Nokea
Which of the following individuals is at the highest risk of suicide?
- A. An 80-year-old man who lost his wife last year
- B. A 36-year-old woman whose former neighbor committed suicide
- C. A 40-year-old married businessman
- D. A 46-year-old former alcoholic who has been sober for 12 years
Correct Answer: A
Rationale: The correct answer is an 80-year-old man who lost his wife last year. Certain factors increase the risk of suicide, such as recent loss of a loved one, in this case, the man's wife. The elderly are a high-risk group due to factors like social isolation, physical health issues, and bereavement. While experiencing a loss can affect anyone, the combination of age, loss of a spouse, and the associated emotional impact elevates the risk significantly. The other choices are not at the highest risk of suicide. A former alcoholic who has been sober for 12 years has taken steps towards recovery, reducing the immediate risk. A 40-year-old married businessman and a 36-year-old woman whose former neighbor committed suicide do not have the same level of immediate risk as the elderly man who recently lost his wife.
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A health care provider discusses with a client the need for an abdominoperineal resection and a colostomy. After the health care provider leaves the room, the client tells the nurse about being relieved that only minor surgery is necessary. Which psychological process explains this client's reaction?
- A. Reflection
- B. Regression
- C. Repudiation
- D. Reconciliation
Correct Answer: C
Rationale: The client's reaction of believing that only minor surgery is necessary when faced with the need for an abdominoperineal resection and a colostomy is an example of repudiation. Repudiation involves a refusal to acknowledge anticipated loss as a defense mechanism against the overwhelming stress of illness. The client is psychologically denying the seriousness of the situation.
The other choices are incorrect because:
- Reflection (Choice A) does not apply since the client is not contemplating the issues of the situation.
- Regression (Choice B) is not demonstrated as the client's behavior does not indicate reverting to an earlier stage of development.
- Reconciliation (Choice D) is not applicable as the client has not made a realistic adjustment to the illness but rather is in denial of its severity.
Which signs and symptoms would the nurse observe in a client with schizophrenia?
- A. Traumatic flashbacks and hypervigilance
- B. Depression and psychomotor retardation
- C. Loosened associations and hallucinations
- D. Ritualistic behavior and obsessive thinking
Correct Answer: C
Rationale: In clients with schizophrenia, the nurse would observe loosened associations and hallucinations. Loosened associations refer to disorganized thinking where thoughts are not logically connected. Hallucinations involve perceiving things that are not based in reality. Traumatic flashbacks and hypervigilance are more indicative of post-traumatic stress disorder. Depression and psychomotor retardation are common in depression, not schizophrenia. Ritualistic behavior and obsessive thinking are typically seen in obsessive-compulsive disorders, not schizophrenia.
Which term or description would the nurse use for a client who repeatedly performs ritualistic behaviors throughout the day to limit anxious feelings?
- A. Obsessions
- B. Compulsions
- C. Under personal control
- D. Related to rebelliousness
Correct Answer: B
Rationale: The correct answer is 'Compulsions.' A compulsion is an uncontrollable, persistent urge to perform an act repetitively to relieve anxiety. In this scenario, the client's repetitive ritualistic behaviors are indicative of compulsions. Obsessions, on the other hand, are persistent ideas, thoughts, or impulses that cannot be eliminated with logical reasoning. The behavior is not under personal control because avoiding it increases anxiety, making it a defense mechanism. It is not related to rebelliousness; instead, clients engage in these behaviors to reduce anxiety.
A daughter of a Chinese-speaking client approaches the nurse and asks multiple questions while maintaining direct eye contact. Which culturally related concept would the daughter's behavior reflect?
- A. Prejudice
- B. Stereotyping
- C. Assimilation
- D. Ethnocentrism
Correct Answer: C
Rationale: The correct answer is assimilation. Assimilation involves incorporating the behaviors of a dominant culture. In this scenario, maintaining eye contact is characteristic of the American or Canadian culture and not of Asian cultures. Prejudice is a negative belief about another person or group and does not characterize this behavior. Stereotyping is the perception that all members of a group are alike, which is not demonstrated by the daughter's behavior. Ethnocentrism is the perception that one's beliefs are superior to those of others, which is not evident in this situation.
During a scheduled health maintenance visit, which common source of stress for a 6-year-old client would the nurse include in the teaching session?
- A. Wanting to be first
- B. Demanding privacy
- C. Having a desire to be like an idol
- D. Being more selective with playmates
Correct Answer: A
Rationale: A common source of stress for a 6-year-old school-age client is competition, such as wanting to be first or the best (winning). This aspect can create stress for a 6-year-old as they navigate social interactions and activities. Therefore, the nurse would address this issue during the teaching session at the health maintenance visit. Demanding privacy, having a desire to be like an idol, and being more selective with playmates are characteristics more commonly associated with 7-year-old clients, not typically seen in the stressors of a 6-year-old. Understanding age-appropriate stressors is crucial for providing tailored education and support in pediatric care.