Which is not an axis on Holland & Kilpatrick's Dimensions of Ethical Judgement?
- A. Internalized - Externalized
- B. Localized - Diffused
- C. Means - Ends
- D. Independence Autonomy - Mutuality Commonality
Correct Answer: C
Rationale: Means-Ends is not listed as an axis in their framework, which focuses on other dimensions.
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The treatment team plans care for a person diagnosed with paranoid schizophrenia and cannabis abuse. The person has recently used cannabis daily and is experiencing increased hallucinations and delusions. Which principle applies to care planning?
- A. Consider each diagnosis primary and provide simultaneous treatment.
- B. The person will benefit from treatment in a residential treatment facility.
- C. Withdraw the person from cannabis, and then treat the symptoms of schizophrenia.
- D. Treat the schizophrenia first, and then establish the goals for the treatment of substance abuse.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Dual diagnosis: Simultaneous treatment is crucial as both conditions impact each other.
2. Cannabis withdrawal may worsen schizophrenia symptoms, so treating both concurrently is essential.
3. Addressing both diagnoses concurrently increases treatment effectiveness.
4. Residential treatment may not be necessary at this stage without considering simultaneous treatment.
Summary:
B: Residential treatment may not be needed immediately; focus on simultaneous treatment.
C: Withdrawal may worsen schizophrenia symptoms; treating both conditions concurrently is preferable.
D: Treating schizophrenia first may not address the immediate exacerbation of symptoms due to cannabis use.
In the emergency department, a patient’s vital signs are: blood pressure (BP), 66/40 mm Hg; pulse (P), 140 beats per minute (bpm); and respirations (R), 8 breaths per minute and shallow. The patient overdosed on illegally obtained hydromorphone (Dilaudid). Select the priority outcome.
- A. Within 8 hours, vital signs will stabilize as evidenced by BP greater than 90/60 mm Hg, P less than 100 bpm, and respirations at or above 12 breaths per minute.
- B. The patient will be able to describe a plan for home care and achieve a drug-free state before being released from the emergency department.
- C. The patient will attend daily meetings of Narcotics Anonymous within 1 week of beginning treatment.
- D. The patient will identify two community resources for the treatment of substance abuse by discharge.
Correct Answer: A
Rationale: The correct answer is A because stabilizing the patient's vital signs is the top priority in this critical situation. A blood pressure of 66/40 mm Hg indicates severe hypotension, which can lead to organ failure. A pulse of 140 bpm and shallow respirations of 8 bpm indicate poor perfusion and respiratory distress. Achieving a BP greater than 90/60 mm Hg, P less than 100 bpm, and respirations at or above 12 bpm indicates improved perfusion and oxygenation, which are crucial for the patient's survival.
Option B is incorrect as achieving a drug-free state is not the immediate priority in an overdose situation. Option C is incorrect as attending Narcotics Anonymous meetings is important for long-term recovery but not the immediate priority. Option D is incorrect as identifying community resources for substance abuse treatment is important but not as critical as stabilizing the vital signs in an overdose situation.
The adult children of an elderly client are interested in the use of complementary and alternative medicine (CAM) therapies to help manage their mother's poststroke depression. The nurse responds:
- A. There has been no research done to investigate the effectiveness of CAM on depression like your mother's.'
- B. At your mother's age CAM therapies are not indicated since they may affect her impaired renal function.'
- C. There has been some research to support the use of acupuncture in managing depression that occurs after strokes.'
- D. I'd suggest you discuss this with your mother's physician before you mention the idea to her since the research on the subject is inconclusive.'
Correct Answer: C
Rationale: Rationale for Correct Answer C: The nurse's response is correct because there has been some research supporting the use of acupuncture in managing depression post-stroke. Acupuncture is a form of CAM therapy that has shown promising results in improving mental health outcomes for stroke patients. By suggesting acupuncture, the nurse is offering a potential evidence-based solution for the client's post-stroke depression. This response aligns with the client's interests in exploring CAM therapies and provides a feasible option for consideration.
Incorrect Answers:
A: This answer is incorrect because it states there has been no research on the effectiveness of CAM for depression after strokes, which is misleading as there is research supporting the use of acupuncture.
B: This answer is incorrect because it assumes that age-related factors like impaired renal function would automatically preclude the use of CAM therapies, which is not always the case.
D: This answer is incorrect because it suggests consulting the physician due to inconclusive research, which may hinder the exploration of potentially beneficial CAM therapies like acupuncture
Which of the following is not considered one of the 'Ten Rights of Medication Administration'?
- A. The 'right' verification
- B. The 'right' to refuse
- C. The 'right' documentation
- D. The 'right' client education
Correct Answer: A
Rationale: Verification (A) is not among the standard Ten Rights.
The intermittent exiting and entering of various family members and reestablishing of the bond of the dyadic marital relationship are characteristics associated with which stage of family development?
- A. The newly married couple
- B. The family with adolescents
- C. The family launching grown children
- D. The family in later life
Correct Answer: C
Rationale: The correct answer is C: The family launching grown children. This stage is characterized by children leaving the home, creating opportunities for the marital couple to reestablish their bond. This process involves adjusting to the "empty nest" and focusing on the marital relationship. A: The newly married couple is focused on establishing their relationship. B: The family with adolescents deals with parenting challenges. D: The family in later life focuses on retirement and aging concerns.