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The psychiatric-mental health nurse, who is teaching a patient's parents how to use positive reinforcement techniques with the patient, recommends:
- A. agreeing with the child's statements, whether negative or positive, and simply restating the child's statements without other comment
- B. controlling the child's behavior, so there is no chance of negative behavior
- C. removing adverse consequences to produce positive results
- D. rewarding positive behaviors to promote their recurrence
Correct Answer: D
Rationale: Positive reinforcement rewards desired behaviors, increasing their frequency, a core behavioral strategy.
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Which assessment findings would alert the nurse that an older patient may have an increased risk for development of geriatric alcohol abuse? Select one tha does not apply.
- A. Mild recent memory impairment
- B. Eighth grade education
- C. Death of spouse
- D. Retirement
Correct Answer: A
Rationale: Geriatric problem drinking often begins in response to stressors like retirement (D), loss of spouse (C), and loneliness (E), with risk factors including less than high school education (B). Mild memory impairment (A) is not a predisposing factor.
The early stage of Alzheimer's disease is characterized by:
- A. Loss of recent memory
- B. Loss of remote memory
- C. Withdrawal from family
- D. Apraxia
Correct Answer: A
Rationale: The correct answer is A: Loss of recent memory. In the early stage of Alzheimer's disease, individuals typically experience difficulty remembering recent events, conversations, or information. This is due to the initial impact of the disease on the hippocampus and other brain regions responsible for forming new memories. Choices B, C, and D are incorrect because loss of remote memory (choice B) usually occurs in later stages, withdrawal from family (choice C) can be a result of various factors beyond memory loss, and apraxia (choice D) refers to the inability to perform coordinated movements and is not a primary symptom of early-stage Alzheimer's.
The experienced nurse assessing a battered woman client uses many open-ended questions during the interview. The rationale for this is that:
- A. The woman will feel more in charge of the interview
- B. Such questions allow for simple yes or no answers when the client is upset
- C. The questions are direct and easily understood by anxious individuals
- D. Clients can refuse to answer when sensitive information is being probed
Correct Answer: A
Rationale: The correct answer is A because using open-ended questions allows the client to express themselves freely, promoting a sense of control and empowerment. This approach helps build trust and rapport, enabling the client to share their experiences more openly. Choice B is incorrect because closed-ended questions limit the client's ability to fully express themselves. Choice C is incorrect as open-ended questions encourage deeper reflection and discussion, which may not be easily understood by anxious individuals. Choice D is incorrect because while clients can refuse to answer sensitive questions, open-ended questions actually encourage them to share more, rather than withhold information.
What is the most appropriate nursing goal for a patient with bulimia nervosa?
- A. To eliminate binge-purge episodes and restore healthy eating habits.
- B. To focus on weight loss and body image issues.
- C. To monitor calorie intake and restrict food consumption.
- D. To encourage excessive exercise to maintain weight control.
Correct Answer: A
Rationale: The correct answer is A: To eliminate binge-purge episodes and restore healthy eating habits. This goal is appropriate as it addresses the core issue of bulimia nervosa, which is the cycle of bingeing and purging. By focusing on eliminating these episodes and promoting healthy eating habits, the patient can achieve long-term recovery.
Choices B, C, and D are incorrect because they do not address the underlying psychological and behavioral aspects of bulimia nervosa. Weight loss and body image issues (B) may exacerbate the disorder, monitoring calorie intake and restricting food consumption (C) can reinforce the cycle of bingeing and purging, and encouraging excessive exercise (D) can lead to further health complications.
A patient with paranoid personality disorder is noted to sit alone in a corner of the unit living room. When anyone approaches, the patient is haughty or simply ignores the other person. When staff invite her to join an activity, she tells them, 'I do not care to be with people who do not like me.' A nursing diagnosis that should be considered is:
- A. splitting.
- B. activity intolerance.
- C. powerlessness.
- D. impaired social interaction.
Correct Answer: D
Rationale: The correct answer is D: impaired social interaction. This patient's behavior of sitting alone, being haughty, and refusing to engage with others indicates difficulty in social interactions. The patient's belief that others do not like her also suggests social challenges. Impaired social interaction relates to difficulty in establishing or maintaining relationships.
A: Splitting is a defense mechanism where the patient views people as all good or all bad, which is not evident in this scenario.
B: Activity intolerance refers to insufficient physiological or psychological energy to endure or complete required or desired daily activities. This does not apply here.
C: Powerlessness refers to the perception of lack of control over a situation, which is not the primary issue in this case.