Nokea
When advising an Asian Indian patient to reduce his/her risk for coronary heart disease, which of the following dietary changes would be the most effective?
- A. Recommend healthy substitutions for ingredients typically found in traditional food
- B. Avoid curry, a common Indian spice
- C. Recommend the addition of lean beef
- D. Replace herbs in the patient's diet with salt
Correct Answer: A
Rationale: Substitutions maintain cultural relevance while improving heart health.
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A client diagnosed with depression has reported fatigue and poor concentration. When she is told that the results of her sleep study show that she has excessive REM sleep cycles, the client asks the nurse to explain what those results mean. The nurse best answers the client's concerns by replying:
- A. It means that you are sleep deprived.'
- B. REM sleep stands for rapid eye movement sleep.'
- C. Too much REM sleep deprives you of deep restoring sleep.'
- D. Depressed individuals generally experience prolonged periods of REM sleep.'
Correct Answer: C
Rationale: The correct answer is C: "Too much REM sleep deprives you of deep restoring sleep." This is the best answer because excessive REM sleep can disrupt the normal sleep cycle, leading to a deprivation of deep, restorative sleep stages like slow-wave sleep. During REM sleep, the brain is active, but the body remains mostly immobile. This can result in poor sleep quality and contribute to symptoms of fatigue and poor concentration reported by the client.
Choice A is incorrect because excessive REM sleep does not necessarily mean the client is sleep deprived. Choice B is an oversimplification and does not address the potential negative impact of excessive REM sleep on sleep quality. Choice D is also incorrect because while depressed individuals may have alterations in their sleep patterns, not all depressed individuals experience prolonged periods of REM sleep.
Which treatment has been identified as a best practice for persons with borderline personality disorder?
- A. Dialectical behavioral therapy (DBT)
- B. Cognitive Behavioral Therapy (CBT)
- C. Mindfulness-Based Cognitive Therapy (MBCT)
- D. Exposure and Response Prevention (ERP)
Correct Answer: A
Rationale: The correct answer is A: Dialectical Behavioral Therapy (DBT). DBT is specifically designed for individuals with borderline personality disorder, focusing on emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness. It has shown to be effective in reducing self-harm behaviors and improving overall functioning. CBT (B) may be helpful for some symptoms but lacks the comprehensive approach of DBT. MBCT (C) is primarily used for depression and may not address the specific needs of individuals with borderline personality disorder. ERP (D) is used for anxiety disorders, not BPD.
Undesirable behaviour is also weakened or eliminated by
- A. Positive reinforcement
- B. Extinction
- C. Equilibrium
- D. All of these
Correct Answer: B
Rationale: Extinction removes reinforcement to weaken behavior (Skinner).
The difference between child abuse and child neglect is:
- A. Abuse is done on purpose; neglect is accidental.
- B. Abuse is an act of commission; neglect is an act of omission.
- C. Abuse is a crime; neglect is not.
- D. Children are often afraid to report abuse, but are willing to report neglect.
Correct Answer: B
Rationale: Abuse is purposeful mistreatment of another (therefore commission) and neglect is deprivation that is an omission of needed care.
Jack and Ann have come to the clinic for family therapy. They have been married for 18 years. Jack had an affair with his secretary 5 years ago. He fired the secretary and assures Ann and the nurse that he has been faithful ever since. Jack tells the nurse, 'We have never been able to get along with each other. We can’t talk about anything . . . all we do is shout at each other. And every time she gets angry with me, she brings up my infidelity. I can’t even imagine how many times each of us has threatened divorce over the years. Our kids don’t have any idea what it is like to have parents who get along with each other. I’ve really had enough!' The nurse would most likely document which of the following in her assessment of this couple?
- A. Marital skew
- B. Pseudohostility
- C. Double-bind communication
- D. Marital schism
Correct Answer: D
Rationale: The correct answer is D: Marital schism. Marital schism refers to a state of constant conflict and disengagement in a marriage. In this scenario, Jack and Ann exhibit a significant disconnect in their relationship, as evidenced by their inability to communicate effectively, frequent shouting matches, and unresolved issues such as Jack's infidelity. The nurse would likely document a marital schism in her assessment due to the ongoing discord and lack of emotional connection between the couple.
Incorrect choices:
A: Marital skew typically refers to power imbalances in a relationship, which is not the primary issue in this case.
B: Pseudohostility involves false or exaggerated hostility, which is not the main concern in Jack and Ann's situation.
C: Double-bind communication involves contradictory messages leading to confusion, which is not the central issue in this scenario.