.
The nurse is caring for a client who consistently presents to the emergency department with symptoms of varied illnesses. Family members correlate the symptoms to illnesses seen on television or in other family members. When viewing past documentation of client history, which would the nurse anticipate?
- A. An autoimmune disorder
- B. Hypochondriasis
- C. Paranoid schizophrenia
- D. Physical abuse
Correct Answer: B
Rationale: Hypochondriasis is an abnormal fixation about the status of one's health. Some would propose that the disorder occurs when a person receives excessive attention and concern from others during childhood illnesses, which were unconsciously perceived as rewarding. The other disorders are not related.
The nurse is caring for a client and family member who are distressed about not having a concrete medical diagnosis. The client states, 'I have been through a lot of tests, and I still know nothing.' When confirming a psychobiologic diagnosis, the nurse is most accurate to state which of the following?
- A. We should have the conclusion of the tests soon. Hang in there.
- B. Diagnosis takes time to consult the specialist and to get those reports.
- C. Confirmation is achieved by ruling out other diseases that manifest similar symptoms.
- D. Psychotherapy will provide the best data to make a diagnosis.
Correct Answer: C
Rationale: Unfortunately, it has time to obtain a definitive diagnosis for a psychobiologic disorder. Diagnosis is frequently achieved by ruling out other diseases which manifest similar signs and symptoms. Stating the circumstances in the delay in diagnosis is the best and most accurate explanation. Simply saying that the tests will conclude soon and that it takes time to receive reports from specialists is general and does not assist the client in understanding why waiting for the reports is necessary. Psychotherapy provides a component of assessment data but not the best data.
The nurse is caring for a client who is taking a medication that affects the function of the neurotransmitter norepinephrine. The client asks 'What does norepinephrine normally do in the body?' What should the nurse include in the response? Select all that apply.
- A. Affects attention and concentration
- B. Raises energy level
- C. Heightens arousal
- D. Assists memory storage
- E. Decreases seizure potential
Correct Answer: A,B,C
Rationale: The nurse should inform the client that norepinephrine affects attention and concentration, raises energy level, and heightens arousal. It does not assist memory storage or decrease seizure potential.
The nurse is instructing a community education class on stress. The nurse asks the participants, 'Is all stress bad for you?' Which answer by the participants indicates that teaching has been effective?
- A. No, all stress has negative effects on the body systems.
- B. Yes, all stress is bad but in varying degrees depending on the nature.
- C. No, not all stress is bad, but all stress can make a person sick.
- D. No, the right amount of stress can be motivating to accomplish goals.
Correct Answer: D
Rationale: Teaching has been effective if participants state that not all stress is bad because the right amount of stress can be motivating. Just the right amount of stress, called eustress, is what maintains a healthy balance in life. The other statements are not accurate.