Nokea
Which behavior would the nurse expect to observe in a person who commits psychic rape?
- A. The perpetrator gives money to the patient after the rape.
- B. The perpetrator seduces the patient by providing wine, flowers, and music.
- C. The perpetrator threatens the patient to submit or else be severely beaten.
- D. The perpetrator mentions always including violent bondage in sexual activities.
Correct Answer: D
Rationale: The correct answer is D because mentioning violent bondage in sexual activities indicates a pattern of behavior associated with psychic rape, where the perpetrator exerts control and inflicts harm on the victim. This choice aligns with the power dynamics and manipulation typically seen in cases of psychic rape.
A: Giving money after the rape does not necessarily indicate psychic rape and is more characteristic of bribery or transactional behavior.
B: Seduction with wine, flowers, and music may indicate manipulation but does not specifically relate to the psychological violation inherent in psychic rape.
C: Threatening the patient with violence is a form of physical coercion rather than psychic rape, which involves psychological manipulation and violation.
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Which of the following can potentially be diagnostic at the clinic?
- A. The Ages & Stages questionnaire
- B. The Vanderbilt Rating Scale
- C. The MCHAT R/F
- D. The Goodenough Draw a Man test
Correct Answer: C
Rationale: The MCHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-up) is a validated diagnostic screening tool for autism that can be used in a clinic setting, unlike the others which are more general developmental or cognitive assessments.
Major concerns of the elderly living alone in their home are: (Name 1)
- A. Safety
- B. Quality of life
- C. Support system
- D. Access to medical care
Correct Answer: A
Rationale: Safety (A) is a major concern for the elderly living alone, as it impacts their ability to remain independent and healthy. Other concerns like quality of life (B), support system (C), and medical access (D) are also relevant but asked as a single choice here.
A 28-year-old female client was admitted 3 days ago after she ran nude through the streets, shouting that she was the 'Queen of Hearts.' The client has remained delusional since admission. An initial expected outcome would be that the client will:
- A. Allow the nurse to logically dispute the delusion
- B. Distinguish external boundaries
- C. Engage in reality-oriented conversation
- D. Explain why she thinks she is the 'Queen of Hearts'
Correct Answer: C
Rationale: The correct answer is C: Engage in reality-oriented conversation. This is the most appropriate initial expected outcome because it focuses on helping the client ground herself in reality. Engaging in reality-oriented conversation can help the client understand and acknowledge her delusions, leading to potential insight and eventual treatment.
A: Allowing the nurse to logically dispute the delusion may not be effective initially as the client may not be receptive to this approach during the acute phase of her delusion.
B: Distinguishing external boundaries may not address the underlying delusional beliefs and may not be the most immediate concern.
D: Explaining why she thinks she is the 'Queen of Hearts' may reinforce the delusion rather than challenging it.
The antisocial personality
- A. avoids other people as much as possible
- B. is relatively easy to treat effectively by psychotherapy
- C. tends to be selfish and lacking remorse
- D. usually gives a bad first impression
Correct Answer: C
Rationale: Antisocial personality involves selfishness and lack of remorse, often masked by initial charm.
The nurse at the clinic is interviewing a patient who offers a number of vague somatic complaints that might not ordinarily prompt a visit to a caregiver: fatigue, back pain, headaches, and sleep disturbance. The patient seems tense, and after having spoken of the symptoms, seems reluctant to provide more information and is in a hurry to leave. The nurse can best serve the patient by:
- A. Asking if the patient has ever had psychiatric counseling.
- B. Completing a structured abuse assessment protocol.
- C. Exploring the possibility of patient social isolation.
- D. Asking the patient to disrobe to check for signs of abuse.
Correct Answer: B
Rationale: The correct answer is B: Completing a structured abuse assessment protocol. Given the patient's vague complaints, tension, reluctance to provide more information, and hurry to leave, these could be signs of potential abuse. Completing a structured abuse assessment protocol allows the nurse to systematically assess for any signs of abuse, which could be contributing to the patient's somatic complaints. This approach is necessary to ensure the patient's safety and well-being.
Incorrect choices:
A: Asking if the patient has ever had psychiatric counseling - This choice does not directly address the potential abuse concerns indicated by the patient's behavior.
C: Exploring the possibility of patient social isolation - While social isolation could be a contributing factor, the urgency to leave and reluctance to provide information are more indicative of potential abuse.
D: Asking the patient to disrobe to check for signs of abuse - This choice is invasive and inappropriate without first completing a structured abuse assessment protocol to determine if abuse is likely.