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Which response by the nurse to a Korean American daughter caring for her aged father would best reflect an understanding of the family's culture?
- A. "Being expected to care for one's family can be a significant burden to bear."Â
- B. "You seem very tired. Respite care for a day or two each week might help you."Â
- C. "Caring for a loved one in need can be both a great honor and a great challenge."Â
- D. "There is a very nice nursing home not far from here. Your father might like it there."Â
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the dual nature of caregiving in Korean American culture - as both an honor and a challenge. This response shows cultural sensitivity by recognizing the cultural values of respect for elders and familial duty. Choice A could be seen as negative and judgmental. Choice B, while offering a practical solution, doesn't address the cultural aspects of caregiving. Choice D may be perceived as insensitive and dismissive of the importance of family in Korean culture. Overall, choice C demonstrates empathy and understanding of the family's cultural values, making it the best response.
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A patient with anorexia nervosa is being treated with refeeding. Which complication should the nurse monitor for during this phase?
- A. Hyperkalemia and hyperglycemia.
- B. Hypophosphatemia and cardiac arrhythmias.
- C. Increased appetite and food cravings.
- D. Dehydration and hypotension.
Correct Answer: B
Rationale: The correct answer is B: Hypophosphatemia and cardiac arrhythmias. During refeeding in anorexia nervosa, there is a risk of rapid shifts in electrolytes, particularly phosphorus, leading to hypophosphatemia which can cause cardiac arrhythmias. This is a critical complication that the nurse should monitor for. Hyperkalemia and hyperglycemia (choice A) are less common in refeeding syndrome. Increased appetite and food cravings (choice C) are expected outcomes of refeeding, not complications. Dehydration and hypotension (choice D) are potential issues but are not specific to refeeding in anorexia nervosa.
A woman whose husband physically abuses her mentions to the nurse, 'Someday I'll have to leave him.' Which of the following would be the nurse's best response?
- A. Yes, you should, before he harms you badly.'
- B. Could we talk about developing a safety plan?'
- C. Are you afraid of what your family will say?'
- D. I don't know why you would stay with him.'
Correct Answer: B
Rationale: The correct answer is B: "Could we talk about developing a safety plan?" This response is the best choice as it acknowledges the woman's situation, offers support, and focuses on practical steps to ensure her safety. By suggesting a safety plan, the nurse is addressing the immediate concern of potential harm and empowering the woman to take control of her situation.
Incorrect Choices:
A: This response is too direct and may not take into account the complexities of the woman's situation. It lacks empathy and does not offer a constructive solution.
C: This response shifts the focus away from the woman's safety and onto external factors. It may come across as judgmental and unhelpful.
D: This response is dismissive and fails to acknowledge the seriousness of the situation. It does not offer any support or guidance to the woman in need.
A client who has been diagnosed as having paranoid schizophrenia is highly suspicious and delusional. He hears voices telling him terrorists are plotting to assassinate him. He refuses to eat, saying the food is poisoned. The nursing action that best addresses his needs is to:
- A. Explain that others eat the food and are not harmed
- B. Allow client to select food from vending machines
- C. Assist client with personal hygiene and grooming
- D. Not allow client to verbalize delusional thoughts
Correct Answer: B
Rationale: The correct answer is B: Allow client to select food from vending machines. This option respects the client's autonomy and addresses his specific delusion of food being poisoned. By allowing the client to select food from vending machines, he can choose items he believes are safe, which can help alleviate his paranoia and increase his trust in the care being provided. This approach promotes a therapeutic relationship and empowers the client in making choices about his care.
Explanation of why other choices are incorrect:
A: Explaining that others eat the food and are not harmed may not be effective as the client's delusion is strong, and rational arguments may not be helpful in this case.
C: Assisting with personal hygiene and grooming is important but does not directly address the client's delusion about food being poisoned.
D: Not allowing the client to verbalize delusional thoughts can escalate the client's distress and hinder the therapeutic relationship. It is essential to acknowledge the client's experiences and work towards building trust and rapport
A 17-year-old client who has anorexia nervosa states she believes she will have fewer problems in college and will be more popular if she continues to lose weight. What nursing intervention would be useful at this time?
- A. Assisting the client to identify the problems causing her concern.
- B. Determining what she hopes to gain from the behavior.
- C. Explaining that her chances for becoming ill from losing weight are high.
- D. Having a physical report sent to college officials indicating her condition.
Correct Answer: A
Rationale: The correct answer is A because it focuses on assisting the client to identify the problems causing her concern. By helping the client explore the underlying issues driving her desire to lose weight, the nurse can address the root cause of her behavior. This intervention promotes self-awareness and insight, enabling the client to better understand her motivations and make informed choices.
Option B is incorrect because while determining what the client hopes to gain from the behavior is important, it does not directly address the immediate concern of identifying underlying problems.
Option C is incorrect because simply explaining the risks of becoming ill may not effectively address the client's belief that losing weight will lead to fewer problems and increased popularity.
Option D is incorrect because sending a physical report to college officials without the client's consent may violate confidentiality and trust, and it does not address the client's psychological needs.
When analyzing the behaviors of a 23-year-old who meets the criteria for antisocial personality disorder, the nurse recognizes that the following nursing diagnosis would be pertinent to his care:
- A. Risk for self-mutilation
- B. Disturbed personal identity
- C. Impaired social interaction
- D. Social isolation
Correct Answer: C
Rationale: Step-by-step rationale for choice C (Impaired social interaction) being the correct answer:
1. Antisocial personality disorder is characterized by a lack of regard for others and a pattern of violating their rights.
2. Individuals with this disorder often have difficulty forming and maintaining healthy relationships.
3. Impaired social interaction reflects the challenges the individual faces in relating to others.
4. This nursing diagnosis would address the core issue of social dysfunction in individuals with antisocial personality disorder.
Summary of why the other choices are incorrect:
A. Risk for self-mutilation - Not typically associated with antisocial personality disorder, more common in other mental health conditions.
B. Disturbed personal identity - Not a primary concern in antisocial personality disorder, which is more about behavior than identity.
D. Social isolation - While individuals with antisocial personality disorder may isolate themselves, impaired social interaction is a more direct and specific issue to address in their care.