Nokea
Which of the following roles does a case manager not perform?
- A. Counselor - a client focussed enabler and educator
- B. Advisor - providing the client with advice from previous experience
- C. Coordinator - Matching a client with services, brokering
- D. Advocacy - Focus on mediating and organizing a client's service system
Correct Answer: B
Rationale: Advising from personal experience is less typical; case managers focus on systemic roles.
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With growing age motivation reduces naturally
- A. Extrinsic
- B. Frequent
- C. Intrinsic
- D. Concentrated
Correct Answer: C
Rationale: Intrinsic motivation declines with age due to priority shifts.
Mrs Wang is a retired teacher and used to take trips on cruise ships with her friends to gamble at the casino. She now goes to the local casino every other day by herself and is preoccupied with gambling. Her problem surfaced when she was caught on the closed circuit camera for trying to steal casino chips. Her husband was at a loss and reports that she keeps talking about gambling and boasts to her friends about the large amounts she places per bet. Her luck has turned for the worse, but she insists on going back to 'recoup' her losses. She has pawned most of her jewelry, stopped seeing her friends, and lies to her family about the amounts she has lost. Mrs Wang has features of a
- A. Social gambler.
- B. At risk gambler.
- C. Problem gambler.
- D. Pathological gambler.
Correct Answer: D
Rationale: Mrs. Wang's preoccupation, theft, financial loss, and deceit indicate pathological gambling, a severe disorder per DSM-5 criteria.
The nurse is concerned that a depressed client may be displaying a nonverbal suicidal threat when he presents another client with his favorite shirt as a 'gift.' The nurse's initial intervention is to:
- A. Place the client on suicide precautions including 15-minute checks.
- B. Ask the client if he is experiencing suicidal ideations with a plan to hurt himself.
- C. Support the client by telling him that he will need the shirt when he's discharged.
- D. Document that the client has shown behaviors that are likely subtle suicide threats.
Correct Answer: B
Rationale: The correct answer is B because asking the client directly about suicidal ideations with a plan to hurt himself is the most immediate and appropriate intervention to assess the client's safety. This approach allows the nurse to directly address the potential risk of suicide and initiate appropriate interventions if necessary. Placing the client on suicide precautions (choice A) without assessing the client's thoughts may be premature and intrusive. Supporting the client about the shirt (choice C) does not address the underlying concern of suicidal behavior. Simply documenting the behavior (choice D) without taking immediate action to assess and address the risk is insufficient in ensuring the client's safety.
A nurse worked at a hospital for several months, resigned, and then took a position at another hospital. In the new position, the nurse often volunteers to be the medication nurse. After several serious medication errors, an investigation reveals that the nurse was diverting patient narcotics for self-use. What early indicator of the nurse’s drug use was evident?
- A. Accepting responsibility for medication errors.
- B. Seeking to be assigned as the medication nurse.
- C. Frequent complaints of physical pain.
- D. High sociability with peers.
Correct Answer: B
Rationale: The correct answer is B: Seeking to be assigned as the medication nurse. This behavior is an early indicator of drug use because it provides the nurse with easier access to narcotics, which they may be seeking for self-use. By actively seeking out this responsibility, the nurse may have ulterior motives related to drug diversion.
Choice A is incorrect because accepting responsibility for medication errors is a common behavior among healthcare professionals and does not necessarily indicate drug use. Choice C, frequent complaints of physical pain, is also incorrect as it could be related to various health issues and not specifically drug use. Choice D, high sociability with peers, is not a direct indicator of drug use and does not provide any evidence of potential drug diversion.
A client diagnosed with chronic depression appears sad and joyless when arriving at the mental health clinic for a scheduled appointment. The nurse best assesses the client's mood by:
- A. Observing the client's posture, dress, and hygiene in detail.
- B. Asking, 'You seem very sad and forlorn; are you depressed today?'
- C. Asking, 'On a scale of 0 to 10 with 10 being as happy as you can ever remember being, how do you feel today?'
- D. Observing the way the client interacts with other staff to determine whether the client is demonstrating signs of depression.
Correct Answer: C
Rationale: The correct answer is C because it directly assesses the client's self-reported mood level, providing valuable insight into their emotional state. By using a standardized scale, the nurse can quantitatively evaluate the client's mood, allowing for a more accurate assessment.
Choice A is incorrect because assessing posture, dress, and hygiene does not directly assess the client's mood; it provides information on physical appearance.
Choice B is incorrect because asking if the client is depressed is leading and may not elicit an accurate response; it assumes the client's emotional state.
Choice D is incorrect because observing interactions with staff may not accurately reflect the client's mood; it could be influenced by various factors such as social skills or current circumstances.