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Which action will best facilitate the development of trust between a nurse and patient?
- A. Responding positively to the patient’s demands
- B. Clarifying with the patient whenever there is doubt
- C. Staying available to the patient for the entire shift
- D. Following through with whatever was promised
Correct Answer: B
Rationale: The correct answer is B, clarifying with the patient whenever there is doubt. This action shows active listening, respect, and a willingness to understand the patient's needs. By seeking clarification, the nurse demonstrates genuine interest in the patient's perspective, which helps build trust. Responding positively to demands (A) may not always be appropriate or feasible. Staying available for the entire shift (C) is important but not the sole factor in trust-building. Following through with promises (D) is crucial but does not address the patient's concerns or doubts directly. Clarifying doubts fosters clear communication and mutual understanding, establishing a foundation of trust.
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Which intervention will the nurse planning care for a patient with acute grief implement?a. Providing information about the grief process
- A. Providing information about the grief process.
- B. Suggesting utilization of community resources in a few weeks
- C. Encouraging dependence on the nurse for support
- D. Assessing for signs of complicated grief or depression
Correct Answer: A
Rationale: The correct answer is A because providing information about the grief process helps the patient understand their feelings and reactions, promoting emotional healing. Choice B is incorrect because suggesting community resources may not address the patient's immediate needs. Choice C is incorrect as encouraging dependence on the nurse may hinder the patient's ability to cope independently. Choice D is incorrect because assessing for complicated grief or depression is important but not the initial intervention in planning care for acute grief.
Which statement by a 16-year-old is considered as positive evidence that the family’s involvement in therapy is moving them towards effective functioning?
- A. “My dad has finally stopped giving me advice on how to live my life.”
- B. “I stopped playing football since practice required me to be away from home so often.”
- C. “Since my mother quit her job, she is more available to keep the home running smoothly.”
- D. “Eating dinner with my parents on Sunday nights has helped us be more aware of each other’s needs.”
Correct Answer: D
Rationale: The correct answer is D because it shows positive evidence of improved family dynamics through increased communication and awareness of each other's needs. Eating dinner together signifies a commitment to spending quality time and fostering connections. Choice A indicates a lack of interference but not necessarily improved functioning. Choice B suggests withdrawal from activities, which may not be positive. Choice C implies a sacrifice that may not directly lead to effective functioning.
An adult patient shares that, When my mother died when we were children, I never saw my
father show any emotion. What do you think will happen with those unexpressed feelings?
Which response is most appropriate?
- A. Pent-up emotions may lead to depression or other disorders.
- B. Your father probably has worked through his grief by this time.
- C. Maybe you can teach him how to best express his own feelings.
- D. If feelings are not effectively expressed, the person can become suicidal.
Correct Answer: A
Rationale: Step 1: Pent-up emotions are emotions that are suppressed or not expressed.
Step 2: Unexpressed feelings, especially from past traumatic events, can lead to emotional distress.
Step 3: Long-term suppression can manifest as depression or other mental health disorders.
Step 4: Therefore, choice A is the most appropriate response as it highlights the potential negative consequences of unexpressed emotions.
Summary:
- Choice B assumes the father has processed his grief, which may not be the case.
- Choice C oversimplifies the complexity of emotional expression and may not address the root issue.
- Choice D jumps to an extreme outcome without considering the range of possible consequences.
A newly admitted patient diagnosed with major depression has gained 20 pounds over a few months and has suicidal ideation. The patient has taken an antidepressant medication for 1 week without remission of symptoms. Select the priority nursing diagnosis.
- A. Imbalanced nutrition: more than body requirements.
- B. Chronic low self-esteem.
- C. Risk for suicide.
- D. Hopelessness.
Correct Answer: C
Rationale: The priority nursing diagnosis in this case is C: Risk for suicide. This is because the patient is exhibiting suicidal ideation, which poses an immediate threat to their safety and well-being. Suicidal ideation requires urgent intervention to ensure the patient's safety. The patient's major depression, weight gain, and lack of symptom remission from the antidepressant medication further emphasize the seriousness of the situation. Choices A, B, and D are not the priority in this scenario as they do not address the immediate risk of harm to the patient. Imbalanced nutrition and chronic low self-esteem are important concerns but do not take precedence over the risk of suicide. Hopelessness, while relevant, is not as urgent as addressing the immediate risk of suicide.
The nurse determines that a patient is showing a decline in explicit memory. Which characterizes such a deficiency?
- A. Inability to remember how to operate a common kitchen appliance
- B. Difficulty remembering the name of a place visited 20 years ago
- C. Being unsuccessful at retaining new information
- D. Forgetting the ingredients of a favorite recipe
Correct Answer: B
Rationale: The correct answer is B because difficulty remembering the name of a place visited 20 years ago is a specific example of explicit memory decline. Explicit memory refers to the ability to consciously recall past events, facts, or experiences. This choice directly relates to a long-term memory retrieval issue, which is a hallmark of explicit memory decline. Choices A, C, and D do not specifically address explicit memory decline but rather touch on different memory processes such as procedural memory (A), short-term memory (C), and semantic memory (D).