Nokea
Which symptom reported by a client, age 35, who was sexually abused as a child reflects the diagnosis of posttraumatic stress disorder (PTSD)?
- A. Reexperiencing the traumatic event
- B. Refusing to go to public places from which escape may be difficult
- C. Seeking advice and guidance prior to making any significant decision
- D. Ruminating over the abuse with friends and acquaintances
Correct Answer: A
Rationale: The correct answer is A: Reexperiencing the traumatic event. This symptom is a key criterion for diagnosing PTSD according to the DSM-5. It includes flashbacks, nightmares, or intrusive thoughts related to the traumatic event. This symptom indicates that the client is experiencing distressing memories of the past abuse, which is a common feature of PTSD.
Choice B is incorrect because it describes agoraphobia, a separate anxiety disorder, not specific to PTSD. Choice C is incorrect as seeking advice is not a diagnostic criterion for PTSD. Choice D is incorrect because ruminating over the abuse with others may reflect coping mechanisms or seeking support, but it does not necessarily indicate PTSD.
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A women who is 16 weeks pregnant presents with symptoms suggestive of a urinary tract infection. Which one of the following is correct?
- A. She should be assured that urinary tract infections are common in pregnancy and require no treatment.
- B. A midstream urine should be collected and the bacteriology report awaited.
- C. A midstream urine should be collected and a wide spectrum antibiotic prescribed.
- D. A self-retaining catheter should be introduced to promote free drainage of urine.
Correct Answer: C
Rationale: In pregnancy, UTIs require prompt treatment due to risks like pyelonephritis. Collecting a midstream urine and starting a broad-spectrum antibiotic (C) is standard, pending culture results. Ignoring treatment (A), waiting without antibiotics (B), or invasive measures (D, E) are inappropriate.
A patient, aged 77 years, has Alzheimer's disease and lives with her daughter. While checking her blood pressure at the clinic, the nurse noticed fresh bruises on the patient's palms and buttocks. The patient could not explain these bruises. The nurse discussed her observations with the daughter, who became defensive and said that her mother was very difficult to manage. She stated, "My mother is getting worse every week. She is not my mother anymore. She can't recognize me, and she wanders all night. We take turns because she has to be watched constantly. Last night I fell asleep, and she fell down the stairs while wandering."Â Which statement is most accurate?
- A. Reporting the injuries in this case is not indicated by available data.
- B. The nurse should report the injuries as suggestive of elder abuse.
- C. The nurse is only required to report the injury if the patient is incompetent.
- D. The nurse is legally required to report the injuries as possible abuse.
Correct Answer: A
Rationale: Step 1: The nurse observed bruises on the patient's palms and buttocks.
Step 2: The patient could not explain these bruises.
Step 3: The daughter mentioned the patient's worsening condition and the incident of falling down the stairs.
Step 4: The daughter's statement indicates the patient's deteriorating cognitive and physical abilities.
Step 5: The daughter's challenges in managing the patient are due to the progression of Alzheimer's disease.
Step 6: There is no explicit evidence or indication of elder abuse based on the provided information.
Step 7: Reporting the injuries without clear signs of abuse may harm the patient's relationship with the daughter.
Step 8: Therefore, the most appropriate action is not to report the injuries based on the available data to avoid potential harm.
Summary:
- Choice A is correct as reporting the injuries is not indicated by the available data.
- Choices B, C, and D are incorrect as there is no clear evidence of elder abuse in the scenario
To cope with the devastating effects of schizophrenia and other serious mental illnesses, family members or significant others and clients will benefit most from:
- A. Regular psychoanalysis
- B. Intensive short-term therapy
- C. Ongoing treatment and support
- D. Continued medication adjustments
Correct Answer: C
Rationale: The correct answer is C: Ongoing treatment and support. This option is the most beneficial for coping with serious mental illnesses like schizophrenia because it involves long-term management and assistance. Ongoing treatment can include therapy, medication management, and support groups, which are crucial for helping individuals and their families manage symptoms and improve overall quality of life.
Explanation:
A: Regular psychoanalysis is not the most effective approach for managing the devastating effects of serious mental illnesses like schizophrenia. It may not provide the immediate support and intervention needed for crisis situations.
B: Intensive short-term therapy may offer temporary relief, but ongoing treatment and support are essential for long-term management and stability.
D: Continued medication adjustments are important, but they are just one aspect of a comprehensive treatment plan. Ongoing treatment and support encompass a broader range of interventions that are necessary for addressing the complex needs of individuals with serious mental illnesses.
A child, aged 11 years, stays home from school to care for his siblings while his mother works, because the family cannot afford a babysitter. The home is cluttered and dirty. When asked about his parents, the child reluctantly reveals that he thinks his father does not like him very much because he calls him 'stupid' and says he can never do anything right. This should be assessed as:
- A. physical abuse.
- B. sexual abuse.
- C. emotional abuse.
- D. economic abuse.
Correct Answer: C
Rationale: Explanation:
C: Emotional abuse is the correct assessment as the father's behavior of calling the child 'stupid' and criticizing him can cause psychological harm. This behavior undermines the child's self-esteem and mental well-being. The child's reluctance to speak about his parents also indicates emotional distress.
Incorrect choices:
A: Physical abuse involves causing physical harm, which is not evident in the scenario.
B: Sexual abuse involves inappropriate sexual behavior, which is not indicated in the scenario.
D: Economic abuse involves financial control or exploitation, which is not the primary issue in this scenario.
A 70-year-old woman is beginning to notice mild memory impairment. She fears she is developing dementia. What is the most likely cause of her memory impairment?
- A. Normal aging.
- B. Alzheimer's disease.
- C. Depression.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Alzheimer's disease. This is the most likely cause of memory impairment in a 70-year-old woman experiencing mild memory issues. Alzheimer's disease is a progressive neurodegenerative disorder that affects memory, thinking, and behavior. It is the most common cause of dementia in older adults. Normal aging (choice A) typically involves some mild memory decline, but significant impairment is not considered a normal part of aging. Depression (choice C) can also impact memory, but in this case, the woman's primary concern is memory impairment, not depressive symptoms. Choice D is incorrect as Alzheimer's disease is a possible explanation for her memory issues.