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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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The nursing approach that will minimize power struggles between the client with an eating disorder and the nurse is best characterized as:
- A. authoritarian and autocratic.
- B. laid-back and flexible.
- C. rigid and unyielding.
- D. compassionate and firm.
Correct Answer: D
Rationale: The correct answer is D: compassionate and firm. This approach balances empathy and boundaries, fostering trust and cooperation while maintaining structure. Compassion helps build rapport and understanding, essential for addressing the underlying issues of the eating disorder. Firmness sets clear limits and expectations, promoting accountability and progress. Authoritarian and autocratic (A) can create resistance and hinder therapeutic alliance. Laid-back and flexible (B) may enable unhealthy behaviors. Rigid and unyielding (C) can lead to power struggles and hinder therapeutic progress.
An outpatient diagnosed with schizophrenia attends programming at a community mental health center. The patient says, I threw away the pills because they keep me from hearing God. Which response by the nurse would most likely to benefit this patient?
- A. You need your medicine. Your schizophrenia will get worse without it.
- B. Do you want to be hospitalized again? You must take your medication.
- C. I would like you to come to the medication education group every Thursday.
- D. I noticed that when you take the medicine, you have been able to hold a job you wanted.
Correct Answer: D
Rationale: Connecting medication to the patient's goal (job) (D) motivates adherence despite desirable hallucinations. Exhortations (A, B) ignore insight issues, and education (C) assumes a knowledge deficit, not the core problem.
A nurse is working with a patient with bulimia nervosa. Which outcome would indicate successful intervention?
- A. The patient eats three full meals daily without purging.
- B. The patient agrees to begin psychotherapy without resistance.
- C. The patient loses 5% of their body weight over 3 months.
- D. The patient expresses improved body image but still purges occasionally.
Correct Answer: A
Rationale: The correct answer is A because it indicates successful intervention in bulimia nervosa by demonstrating healthy eating behavior without purging. This outcome reflects improved control over binge-purge cycles and supports physical health. Choices B and D show progress but do not directly address the core issue of purging behavior. Choice C, losing weight, can be a misleading indicator and may not necessarily reflect improved psychological and behavioral outcomes associated with recovery from bulimia nervosa.
A victim of physical abuse by her domestic partner is being treated for a broken humerus. Which indicator for the outcome of Abuse protection is most important to achieve before the patient leaves the emergency department?
- A. The patient has completed and reviewed a workable safety plan.
- B. She agrees to seek a restraining order limiting contact by the perpetrator.
- C. The patient demonstrates insight into the abusive nature of the relationship.
- D. She has been referred to counseling and battered-person support groups.
Correct Answer: A
Rationale: The correct answer is A because a safety plan is crucial for the victim's immediate safety and future protection. It helps the victim know what to do in case of danger, ensuring a proactive approach to safety. Choice B may not always be feasible or effective in preventing further abuse. Choice C, while important, does not guarantee safety outside the emergency department. Choice D is beneficial but does not address the immediate safety concerns as effectively as having a safety plan in place. Thus, completing and reviewing a workable safety plan is the most important indicator for the outcome of abuse protection in this scenario.
A nurse is caring for a patient with anorexia nervosa who is refusing to eat. What should the nurse do first?
- A. Provide a structured meal plan and encourage the patient to eat.
- B. Avoid discussing food intake to reduce anxiety.
- C. Allow the patient to skip meals to avoid pressure.
- D. Offer incentives for eating a full meal.
Correct Answer: A
Rationale: The correct answer is A: Provide a structured meal plan and encourage the patient to eat. This is the first step because patients with anorexia nervosa often struggle with disordered eating behaviors and need guidance and support to establish healthy eating habits. Providing a structured meal plan helps the patient understand the importance of regular and balanced meals. Encouraging the patient to eat helps address their resistance and fear around food.
Incorrect choices:
B: Avoid discussing food intake to reduce anxiety - This choice is incorrect because avoiding discussing food intake does not address the underlying issue and may perpetuate the patient's disordered eating behavior.
C: Allow the patient to skip meals to avoid pressure - Allowing the patient to skip meals enables their unhealthy behavior and does not promote recovery.
D: Offer incentives for eating a full meal - While incentives may be used as a motivational tool, they do not address the core issue of establishing a healthy relationship with food.