Nokea
Which of the following meets the DSM-IV-TR criteria for moderate mental retardation?
- A. Requires constant one-on-one supervision and total physical care
- B. Advanced as far as the second grade and provides her own personal care with supervision
- C. Attends the local community college for developmental English and math courses
- D. Advanced as far as the sixth grade and works at a warehouse every day and supports himself.
Correct Answer: D
Rationale: The correct answer is D because the DSM-IV-TR criteria for moderate mental retardation includes an IQ range of 35-49, which typically corresponds to functioning at around the level of a 6 to 9-year-old. Choice D best fits this criteria as the individual has advanced to the sixth grade level academically, indicating a level of functioning consistent with moderate mental retardation. Choices A, B, and C do not meet the criteria as they suggest a higher level of functioning and independence than what is typically associated with moderate mental retardation.
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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.
Select the best outcome for a patient with the nursing diagnosis: "Impaired social interaction related to sociocultural dissonance as evidenced by stating, 'Although I’d like to, I don’t join in because I don’t speak the language very well.'” Patient will:
- A. Show improved use of language.
- B. Demonstrate improved social skills.
- C. Become more independent in decision-making.
- D. Select and participate in one group activity per day.
Correct Answer: D
Rationale: The correct answer is D: Select and participate in one group activity per day. This outcome directly addresses the nursing diagnosis of impaired social interaction by encouraging the patient to engage in a specific social activity daily. This goal promotes social interaction, helps the patient overcome language barriers, and gradually enhances their social skills. It provides a structured approach to improve the patient's sociocultural integration.
A: Show improved use of language - This choice focuses solely on language skills but does not directly address the social interaction issue.
B: Demonstrate improved social skills - While this choice is related to the nursing diagnosis, it is too broad and lacks specificity compared to choice D.
C: Become more independent in decision-making - This choice is not directly related to addressing impaired social interaction caused by language barriers.
The Omnibus Budget Reconciliation Act (OBRA) provides standards of care for which of the following?
- A. Very young
- B. Older adults
- C. Those who have certain intellectual communication difficulties Those who have certain intellectual communication difficulties
- D. Those without medical insurance
Correct Answer: B
Rationale: The correct answer is B: Older adults. OBRA primarily focuses on setting standards of care for older adults in long-term care facilities, ensuring their safety and well-being. This is because older adults are a vulnerable population requiring specialized care and attention. Choices A, C, and D are incorrect because OBRA does not specifically address very young individuals, those with intellectual communication difficulties, or individuals without medical insurance. The Act mainly pertains to the care and rights of older adults in long-term care settings.
Which activities should the nurse evaluate in an assessment of an older patient’s functional status? (Select all that apply.)
- A. Possessing the ability to prepare nutritious meals independently.
- B. Having the financial resources available to live independently
- C. Performing regular, simple maintenance on their primary residence.
- D. Effectively toileting themselves for both bowel and bladder elimination.
Correct Answer: A,C
Rationale: The correct answers are A and C. A nurse should evaluate if the older patient can prepare nutritious meals independently, as this indicates their ability to meet basic nutritional needs and maintain independence in daily living. Additionally, assessing if the patient can perform regular, simple maintenance on their primary residence is important for gauging their ability to live safely and comfortably. Choices B and D are incorrect as financial resources and toileting abilities, while important, do not directly reflect functional status in the same way as meal preparation and home maintenance.
During a grief-processing group, an elderly patient stated, “For the first time since my husband died, I’m having more good days than bad.” This statement suggests that the patient has:
- A. Reached the phase of reestablishment
- B. Determined she is ready to terminate the support group
- C. Completed her “grief work” successfully
- D. Replaced old memories with new ones.
Correct Answer: C
Rationale: The correct answer is C: Completed her "grief work" successfully. This statement indicates progress in the grieving process, moving towards acceptance and healing. The patient acknowledging having more good days than bad reflects a positive shift in coping with the loss, indicating that she has processed her grief and is beginning to adapt to life without her husband. This suggests that the patient has worked through her emotions, memories, and adjustments related to the loss, reaching a point where she is experiencing more peace and acceptance.
Summary:
A: Reestablishment is not the correct choice as it does not specifically address the completion of the grief work.
B: Determining readiness to terminate the support group is premature, as the patient may still benefit from continued support.
D: Replacing old memories with new ones is not supported by the patient's statement and does not necessarily indicate successful grief processing.