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Treatment of communication disorders is normally the domain of speech therapists and related disciplines, and a range of successful treatment programmes and equipment are available for disabilities such as phonological disorder and stuttering (Saltuklaroglu & Kalinowski, 2005; Law, Garrett & Nye, 2004). For example, hand-held equipment can provide which of the following?
- A. Significant auditory feedback (SAF)
- B. Magnified auditory feedback (MAF)
- C. Altered auditory feedback (AAF)
- D. Actual auditory feedback (AAF)
Correct Answer: C
Rationale: Altered Auditory Feedback (AAF): A treatment for stuttering providing delayed auditory feedback or frequency changes to improve speech fluency.
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A young, newly married adult says, 'My spouse never lets me out of sight. I'm not allowed to do anything on my own, and I'm constantly accused of cheating.' Which nursing communication is most therapeutic for this patient?
- A. Have you discussed the behavior with your spouse?'
- B. How does your spouse's behavior make you feel?'
- C. Are there other examples of controlling behaviors on your spouse's part?'
- D. Do you feel that your spouse has anything to be upset or suspicious about?'
Correct Answer: B
Rationale: The correct answer is B: "How does your spouse's behavior make you feel?" This question focuses on the patient's emotions, allowing them to express their feelings and validating their experiences. It shows empathy and encourages the patient to explore and understand their own emotional responses to the situation.
Choice A focuses on addressing the behavior directly without acknowledging the patient's emotions. Choice C asks for more examples of controlling behavior, which may feel judgmental. Choice D suggests that the spouse's behavior is justified, which can further invalidate the patient's feelings. Overall, choice B is the most therapeutic as it promotes emotional exploration and support.
The treatment team implements a behavior modification approach using a contract for a client with antisocial personality disorder. An expected outcome of this approach is that client will:
- A. Learn how to avoid punishment
- B. Explain why he breaks rules
- C. Comply with behaviors specified in the contract
- D. Develop empathy in interpersonal contacts with peers
Correct Answer: C
Rationale: The correct answer is C because compliance with the behaviors specified in the contract is a key goal of behavior modification. This outcome focuses on specific, observable behaviors that the client agrees to follow. This approach helps in setting clear expectations and consequences, which is beneficial for individuals with antisocial personality disorder.
Explanation for why the other choices are incorrect:
A: Learning how to avoid punishment may not necessarily lead to behavior change or compliance with the contract terms.
B: Explaining why he breaks rules may not necessarily result in actual behavior change or adherence to the contract.
D: Developing empathy is a more complex and long-term goal that may not directly relate to compliance with the contract terms.
A nursing intervention that will be planned to occur early in the nurse-patient relationship with a client with an eating disorder is:
- A. formulating a nurse-client contract.
- B. using confrontation to attack denial.
- C. placing the client in a therapeutic group.
- D. attacking enmeshment by separating client and family.
Correct Answer: A
Rationale: The correct answer is A: formulating a nurse-client contract. This intervention is essential early in the nurse-patient relationship with a client with an eating disorder because it establishes clear boundaries, roles, and expectations. By creating a contract, both the nurse and the client can communicate openly about their goals, responsibilities, and treatment plan. This helps build trust, promotes collaboration, and provides a framework for the therapeutic relationship.
Choices B, C, and D are incorrect:
B: Using confrontation to attack denial may be counterproductive and harmful in the early stages of the relationship as it can lead to resistance and damage trust.
C: Placing the client in a therapeutic group may be beneficial at a later stage but not necessarily an appropriate early intervention when individual needs should be addressed first.
D: Attacking enmeshment by separating client and family is not a suitable early intervention as it may cause distress and disrupt important support systems.
A patient with fluctuating levels of awareness, confusion, and disorientation shouts, 'The bugs, they are crawling on my legs! Get them off me!' The nurse's inspections show that no bugs are present. The nurse can best assess this presentation as:
- A. Perseveration.
- B. Hypermetamorphosis.
- C. Tactile hallucinations.
- D. None of the above.
Correct Answer: C
Rationale: The correct answer is C: Tactile hallucinations. Tactile hallucinations involve the perception of physical sensations such as bugs crawling on the skin when no external stimuli are present. In this scenario, the patient's complaint of bugs crawling on their legs despite the nurse's inspection confirming the absence of bugs indicates a sensory hallucination, specifically a tactile one. This is different from perseveration (repetition of a particular response or activity) and hypermetamorphosis (excessive attention to environmental details). Choosing "None of the above" would not address the specific symptom of tactile hallucinations described in the patient's presentation.
What is the primary nursing concern for a patient with anorexia nervosa during the early stages of treatment?
- A. Ensuring rapid weight gain to restore health.
- B. Addressing the patient's psychological issues related to body image.
- C. Maintaining nutritional intake to prevent further weight loss.
- D. Promoting self-esteem and body image satisfaction.
Correct Answer: C
Rationale: The primary nursing concern for a patient with anorexia nervosa in the early stages of treatment is maintaining nutritional intake to prevent further weight loss. This is crucial as malnutrition can lead to serious health complications. Ensuring adequate nutrition supports physical health and provides a foundation for addressing psychological issues in later stages of treatment. Rapid weight gain (A) can be harmful and lead to refeeding syndrome. Addressing psychological issues (B) and promoting self-esteem (D) are important but secondary concerns once nutritional stability is achieved.