Nokea
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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A 79-year-old white male tells a nurse, “I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing.” The nurse should analyze this comment as:
- A. Normal pessimism of the elderly.
- B. A call for sympathy
- C. Evidence of risks for suicide.
- D. Normal grieving.
Correct Answer: C
Rationale: The correct answer is C: Evidence of risks for suicide. The statement contains indicators such as feeling very sad, lack of purpose, isolation, and declining health, which are red flags for suicide risk in older adults. It is crucial for healthcare providers to assess and intervene promptly in such cases to prevent harm. Choices A, B, and D are incorrect because they do not address the seriousness of the situation or the potential risk for self-harm.
When asked, the nurse explains that “grief work” refers to:
- A. Establishing new methods of coping with stress
- B. Evaluating progress made toward accepting the loss
- C. The means by which one moves through the grief process
- D. Actively seeking assistance to cope with the loss.
Correct Answer: C
Rationale: The correct answer is C because "grief work" refers to the psychological process of actively working through and resolving the emotions and thoughts associated with a loss. This involves facing and processing the feelings of grief rather than avoiding them, ultimately leading to acceptance and healing. Choice A is incorrect as it focuses on coping with stress, not specifically grief. Choice B is incorrect as it emphasizes evaluating progress rather than the process of grieving itself. Choice D is incorrect as it pertains to seeking assistance, which is a part of coping but not the definition of grief work.
What is the basis for the reduction in disturbed thought processes when a patient is administered haloperidol (Haldol)?
- A. Reduction in the number of brain cells that crave dopamin
- B. Dopamine receptors are enhanced, making more dopamine available.
- C. Medication causes an increased cellular production of dopamine
- D. Dopamine receptors are blocked, making dopamine less available.
Correct Answer: D
Rationale: The correct answer is D because haloperidol is a dopamine receptor antagonist. By blocking dopamine receptors, it reduces the activity of dopamine in the brain, which helps in reducing disturbed thought processes. Option A is incorrect as dopamine craving is not related to the mechanism of action of haloperidol. Option B is incorrect as enhancing dopamine receptors would increase dopamine activity, opposite to the intended effect of haloperidol. Option C is incorrect as increasing cellular production of dopamine would also increase dopamine activity, contradicting the purpose of using haloperidol.
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.
A health care provider writes these new prescriptions for a resident in a skilled nursing facility: 2 G sodium diet, Restraint as needed, Limit fluids to 1800 mL daily, Continue antihypertensive medication, Milk of magnesia 30 mL PO once if no bowel movement for 3 days. The nurse should:
- A. Question the fluid restriction.
- B. Question the order for restraint.
- C. Transcribe the prescriptions as written.
- D. Assess the resident’s bowel elimination
Correct Answer: A
Rationale: Step 1: Fluid restriction of 1800 mL may not be appropriate for all residents in a skilled nursing facility. Step 2: Excessive fluid restriction can lead to dehydration, especially in elderly residents. Step 3: It is crucial for the nurse to question the fluid restriction to ensure it is safe for the resident. Therefore, the correct answer is A.
Summary:
- Option A is correct as questioning the fluid restriction is essential for the resident's safety.
- Option B is incorrect as restraining a resident should only be used as a last resort and should be questioned if not necessary.
- Option C is incorrect as blindly transcribing without assessing appropriateness can be harmful.
- Option D is incorrect as assessing bowel elimination is important but addressing the fluid restriction is more urgent in this scenario.