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Which of the following is an effective communication technique that should be included in the teaching plan for the family members of a woman in whom Alzheimer's disease has been diagnosed recently?
- A. Use simple, familiar words, along with short and simple sentences.
- B. If the client tends to pace a lot, be sure to encourage her to sit during interactions.
- C. If she doesn't understand the communication, change key words.
- D. Use hand gestures when speaking to try to explain what is being said.
Correct Answer: A
Rationale: The correct answer is A: Use simple, familiar words, along with short and simple sentences. This is an effective communication technique for individuals with Alzheimer's disease as it helps in enhancing understanding and reduces confusion. Complex language or sentences may be difficult for the patient to comprehend.
Choice B is incorrect because encouraging the client to sit during interactions does not directly relate to effective communication techniques. Choice C is incorrect as changing key words can lead to further confusion and may not aid in understanding. Choice D is incorrect because using hand gestures may not always effectively convey the message and can potentially cause more confusion for individuals with Alzheimer's disease.
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An adult patient tells the case manager, 'I dont have bipolar disorder anymore, so I dont need medicine. After I was in the hospital last year, you helped me get an apartment and disability checks. Now Im bored and dont have any friends.' Where should the nurse refer the patient? Select one tha does not apply.
- A. Psychoeducational classes
- B. Vocational rehabilitation
- C. Social skills training
- D. A homeless shelter
Correct Answer: D
Rationale: The patient does not understand the illness and need for adherence to the medication regimen. Psychoeducation for the patient (and family) can address this lack of knowledge. The patient, who considers himself friendless, could also profit from social skills training to improve the quality of interpersonal relationships. Many patients with serious mental illness have such poor communication skills that others are uncomfortable interacting with them. Interactional skills can be effectively taught by breaking the skill down into smaller verbal and nonverbal components. Work gives meaning and purpose to life, so vocational rehabilitation can assist with this aspect of care. The nurse case manager will function in the role of crisis stabilizer, so no related referral is needed. The patient presently has a home and does not require a homeless shelter.
A rape victim tells the nurse, "I should not have been out on the street alone."Â Select the nurse's most helpful response.
- A. Rape can happen anywhere.
- B. Blaming yourself increases your anxiety and discomfort.
- C. You are right. You should not have been alone on the street at night.
- D. You feel as though this would not have happened if you had not been alone.
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the victim's feelings without placing blame or judgment. By reflecting the victim's feelings back to them, the nurse validates their experience and shows empathy. This response encourages the victim to express their emotions and helps in building trust with the nurse.
Other choices are incorrect:
A: This choice does not address the victim's feelings of self-blame and does not provide the needed support.
B: While this choice acknowledges the negative impact of self-blame, it does not directly address the victim's statement.
C: This choice may be perceived as dismissive or blaming, which can further harm the victim's emotional well-being.
If you met an individual who appeared to be very charming at first, but later you discovered that he or she manipulated people, caused others hurt without a second thought, and could not be depended upon, you might suspect him of being
- A. dependent
- B. narcissistic
- C. paranoid
- D. antisocial
Correct Answer: D
Rationale: Antisocial personality disorder features charm, manipulation, and lack of remorse, fitting this description perfectly.
A 5-year-old presents with a history of urgency of micturition, occasional enuresis, and a slight, non-offensive vaginal discharge for 3 months. She has had no vaginal bleeding. Examination reveals some reddening of the labia majora. Which one of the following is the most likely diagnosis?
- A. Trichomonal infection.
- B. Gonorrhoea.
- C. Cystitis.
- D. Non-specific vulvo-vaginitis.
Correct Answer: D
Rationale: Non-specific vulvo-vaginitis (E) is common in young girls due to hygiene or irritation, causing these symptoms. Trichomonas (A) and gonorrhoea (B) are rare without sexual history, cystitis (C) lacks vaginal signs, and foreign body (D) typically causes bleeding or foul discharge.
The nurse is to perform a complete assessment of a client in her home, using the Mini-Mental State Examination as one component. When the nurse arrives, the client is seated at the table with her husband, the TV is on, and several grandchildren are visiting. The client's husband says, 'Let's get on with this business.' The client is quiet, but her hands are gripped tightly, and she is staring at the ceiling. The best action for the nurse to take would be to:
- A. Explain to the husband that accurate data will be sought, and ask him to stay with the grandchildren in another room
- B. Explain the importance of the testing process and make an appointment for another day when the environment can be better controlled
- C. Not perform the test during the assessment (because it will not be valid) and rely on observations and reports from the family
- D. Ask the husband to make an appointment to bring his wife to the clinic for testing
Correct Answer: B
Rationale: The correct answer is B because conducting a Mini-Mental State Examination (MMSE) in a distracting environment with the client exhibiting signs of distress would likely yield inaccurate results. By explaining the importance of the testing process and rescheduling for a quieter day, the nurse ensures a more accurate assessment. This allows for a controlled environment conducive to obtaining reliable data.
Choice A is incorrect because simply moving the husband and grandchildren to another room may not eliminate distractions or address the client's distress, potentially still impacting the accuracy of the assessment.
Choice C is incorrect as relying solely on observations and reports from the family may not provide a comprehensive assessment of the client's cognitive function, as the MMSE is a standardized tool designed for objective evaluation.
Choice D is incorrect as it does not address the immediate issue of conducting the assessment in a more suitable environment and may disrupt the client's routine by requiring a clinic visit.