Nokea
The plan of care for a patient who has demonstrated outbursts of physical violence against his family when frustrated, followed by periods of remorse after each outburst, would be considered successful when the patient:
- A. Expresses frustration verbally instead of physically.
- B. Agrees to seek group counseling at a future time.
- C. Explains the reason for his behavior toward the victim.
- D. Identifies three personal strengths and coping strategies.
Correct Answer: A
Rationale: The correct answer is A because expressing frustration verbally instead of physically shows progress in managing emotions constructively. This approach helps prevent harm and promotes effective communication. Choice B doesn't address immediate behavior change. Choice C focuses on explaining behavior rather than changing it. Choice D is more about self-awareness and coping strategies, which is important but doesn't directly address the violent behavior.
You may also like to solve these questions
When planning nursing care for a client with a dependent personality disorder, the nurse recognizes which of the following as characteristic behavior for someone with this disorder? The client:
- A. Perceives his or her behavior to be embarrassing
- B. Believes he or she cannot function without help of others
- C. Exaggerates the potential dangers of ordinary situations
- D. Demands excessive attention from others
Correct Answer: B
Rationale: The correct answer is B because individuals with dependent personality disorder typically believe they cannot function without the help of others. This is a key characteristic of the disorder as they rely heavily on others for decision-making and day-to-day tasks. This behavior stems from an intense fear of separation and abandonment.
Choice A (perceiving behavior as embarrassing) is incorrect as it is more aligned with social anxiety disorder rather than dependent personality disorder. Choice C (exaggerating dangers) is incorrect as it is more characteristic of individuals with anxiety disorders. Choice D (demanding excessive attention) is incorrect as it is more typical of individuals with histrionic personality disorder.
In Avoidant/Restrictive Food Intake Disorder (ARFID), which of the following is a characteristic clinical feature?
- A. Do not prefer foods with strong smells
- B. Do not prefer bland foods
- C. Do not have weight concerns
- D. Do not prefer solid foods
Correct Answer: C
Rationale: ARFID involves food avoidance without body image concerns, unlike AN; lack of weight concerns is a key feature per DSM-5.
An elderly client was well until 12 hours ago, when she reported to her family that during the evening she saw strange faces peering in her windows and in the middle of the night awakened to see a man standing at the foot of her bed. She admits to being very frightened. She is presently pacing and somewhat agitated in the examining room. The client's family reports that the client has recently been to the doctor, who made some medication changes, although they are unsure what the changes were. The nurse hearing this history will identify the history and symptoms as pointing to:
- A. Delirium related to drug toxicity
- B. Pick's disease
- C. Parkinson's dementia
- D. Amnestic disorder
Correct Answer: A
Rationale: The correct answer is A: Delirium related to drug toxicity. The client's sudden onset of visual hallucinations, fear, agitation, recent medication changes, and pacing behavior are indicative of delirium. Delirium is an acute change in mental status characterized by confusion, disorientation, and perceptual disturbances, often triggered by medication changes in the elderly. Pick's disease (B) is a type of frontotemporal dementia characterized by personality changes and language difficulties. Parkinson's dementia (C) is a type of dementia associated with Parkinson's disease, presenting with motor symptoms first. Amnestic disorder (D) is a memory impairment disorder, not consistent with the client's symptoms.
A nurse is working with a patient with anorexia nervosa. What is the priority assessment for this patient?
- A. Height and weight changes.
- B. Food intake and nutritional status.
- C. Mental health status and body image concerns.
- D. Vital signs and cardiovascular function.
Correct Answer: A
Rationale: The correct answer is A: Height and weight changes. In anorexia nervosa, monitoring height and weight is crucial to assess the severity of malnutrition and potential complications. Weight loss is a key indicator of the patient's nutritional status and overall health decline. Height measurement also helps determine growth patterns in younger patients.
Choice B: Food intake and nutritional status, although important, is not the priority as weight changes provide a more direct reflection of the patient's nutritional status.
Choice C: Mental health status and body image concerns are significant in anorexia nervosa, but assessing height and weight takes precedence due to the immediate physical risks associated with severe malnutrition.
Choice D: Vital signs and cardiovascular function are important, but monitoring height and weight is more specific to the nutritional deficiencies seen in anorexia nervosa.
A patient diagnosed with serious mental illness was living successfully in a group home but wanted an apartment. The prospective landlord said, 'People like you have trouble getting along and paying their rent.' The patient and nurse meet for a problem-solving session. Which options should the nurse endorse? Select one tha does not apply.
- A. Coach the patient in ways to control symptoms effectively
- B. Seek out landlords less affected by the stigma associated with mental illness
- C. Threaten the landlord with legal action because of the discriminatory actions
- D. Have the case manager meet with the landlord to provide education about mental illness
Correct Answer: C
Rationale: Managing symptoms so that they are less obvious or socially disruptive can reduce negative reactions and reduce rejection due to stigma. Seeking a more receptive landlord might be the most expeditious route to housing for this patient. Educating the landlord to reduce stigma might make him more receptive and give the case manager an opportunity to address some of his concerns (e.g., the case manager could arrange a payee to assure that the rent is paid each month). However, threatening a lawsuit would increase the landlords defensiveness and would likely be a long and expensive undertaking. Delaying the patients efforts to become more independent is not clinically necessary according to the data noted here; the problem is the landlords bias and response, not the patients illness. It would be unethical to encourage falsification and poor role modeling to do so; further, if falsification is discovered, it could permit the landlord to refuse or cancel her lease.