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The nursing approach that will minimize power struggles between the client with an eating disorder and the nurse is best characterized as:
- A. authoritarian and autocratic.
- B. laid-back and flexible.
- C. rigid and unyielding.
- D. compassionate and firm.
Correct Answer: D
Rationale: The correct answer is D: compassionate and firm. This approach balances empathy and boundaries, fostering trust and cooperation while maintaining structure. Compassion helps build rapport and understanding, essential for addressing the underlying issues of the eating disorder. Firmness sets clear limits and expectations, promoting accountability and progress. Authoritarian and autocratic (A) can create resistance and hinder therapeutic alliance. Laid-back and flexible (B) may enable unhealthy behaviors. Rigid and unyielding (C) can lead to power struggles and hinder therapeutic progress.
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A victim of physical abuse by her domestic partner is being treated for a broken humerus. Which indicator for the outcome of Abuse protection is most important to achieve before the patient leaves the emergency department?
- A. The patient has completed and reviewed a workable safety plan.
- B. She agrees to seek a restraining order limiting contact by the perpetrator.
- C. The patient demonstrates insight into the abusive nature of the relationship.
- D. She has been referred to counseling and battered-person support groups.
Correct Answer: A
Rationale: The correct answer is A because a safety plan is crucial for the victim's immediate safety and future protection. It helps the victim know what to do in case of danger, ensuring a proactive approach to safety. Choice B may not always be feasible or effective in preventing further abuse. Choice C, while important, does not guarantee safety outside the emergency department. Choice D is beneficial but does not address the immediate safety concerns as effectively as having a safety plan in place. Thus, completing and reviewing a workable safety plan is the most important indicator for the outcome of abuse protection in this scenario.
A man who regularly experiences premature ejaculation tells the nurse, 'I feel like such a failure. It's so awful for both me and my partner.' Select the nurse's most therapeutic response.
- A. I sense you are feeling frustrated and upset.
- B. Tell me more about feeling like a failure.
- C. You are too hard on yourself.
- D. What do you mean by awful?
Correct Answer: A
Rationale: The correct answer is A because it acknowledges the man's emotions of frustration and upset, showing empathy and understanding. This response validates his feelings and opens the door for further discussion. Choice B shifts the focus away from the man's current emotions. Choice C minimizes his feelings and may come across as dismissive. Choice D is too vague and doesn't address the man's emotional state directly. Overall, choice A is the most therapeutic as it validates the man's feelings and encourages him to express more.
Which is the most appropriate response when a patient with bulimia nervosa expresses feelings of shame about their purging behaviors?
- A. Encourage the patient to avoid discussing their eating habits.
- B. Agree with the patient's feelings and offer reassurance.
- C. Focus on helping the patient identify triggers for purging behaviors.
- D. Provide education on the benefits of purging for weight management.
Correct Answer: C
Rationale: The correct answer is C because focusing on helping the patient identify triggers for purging behaviors is essential in addressing the underlying issues contributing to their behavior. By identifying triggers, the patient can develop coping strategies and alternative behaviors.
Choice A is incorrect as avoiding discussing eating habits can hinder progress in therapy. Choice B is incorrect as simply agreeing and offering reassurance without addressing the root cause may not lead to lasting change. Choice D is incorrect as it promotes the harmful behavior of purging for weight management, which goes against the goal of treating bulimia nervosa.
An elderly female client on the mental unit suddenly becomes upset because she can't remember where she is and she says, 'I can't think straight.' The staff has never witnessed this behavior in the client, and this type of complaint is not documented in the nursing history. What is the client most likely experiencing?
- A. Hallucinations
- B. Dementia
- C. Delusions
- D. Delirium
Correct Answer: D
Rationale: The correct answer is D: Delirium. Delirium is characterized by sudden onset confusion, disorientation, and impaired cognitive function. In this scenario, the elderly client's sudden confusion and inability to think straight suggest an acute change in mental status, which is indicative of delirium. Delirium is often triggered by underlying medical conditions or medications.
A: Hallucinations involve perceiving things that are not real, which is not described in the scenario.
B: Dementia is a chronic condition with gradual cognitive decline, not sudden onset confusion.
C: Delusions are fixed false beliefs, which are not mentioned in the scenario.
In summary, the client is most likely experiencing delirium due to the sudden onset of confusion and cognitive impairment, which is not consistent with hallucinations, dementia, or delusions.
A physically frail elderly patient with mild cognitive impairments needs services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this patient during the evening and night. Which type of facility should the nurse suggest to meet this patients needs?
- A. Adult day care program
- B. Skilled nursing facility
- C. Partial hospitalization
- D. Group home
Correct Answer: A
Rationale: A day care program provides recreation and social interaction as well as supervision in a safe environment. Nursing, medical, and rehabilitative care are usually not provided. Skilled nursing facilities go beyond meeting recreational and social needs by providing medical interventions and nursing and rehabilitation services on a 24-hour basis. Partial hospitalization provides acute psychiatric hospital programs. A group home is inappropriate and would not meet the patients needs.