Nokea
A grief support group is held at the local community center to assist persons who are dealing with issues of loss. Which remark by one of the members would the nurse interpret as indicating unresolved feelings of guilt?
- A. “I know that my husband had a good life.”
- B. “It seems I miss my son more as time goes on.”
- C. “I am still wishing I had gotten help to him sooner.”
- D. "The holidays are always so hard for me now."
Correct Answer: C
Rationale: The correct answer is C because the statement indicates feelings of guilt about not getting help sooner, suggesting the member may blame themselves for the loss. This remark reflects a sense of responsibility and regret, common in unresolved guilt. Choice A expresses acceptance, B reflects natural grief progression, and D highlights difficulty during specific times, not necessarily linked to guilt. By analyzing the content of each statement, the nurse can identify cues related to unresolved feelings of guilt.
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When a hospitalized patient dies, his wife stares blankly and states, "It can’t be." This indicates:
- A. Despair and protest
- B. Shock and disbelief
- C. Anger and hostility
- D. Disorganization and confusion
Correct Answer: B
Rationale: Correct Answer: B (Shock and disbelief)
Rationale:
1. The wife's blank stare and statement "It can’t be" suggest a state of disbelief and being stunned by the news of her husband's death, indicating shock.
2. Shock is a common initial reaction to unexpected and distressing events, such as the sudden death of a loved one.
3. This choice is the most fitting based on the wife's reaction of disbelief and being unable to accept the reality of the situation.
Summary:
A: Despair and protest - Despair involves a sense of hopelessness, not evident in the wife's initial reaction. Protest implies a more active response, while the wife's reaction is passive.
C: Anger and hostility - There is no indication of anger or hostility in the wife's initial response; rather, it is characterized by disbelief.
D: Disorganization and confusion - While the wife may feel disorganized and confused later, her initial response reflects more shock and disbelief than disorganization
How can the nurse encourage an extremely shy patient to participate therapeutically in a dance activity group?
- A. Offer to dance with the patient.
- B. Ask the patient if this is the first dance he has attended.
- C. Sit with the patient away from the group.
- D. Encourage another patient to ask him to dance.
Correct Answer: A
Rationale: The correct answer is A because offering to dance with the patient shows support, builds trust, and models behavior. This approach can help the shy patient feel more comfortable and encouraged to participate. Choice B focuses on the patient's past experience, which may not directly address the current issue. Choice C isolates the patient, potentially increasing feelings of shyness. Choice D involves a third party, which may not be as effective in building a direct connection with the shy patient. Overall, option A is the most effective in directly engaging and encouraging the shy patient to participate therapeutically in the dance activity group.
After undergoing two of nine electroconvulsive therapy (ECT) procedures, a client states, "I can’t even remember eating breakfast, so I want to stop the ECT." Which is the most appropriate nursing reply?
- A. After you begin the course of treatments, you must complete all of them.
- B. You’ll need to talk with your doctor about what you’re thinking
- C. It is within your right to discontinue the treatments, but let’s talk about your concerns.
- D. Memory loss is a rare side effect of the treatment. I don’t think it should be a concern.
Correct Answer: C
Rationale: The correct answer is C. It acknowledges the client's autonomy while also addressing their concerns. First, it recognizes the client's right to discontinue treatment. Second, it opens the door for a discussion to explore the client's worries and provide support. This response shows empathy and respects the client's decision-making.
Choice A is incorrect because it dismisses the client's autonomy and fails to address their concerns. Choice B is not as appropriate as it suggests only talking to the doctor, missing the opportunity for the nurse to provide immediate support. Choice D is incorrect as it invalidates the client's experience of memory loss and fails to address their concerns.
Which initial short-term outcome would be appropriate for a patient admitted with delusional thoughts?
- A. Accept that delusion is illogical.
- B. Distinguish external boundaries.
- C. Explain the basis for the delusions.
- D. Engage in reality-oriented conversation.
Correct Answer: D
Rationale: The correct answer is D, engage in reality-oriented conversation. This is appropriate because it helps the patient ground themselves in reality and potentially reduce the intensity of their delusions. By discussing real-life events and situations, the patient is encouraged to recognize the disparity between their delusional thoughts and actual reality. Choice A is incorrect as simply accepting the delusion as illogical does not actively address the patient's condition. Choice B, distinguishing external boundaries, is not as effective in directly challenging the delusional thoughts. Choice C, explaining the basis for the delusions, may not be helpful initially as the patient may not be receptive to logical explanations due to their distorted thinking.
The nurse is determining whether the patient’s needs could be best met in a task or a process group. The decision is based on the understanding that a task group focuses on:
- A. The “here and now”
- B. Communication styles
- C. Relations among the members
Correct Answer: A
Rationale: The correct answer is A: The "here and now." In a task group, the focus is on addressing specific goals, tasks, and problem-solving in the present moment. This approach helps members work together efficiently to achieve objectives. Communication styles (B) are more relevant in a group focused on improving communication skills. Relations among the members (C) are typically emphasized in a process group, where the focus is on interpersonal dynamics and relationships. Choice D is incomplete and does not align with the purpose of a task group.