Nokea
What factor is likely the reason a woman with bipolar disorder, manic episode, rarely eats?
- A. Feelings of guilt
- B. Need to control others
- C. Desire for punishment
- D. Excessive physical activity
Correct Answer: D
Rationale: During a manic episode of bipolar disorder, individuals often experience hyperactivity and an inability to stay still. This hyperactivity can manifest as excessive physical activity, which can prevent them from eating regularly. The correct answer is 'Excessive physical activity' because it directly relates to the woman's lack of appetite during the manic episode. Feelings of guilt, the need to control others, and the desire for punishment are not typically associated with eating difficulties in individuals with bipolar disorder during a manic episode. Clients in a manic episode usually have heightened energy levels and may engage in activities that exhaust them, leading to a decreased focus on eating.
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Which statement by an 8-year-old girl, who was just admitted to the hospital, needs to be explored?
- A. Wow! This hospital has bright colors.''
- B. Is my mother allowed to visit me tonight?'
- C. Those boys are so cute. I hope their room is next to mine!'
- D. I'm scared about being here. Can you stay with me awhile?'
Correct Answer: C
Rationale: The correct answer is C. An 8-year-old child showing a strong attraction to boys at this age may raise concerns about precocious sexual behavior or exposure to inappropriate sexual content, potentially signaling the need to investigate for possible sexual abuse. It is important to explore this statement further. Choice A, expressing admiration for bright colors, is a common behavior for children of this age and does not raise immediate concerns. Choice B, inquiring about the mother's visit, is a typical concern for a hospitalized child seeking comfort and support. Choice D, expressing fear and seeking reassurance from the nurse, is also a normal reaction for an 8-year-old in a new and possibly intimidating environment. However, the statement in Choice C stands out as it deviates from age-appropriate behavior and warrants further exploration to ensure the child's safety and well-being.
The nurse leads group therapy for clients diagnosed with substance abuse. A client diagnosed with alcoholism, and who occasionally uses marijuana and cocaine, attends the meeting. During the meeting the client states, 'I am having trouble sitting still. Am I bothering anybody? Maybe I should not come to these meetings.' Which action by the nurse is most appropriate?
- A. Encourage the client to share problems with the group.
- B. Remove the client from the group and further assess needs.
- C. Recognize this as manipulative behavior and encourage the client to remain in the group.
- D. Tell the other group members to ignore the client and continue with the group meeting.
Correct Answer: A
Rationale: Encouraging the client to share promotes engagement and allows the group to support them, addressing their restlessness therapeutically. Removing them isolates, labeling as manipulative is judgmental, and ignoring dismisses their needs.
The parents of a baby born with cleft lip and palate are struggling with shock, grief, and feelings of inadequacy and frustration. Which statement is best for the nurse to make to the parents at this time?
- A. You should focus on your baby's personality, not appearance.
- B. Let me show you pictures of some babies before and after surgery.
- C. There are other problems with this condition that go beyond surgical correction.
- D. Has anyone else in either of your families had cleft lip or palate?
Correct Answer: B
Rationale: Showing pictures of successful surgical outcomes provides hope and tangible evidence of improvement, addressing the parents’ grief and concerns about appearance. Other options may dismiss emotions, overwhelm with additional concerns, or be irrelevant at this stage.
When attempting to incorporate the Latino client's cultural background into the plan of care, which consideration is the most important?
- A. Socioeconomic considerations regarding hospitalization
- B. The meaning and attention the client places on the future
- C. The client's need to control care to ensure desired outcomes
- D. Inclusion of the family in the plan of care with the client's permission
Correct Answer: D
Rationale: The most important consideration when incorporating the Latino client's cultural background into the plan of care is the inclusion of the family in the care plan with the client's permission. In Latino cultures, family plays a vital role, and there is a strong emphasis on family support during challenging times. This support can positively impact the client's health outcomes and overall well-being. Socioeconomic status, although relevant, does not carry more weight than usual in healthcare decisions. Latino clients typically focus on the present rather than the future, and they often attribute outcomes to external factors like fate or divine intervention. While the client's need for control is important, involving the family aligns more closely with the cultural values and preferences of Latino clients.
Which parental statement would the nurse recognize as the appropriate application of time-out when disciplining a 4-year-old?
- A. I send my child to their bedroom for misbehaving.
- B. We limit time-out to 4 minutes per incident.
- C. Putting my child in a dark closet for time-out is very effective.
- D. I explain the reason for the time-out before and after disciplining my child.
Correct Answer: D
Rationale: The correct answer is to explain the reason for the time-out before and after disciplining the child. This approach reinforces the child's association of the time-out with the undesirable behavior, helping the child learn to control those behaviors. Sending a child to their bedroom may lead to negative associations with bedtime or be ineffective if the child enjoys spending time in their bedroom. Time-out should ideally be limited to 1 minute per year of age, so a time-out for a 4-year-old should be limited to 4 minutes. Placing a child in a dark closet can create fear and damage the child's trust in their parents as a source of safety, making it an inappropriate and harmful approach. Even if this method seems effective in the short term, the potential long-term consequences outweigh any immediate benefits.