Nokea
When preparing to administer to domestic violence screening tool to a female client, which statement should the RN provide?
- A. If your partner is abusing you, I need to ask these questions.
- B. State law mandates that I ask if you are a victim of domestic violence.
- C. The HCP provider needs to know if you are experiencing any domestic abuse.
- D. All clients are screened for domestic abuse because it is common in our society.
Correct Answer: D
Rationale: The correct answer is D. By stating that all clients are screened for domestic abuse because it is common in society, the nurse normalizes the screening process and reduces stigma. This approach can help the client feel more comfortable disclosing abuse. Choice A may inadvertently imply that the client's partner is abusing them, potentially leading to a defensive response. Choice B may make the client feel obligated to disclose abuse due to legal reasons, which can feel coercive. Choice C is vague and may not convey the importance of screening for domestic violence.
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The RN is providing care for a client diagnosed with borderline personality disorder who has self-inflicted lacerations on the abdomen. Which approach should the RN use when changing this client’s dressing?
- A. Provide detailed thorough explanations when cleansing wound.
- B. Perform the dressing change in a non-judgmental manner.
- C. Ask in a non-threatening manner why the client cut own abdomen.
- D. Request another staff member assist with the dressing change.
Correct Answer: B
Rationale: The correct answer is B: Perform the dressing change in a non-judgmental manner. When caring for a client with borderline personality disorder who has self-inflicted injuries, it is crucial to approach the situation with empathy and without passing judgment. This approach helps build trust, maintains the therapeutic relationship, and encourages open communication. Providing detailed explanations (choice A) may overwhelm the client. Asking about the self-inflicted behavior (choice C) in a non-threatening manner can be appropriate but should not be the primary focus during the dressing change. Requesting another staff member's assistance (choice D) may not be necessary if the RN can handle the situation effectively.
James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for day shift and anxiously reports, “Last night, demons came to my room and tried to rape me.†Which response would be most therapeutic?
- A. There are no such things as demons. What you saw were hallucinations.
- B. It is not possible for anyone to enter your room at night. You are safe here.
- C. You seem very upset. Please tell me more about what you experienced last night.
- D. That must have been very frightening, but we’ll check on you at night and you’ll be safe.
Correct Answer: C
Rationale: The correct answer is C because it demonstrates empathy and active listening. By acknowledging James's feelings and inviting him to share more about his experience, the response validates his emotions and fosters trust. This approach helps build a therapeutic relationship and allows for a deeper exploration of his hallucinations. Options A and B invalidate James's experience and may increase his distress. Option D offers reassurance but lacks the immediate emotional support James needs.
When developing a plan of care for a client admitted to the psychiatric unit following aspiration of a caustic material related to a suicide attempt, which nursing problem has the highest priority?
- A. Impaired comfort.
- B. Risk for injury.
- C. Ineffective breathing pattern.
- D. Ineffective coping.
Correct Answer: C
Rationale: The correct answer is C: Ineffective breathing pattern. This is the highest priority because aspiration of a caustic material can lead to respiratory distress or compromise. Ensuring the client has a patent airway and adequate breathing is crucial for immediate stabilization and preventing further complications. Impaired comfort (choice A) may be a concern but is secondary to ensuring the client can breathe. Risk for injury (choice B) is important but not as immediate as addressing breathing. Ineffective coping (choice D) is important for long-term recovery but addressing the client's breathing takes precedence in this acute situation.
Which statement made by the nurse demonstrates the best understanding of nonverbal communication?
- A. The patient’s verbal and nonverbal communication is often different.
- B. When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response.
- C. If a patient is slumped in the chair, I can be sure he’s angry or depressed.
- D. It’s easier to understand verbal communication than nonverbal communication.
Correct Answer: B
Rationale: The correct answer is B because it demonstrates an understanding of the importance of checking for congruence between verbal and nonverbal communication to validate responses. Nonverbal cues can provide additional context and insight into a patient's true feelings or intentions. Choice A is too general and does not emphasize the significance of congruence. Choice C makes an assumption based solely on nonverbal cues, which can be misleading. Choice D is incorrect as understanding nonverbal communication is equally important as verbal communication.
Which factors tend to increase the difficulty of diagnosing young children who demonstrate behaviors associated with mental illness? Select all that apply.
- A. Limited language skills
- B. Level of cognitive development
- C. Level of emotional development
- D. Parental denial that a problem exists
Correct Answer: B
Rationale: The correct answer is B: Level of cognitive development. Diagnosing mental illness in young children is challenging due to their limited ability to express their thoughts and emotions. Their cognitive development affects their capacity to understand and communicate symptoms, making it harder to assess their mental health accurately. Limited language skills (A) and emotional development (C) can also contribute to the difficulty of diagnosis, but cognitive development plays a more significant role. Parental denial (D) may hinder seeking help but is not a factor that directly impacts the diagnostic process in the child.