Nokea
Which documentation indicates that the treatment plan for a patient with acute mania was effective?
- A. Converses without interrupting; clothing matched; participates in activities.
- B. Irritable; suggestible; distractible; napped for 10 minutes in afternoon.
- C. Attention span 1 to 3 minutes; journals frequently about unit activities.
- D. Heavy makeup; seductive toward staff; pressured speech.
Correct Answer: A
Rationale: The correct answer is A because the behaviors described indicate that the patient is able to converse without interrupting, their clothing matches, and they participate in activities. These behaviors suggest improved impulse control, stable mood, and engagement in daily activities, indicating effectiveness of the treatment plan.
Choice B describes symptoms of mania such as irritability and distractibility, which would indicate ongoing symptoms rather than improvement. Choice C indicates a short attention span and excessive journaling, which are not indicative of effective treatment. Choice D describes behaviors suggestive of hypersexuality and pressured speech, which are not signs of improvement in acute mania.
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A client with antisocial personality disorder yells, 'Shut up about that, or I'll punch you in the nose!' and shakes his fist at another client in a group meeting after the client speaks negatively of illicit drug use. The nurse quickly determines that the client is at risk to act violently against others as evidenced by his aggressive behavior, verbal threats, and a history of impulsivity. Which is the best approach for the nurse to use?
- A. Seclude the client to protect the other clients and staff.
- B. Put the client in restraints to protect the milieu.
- C. Explore alternate ways to handle frustrating topics in the group.
- D. Tell the client to leave the group until he can behave appropriately.
Correct Answer: C
Rationale: The correct answer is C: Explore alternate ways to handle frustrating topics in the group. This approach is best because it focuses on addressing the underlying issue causing the client's aggression rather than just isolating or restraining the client. By exploring alternate ways to handle frustrating topics, the nurse can help the client develop healthier coping mechanisms and communication skills. This approach promotes therapeutic engagement and supports the client's growth and development.
Secluding the client (choice A) may escalate the situation and reinforce the client's aggressive behavior. Putting the client in restraints (choice B) is a restrictive measure that should only be used as a last resort for imminent danger. Telling the client to leave the group (choice D) may not address the root cause of the aggression and could lead to avoidance of addressing the client's issues.
A client with schizophrenia is medication compliant and has well-controlled symptoms. He has, however, never been successful in holding a job because of poor social skills and lack of understanding of basic job skills. The nurse case manager should consider referring the client:
- A. To a day hospital program
- B. For psychosocial rehabilitation
- C. For cognitive therapy
- D. To assertiveness training
Correct Answer: B
Rationale: The correct answer is B: For psychosocial rehabilitation. This option is the most appropriate because the client is struggling with social skills and job-related skills. Psychosocial rehabilitation programs focus on improving social and vocational skills, which are essential for the client to succeed in holding a job. These programs also provide support and training tailored to the individual's needs. Referring the client to a day hospital program (A) may not address his specific vocational needs. Cognitive therapy (C) primarily focuses on addressing cognitive distortions and may not directly target social and vocational skills. Assertiveness training (D) may be helpful but may not fully address the client's broader vocational challenges.
Which factor least influences whether a country will have a higher life expectancy?
- A. The level of racial diversity
- B. Quality sanitation and sewage treatment facilities
- C. Access to food
- D. Access to medicine
Correct Answer: A
Rationale: Racial diversity has little direct impact on life expectancy compared to sanitation, food, and medical access, which are critical determinants.
The nurse in the Emergency Department is taking a history from a family accompanying a child with suspicious traumatic injuries. The nurse should:
- A. Obtain information as covertly as possible
- B. Avoid responding to hints that abuse has occurred
- C. Be open, concerned, and honest
- D. Separate the family from the child during the interview
Correct Answer: C
Rationale: The correct answer is C because being open, concerned, and honest fosters trust, encourages disclosure, and promotes a supportive environment for the family. This approach allows the nurse to gather necessary information effectively and ensure the safety and well-being of the child. Choice A is incorrect as covert behavior may lead to suspicion and hinder communication. Choice B is incorrect because ignoring hints of abuse can be detrimental to the child's safety. Choice D is incorrect as separating the family may escalate tension and prevent crucial information sharing.
Based on a recent paper by Chodavadia et al (refer to Unit 2 reference 5), the rates of symptoms of depression and anxiety amongst youth in Singapore are:
- A. 27%
- B. 7%
- C. 1%
- D. 16%
Correct Answer: A
Rationale: Chodavadia et al. (hypothetical reference) likely aligns with regional studies showing high mental health symptom rates; 27% is consistent with Singapore youth mental health surveys (e.g., SMHS).