Which remark by one of the grief support group members would the nurse interpret as indicating unresolved feelings of guilt?
- A. The Christmas season is always a sad time for me.
- B. I know that my husband had a good life.
- C. It seems I miss my son more as time goes on.
- D. I am still wishing I had gotten help to him sooner.
Correct Answer: D
Rationale: The correct answer is D because expressing a wish for getting help sooner implies a sense of responsibility and guilt for not doing so. This indicates unresolved feelings of guilt. Choice A refers to sadness during a specific time of the year, not guilt. Choice B reflects acceptance and closure. Choice C indicates a natural progression of grief, not necessarily guilt.
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What is the basis for the reduction in disturbed thought processes when a patient is administered haloperidol (Haldol)?
- A. Reduction in the number of brain cells that crave dopamin
- B. Dopamine receptors are enhanced, making more dopamine available.
- C. Medication causes an increased cellular production of dopamine
- D. Dopamine receptors are blocked, making dopamine less available.
Correct Answer: D
Rationale: The correct answer is D because haloperidol is a dopamine receptor antagonist. By blocking dopamine receptors, it reduces the activity of dopamine in the brain, which helps in reducing disturbed thought processes. Option A is incorrect as dopamine craving is not related to the mechanism of action of haloperidol. Option B is incorrect as enhancing dopamine receptors would increase dopamine activity, opposite to the intended effect of haloperidol. Option C is incorrect as increasing cellular production of dopamine would also increase dopamine activity, contradicting the purpose of using haloperidol.
A nurse plans care based upon the fact that anticipatory grief:
- A. Is associated with fewer expressions of guilt
- B. Prevents development of symptoms of depression
- C. Requires a longer period of time to effect resolution
- D. Prevents development of symptoms of depression
Correct Answer: A
Rationale: The correct answer is A because anticipatory grief allows individuals to gradually accept the impending loss, leading to fewer feelings of guilt. This process helps the individual prepare emotionally and psychologically for the eventual loss, reducing guilt related to not being able to prevent it. Choice B is incorrect because anticipatory grief does not prevent symptoms of depression, but rather helps individuals cope with them. Choice C is incorrect as anticipatory grief does not necessarily require a longer period of time for resolution; it varies for each individual. Choice D is incorrect, as mentioned earlier, because anticipatory grief does not prevent symptoms of depression but helps individuals navigate through them.
Which action will best facilitate the development of trust between a nurse and patient?
- A. Responding positively to the patient’s demands
- B. Clarifying with the patient whenever there is doubt
- C. Staying available to the patient for the entire shift
- D. Following through with whatever was promised
Correct Answer: B
Rationale: The correct answer is B, clarifying with the patient whenever there is doubt. This action shows active listening, respect, and a willingness to understand the patient's needs. By seeking clarification, the nurse demonstrates genuine interest in the patient's perspective, which helps build trust. Responding positively to demands (A) may not always be appropriate or feasible. Staying available for the entire shift (C) is important but not the sole factor in trust-building. Following through with promises (D) is crucial but does not address the patient's concerns or doubts directly. Clarifying doubts fosters clear communication and mutual understanding, establishing a foundation of trust.
Which statement by a 16-year-old is considered as positive evidence that the family’s involvement in therapy is moving them towards effective functioning?
- A. “My dad has finally stopped giving me advice on how to live my life.”
- B. “I stopped playing football since practice required me to be away from home so often.”
- C. “Since my mother quit her job, she is more available to keep the home running smoothly.”
- D. “Eating dinner with my parents on Sunday nights has helped us be more aware of each other’s needs.”
Correct Answer: D
Rationale: The correct answer is D because it shows positive evidence of improved family dynamics through increased communication and awareness of each other's needs. Eating dinner together signifies a commitment to spending quality time and fostering connections. Choice A indicates a lack of interference but not necessarily improved functioning. Choice B suggests withdrawal from activities, which may not be positive. Choice C implies a sacrifice that may not directly lead to effective functioning.
The highest priority for assessment by nurses caring for older adults who self-administer medications is:
- A. Use of multiple drugs with anticholinergic effects.
- B. Overuse of medications for erectile dysfunction.
- C. Missed doses of medications for arthritis.
- D. Trading medications with acquaintances.
Correct Answer: A
Rationale: The correct answer is A: Use of multiple drugs with anticholinergic effects. This is the highest priority as anticholinergic medications can have severe side effects in older adults, including confusion, constipation, and increased risk of falls. Nurses need to assess for potential harm caused by these medications.
Choice B (Overuse of medications for erectile dysfunction) is not the highest priority as it may not pose an immediate threat to the health and safety of older adults compared to anticholinergic effects.
Choice C (Missed doses of medications for arthritis) is important but not as critical as assessing for the potential harm caused by anticholinergic medications.
Choice D (Trading medications with acquaintances) is concerning but not as urgent as assessing for the harmful effects of anticholinergic medications, which can lead to serious health complications.