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Which patient would the group co-leaders determine is demonstrating Yalom’s therapeutic factor termed universality?
- A. Patient A, who states he realizes he is not the only person who has a problem with loneliness
- B. Patient B, who displays dysfunctional interaction patterns learned in his family of origin
- C. Patient C, who states he finally feels a strong sense of belonging
- D. Patient D, who openly expresses his anger about his work
Correct Answer: A
Rationale: The correct answer is A because universality in Yalom's therapeutic factors refers to the recognition that one is not alone in their struggles. Patient A demonstrates this by acknowledging that others also face loneliness, fostering a sense of commonality and reducing feelings of isolation. In contrast, patient B's dysfunctional patterns do not relate to universality. Patient C's sense of belonging is related to group cohesion, not universality. Patient D's anger expression is not directly linked to recognizing shared experiences.
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Planning safety interventions for a teenager with a history of self-injurious behavior is based on what research-based information?
- A. Teenagers rarely entertain the idea of suicide.
- B. Self-injury is always viewed as a risk factor for future suicidal attempts.
- C. Assessment for suicidal ideations is a vital component of this child's care.
- D. Suicides can occur accidentally as a result of self-injurious behaviors.
Correct Answer: D
Rationale: The correct answer is D because research indicates that suicides can occur accidentally as a result of self-injurious behaviors. This is known as an unintentional suicide, where the individual did not intend to die but died due to the severity of their self-injurious behavior. This information is crucial for planning safety interventions for the teenager, as it highlights the potential seriousness of self-injury.
Choice A is incorrect because research shows that suicidal ideation is not uncommon among teenagers, so it cannot be assumed that they rarely entertain the idea of suicide. Choice B is also incorrect because while self-injury can be a risk factor for future suicidal attempts, it is not always the case. Choice C is relevant but not the most specific to the scenario presented in the question, as it focuses solely on suicidal ideations rather than the potential accidental outcomes of self-injury.
A nurse is working with a group of older adults attending a seminar on the physical and emotional effects of aging. Which patient statements are good predictors of positive well-being and perceived mortality? (Select all that apply.)
“Not having to deal with the stress of any major chronic illnesses.”
- A. “Being satisfied with growing older.”
- B. “Feeling younger than my birthdays say I should.”
- C. “Retirement gives me time to do the things I’ve put off doing.”
- D. “At least I don’t have to worry about having enough money to retire.
Correct Answer: A, C
Rationale: The correct answers are A and C. Statement A indicates a positive attitude towards aging, which is a good predictor of positive well-being. Feeling satisfied with growing older can lead to better emotional health and higher perceived mortality. Statement C suggests that retirement provides opportunities for personal fulfillment, which can contribute to positive well-being. Statements B and D do not directly address attitudes towards aging or well-being, making them less reliable predictors.
The common element seen in every type of bereavement is:
- A. Bereavement is a predictable process that is a result of loss.
- B. The individual has experienced the loss of something of importance.
- C. Acute depression is generally experienced by all who grieve for a loss.
- D. Yearning or longing for the deceased
Correct Answer: B
Rationale: The correct answer is B because it captures the essence of bereavement - the experience of loss. This choice acknowledges that bereavement involves losing something significant, which is a universal aspect of grieving. Other choices are incorrect - A is not always predictable, C is not always acute depression, and D focuses on a specific aspect of grief rather than the core element of loss. Therefore, B is the most comprehensive and inclusive choice.
An outcome for a patient experiencing anticipatory grieving for a spouse diagnosed with terminal cancer would be that the patient will:
- A. Continue to be emotionally involved with the dying spouse
- B. Develop protective mental mechanisms to allay the pain of spousal loss
- C. Not voice threats of physical violence that is either self or others directed
- D. Agree to stay at home and care for the spouse with appropriate assistance
Correct Answer: A
Rationale: The correct answer is A because anticipatory grieving involves emotional involvement with the dying spouse. This allows the patient to process emotions, express love, and make meaningful connections before the actual loss. Choice B is incorrect as it suggests avoidance of pain through mental mechanisms, which is not conducive to healthy grieving. Choice C is incorrect as it focuses on a specific behavior (violence) rather than the emotional process of grieving. Choice D is incorrect as it assumes the patient's agreement to care for the spouse is the primary outcome, overlooking the emotional aspect of anticipatory grief.
An older adult patient was diagnosed with schizophrenia at age 18. A nurse at the outpatient medication clinic interviews this patient. Which communication strategy will be most helpful?
- A. Ask questions that can be answered with yes or no.
- B. Use silence often and let the patient take the lead.
- C. Use open-ended, indirect questions.
- D. Ask clear, simple questions using concrete language.
Correct Answer: D
Rationale: The correct answer is D: Ask clear, simple questions using concrete language. This strategy is most helpful because older adults with schizophrenia may have cognitive impairments that affect their ability to process complex information. Clear and simple questions using concrete language can help the patient understand and respond effectively.
Choice A (Ask questions that can be answered with yes or no) limits communication and may not provide enough information for the nurse to assess the patient's condition comprehensively. Choice B (Use silence often and let the patient take the lead) may not be effective as the patient may struggle to communicate effectively due to cognitive impairments. Choice C (Use open-ended, indirect questions) may lead to confusion or misinterpretation for a patient with cognitive challenges.