Nokea
When questioning an elder about suspected abuse, the nurse should keep the questions:
- A. nonjudgmental.
- B. probing.
- C. confrontational.
- D. indirect.
Correct Answer: A
Rationale: Questions about suspected abuse should be direct and nonconfrontational. Indirect questions encourage denial.
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The nurse who was not promoted tells another friend, 'I knew I'd never get the job. The hospital administrator hates me.' If she actually believes this of the administrator, who, in reality, knows little of her, she is demonstrating:
- A. compensation.
- B. reaction formation.
- C. projection.
- D. denial.
Correct Answer: C
Rationale: Projection results in unconsciously adopting blaming behavior. It attributes unacceptable attributes to other people.
The Token Economy is a type of therapy that focuses on:
- A. play therapy.
- B. behavior modification.
- C. milieu therapy.
- D. associative.
Correct Answer: B
Rationale: Behavior modification gives positive feedback and rewards for appropriate behavior.
A batterer is usually someone who:
- A. grew up in a loving, secure home.
- B. was an only child.
- C. was physically or psychologically abused.
- D. admits he has a problem with anger.
Correct Answer: C
Rationale: Many batterers report having been abused as children.
A person using over-the-counter nasal decongestant drops who reports unrelieved and worsening nasal congestion should be instructed to:
- A. switch to a stronger dose of the medication.
- B. discontinue the medication for a few weeks.
- C. continue taking the same medication, but use it more frequently.
- D. use a combination of medications for better relief.
Correct Answer: B
Rationale: Prolonged use of decongestant drops (3 to 5 days) can lead to rebound congestion, which is relieved by discontinuing the medication for 2 to 3 weeks. Nasal congestion results from dilation of nasal blood vessels due to infection, inflammation, or allergy. With this dilation, there is a transudation of fluid into the tissue spaces, resulting in swelling of the nasal cavity. Nasal decongestants (sympathomimetic amines) stimulate the alpha-adrenergic receptors, producing vascular constriction (vasoconstriction) of the capillaries within the nasal mucosa. The result is shrinking of the nasal mucous membranes and a reduction in fluid secretion (runny nose). Decongestants can make a client jittery, nervous, or restless. These side effects decrease or disappear as the body adjusts to the drug. When nasal decongestants are used for longer than 5 days, instead of the nasal membranes constricting, vasodilation occurs, causing increased stuffy nose and nasal congestion. The nurse should emphasize the importance of limiting the use of nasal sprays and drops. As with any alpha-adrenergic drug (for example, decongestants), blood pressure and blood glucose levels can increase. These drugs are contraindicated and should only be used with extreme caution for clients with hypertension, cardiac disease, hyperthyroidism, and diabetes mellitus.
Which of the following coping mechanisms protects an individual from anxiety?
- A. denial and fantasy
- B. rationalization and suppression
- C. regression and displacement
- D. reaction formation and projection
Correct Answer: A
Rationale: Denial and fantasy reduce anxiety by avoiding or reimagining reality, serving as protective coping mechanisms, unlike the other options, which may not consistently reduce anxiety.