The Omnibus Budget Reconciliation Act (OBRA) provides standards of care for which of the following?
- A. Very young
- B. Older adults
- C. Those who have certain intellectual communication difficulties Those who have certain intellectual communication difficulties
- D. Those without medical insurance
Correct Answer: B
Rationale: The correct answer is B: Older adults. OBRA primarily focuses on setting standards of care for older adults in long-term care facilities, ensuring their safety and well-being. This is because older adults are a vulnerable population requiring specialized care and attention. Choices A, C, and D are incorrect because OBRA does not specifically address very young individuals, those with intellectual communication difficulties, or individuals without medical insurance. The Act mainly pertains to the care and rights of older adults in long-term care settings.
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When a hospitalized patient dies, his wife stares blankly and states, "It can’t be." This indicates:
- A. Despair and protest
- B. Shock and disbelief
- C. Anger and hostility
- D. Disorganization and confusion
Correct Answer: B
Rationale: Correct Answer: B (Shock and disbelief)
Rationale:
1. The wife's blank stare and statement "It can’t be" suggest a state of disbelief and being stunned by the news of her husband's death, indicating shock.
2. Shock is a common initial reaction to unexpected and distressing events, such as the sudden death of a loved one.
3. This choice is the most fitting based on the wife's reaction of disbelief and being unable to accept the reality of the situation.
Summary:
A: Despair and protest - Despair involves a sense of hopelessness, not evident in the wife's initial reaction. Protest implies a more active response, while the wife's reaction is passive.
C: Anger and hostility - There is no indication of anger or hostility in the wife's initial response; rather, it is characterized by disbelief.
D: Disorganization and confusion - While the wife may feel disorganized and confused later, her initial response reflects more shock and disbelief than disorganization
A teenage boy has lost his best friend as a result of a hunting accident. His parents report that he is eating and sleeping very little and expresses little interest in school. They are concerned that he talks about the accident repeatedly. These behaviors are generally seen as:
- A. Expressing responsibility for his friends death
- B. Attempts to avoid dealing with his pain
- C. Expressions of a normal grief reaction
- D. Indications of a risk for self-harm
Correct Answer: C
Rationale: The correct answer is C: Expressions of a normal grief reaction. The teenage boy's behaviors of poor appetite, insomnia, lack of interest in school, and repetitive discussions about the accident are common manifestations of grief. This grief reaction is a normal response to losing a close friend in a traumatic manner like a hunting accident. It is important to acknowledge and validate his emotions during this difficult time.
Incorrect Choices:
A: Expressing responsibility for his friend's death - This choice suggests guilt or blame on the part of the boy, which is not evident in the scenario.
B: Attempts to avoid dealing with his pain - The boy's behaviors indicate he is processing his grief rather than avoiding it.
D: Indications of a risk for self-harm - While it is important to monitor for signs of self-harm, the behaviors described are more indicative of grief rather than immediate self-harm risk.
A patient asks, “What advantage does a durable power of attorney for health care have over a living will?” The nurse should reply, A durable power of attorney for health care:
- A. Gives your agent authority to make decisions during any illness if you are incapacitated.
- B. Can be given only to a relative, usually the next of kin, who has your best interests at heart.
- C. Can be used only if you have a terminal illness and become incapacitated.
- D. Cannot be implemented until 30 days after the documents are signed.
Correct Answer: A
Rationale: Correct Answer: A: Gives your agent authority to make decisions during any illness if you are incapacitated.
Rationale:
1. A durable power of attorney for health care allows you to appoint a trusted individual (agent) to make medical decisions on your behalf if you are unable to do so.
2. This authority is not limited to a specific type of illness or condition, ensuring your agent can make decisions for any illness that renders you incapacitated.
3. This flexibility ensures that your wishes are carried out regardless of the circumstances.
Summary of Other Choices:
B: Incorrect - A durable power of attorney can be given to any trusted individual, not just a relative.
C: Incorrect - A durable power of attorney can be used in any situation where you are unable to make decisions, not just in terminal illness.
D: Incorrect - A durable power of attorney can be implemented immediately upon signing, providing timely decision-making support.
Which statement best explains how a mother of several children should prepare to help them cope with the loss of a dear aunt?
- A. Each child will grieve in a unique way and on their own timetable
- B. Children are resilient and simply need love as they grieve.
- C. People regardless of age or gender experience stages of grief.
- D. Extreme reactions are more commonly observed in the young griever
Correct Answer: A
Rationale: The correct answer is A because each child will indeed grieve in a unique way and on their own timetable. This approach recognizes the individuality of each child's emotions and coping mechanisms. By understanding and respecting their differences, the mother can provide tailored support and comfort. Option B oversimplifies the grieving process and ignores the complexity of individual responses. Option C generalizes the stages of grief for all people and does not account for variations in how children may process loss. Option D incorrectly suggests that extreme reactions are more common in young children, which is not necessarily true as grief responses can vary widely among children.
Which response demonstrates both empathy and understanding of the relationship genetics has to the development of schizophrenia in twins?
- A. In fraternal twins, the chance of the other twin developing the disorder is quite small.
- B. No one can say what will happen, so we will hope for the best for you and both of your sons.
- C. You poor woman! I wish I could tell you that your other son will be free of the disorder
- D. Studies show that 50% of twins develop schizophrenia when it is present in the other twin.
Correct Answer: D
Rationale: The correct answer is D because it provides an empathetic response by acknowledging the concern of the parent and demonstrating an understanding of the genetic link between twins and schizophrenia. By citing a specific statistic (50%), it shows knowledge of the relationship between genetics and the development of schizophrenia in twins.
Choice A is incorrect because it downplays the genetic influence by suggesting a small chance, which is not accurate.
Choice B is incorrect because it dismisses the seriousness of the situation and does not address the genetics aspect of the disorder.
Choice C is incorrect because it is not based on factual information and offers sympathy without addressing the genetic component of schizophrenia in twins.