Nokea
Which of the following statements should the nurse use to best describe a very low-calorie diet (VLCD) to a client?
- A. This diet can be used when there is close medical supervision.'
- B. This is a long-term treatment measure that assists obese people who can't lose weight.'
- C. The VLCD consists of solid food items that are pureed to facilitate digestion and absorption.'
- D. A VLCD contains very little protein.'
Correct Answer: A
Rationale: VLCDs are used in the clinical treatment of obesity under close medical supervision. The diet is low in calories, high in quality protein, and has a minimum of carbohydrates to spare protein and prevent ketosis.
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An elderly client denies that abuse is occurring. Which of the following factors could be a barrier for the client to admit being a victim?
- A. knowledge that elder abuse is rare
- B. personal belief that abuse is deserved
- C. lack of developmentally appropriate screening tools
- D. fear of reprisal or further violence if the incident is reported
Correct Answer: D
Rationale: Barriers to reporting elder abuse include victim shame, fear of reprisals, fear of loss of caregiver, and lack of knowledge of agencies that provide services. Many elders fear that reporting abuse results in their placement in long-term care because the current caregiver is the abuser.
A client admitted to the medical nursing unit has classic symptoms of tuberculosis (TB) and tests positive on the purified protein derivative (PPD) skin test. Several months later, the nurse who cared for the client also tests positive on an annual TB skin test for work. The most likely course of treatment if the chest X-ray (CXR) is negative is to:
- A. repeat a TB skin test in six months.
- B. treat the nurse with an anti-infective agent for six months.
- C. monitor for signs and symptoms within the next year.
- D. follow up in one year at the next annual physical with CXR only.
Correct Answer: B
Rationale: Exposure with a positive TB skin test usually requires six months of prophylactic treatment unless contraindicated.
The nurse suspects an elderly client has been the victim of abuse. The client denies abuse and declines assistance. The nurse's next action should be to:
- A. do nothing; the client has the right to refuse treatment.
- B. report the incident to the police.
- C. arrange an appointment with the client's next of kin.
- D. educate the client about available services.
Correct Answer: D
Rationale: Although clients do have the right to refuse treatment, the nurse should remain nonjudgmental and inform the client of available services. Frequently elders are not aware of existing programs.
How does the ANA define the psychiatric nursing role?
- A. a specialized area of nursing practice that employs theories of human behavior as its science and the powerful use of self as its art.
- B. assisting the therapist to relieve the symptoms of clients.
- C. to solve clients' problems and give them the answers.
- D. having a client committed to long-term therapy with the nurse.
Correct Answer: A
Rationale: The ANA sets standards of practice for psychiatric and mental health nursing roles. Quality of care, performance appraisal, education, ethics, collaboration, and research are covered through the use of the Nursing Process.
A nurse is planning a brief treatment program for a client who was raped. A realistic, short-term goal is to:
- A. identify all psychosocial problems.
- B. eliminate the client's enticing behaviors.
- C. resolve feelings of trauma and fear.
- D. verbalize feeling about the event.
Correct Answer: D
Rationale: A realistic short-term goal is for the client to verbalize feelings about the event. A brief treatment program is not designed to identify or resolve problems. The focus is on managing acute symptoms. If in-depth psychological problems are identified, the nurse might make referrals for treatment.