Nokea
Which treatment approach is most appropriate for a patient with antisocial tendencies who has been treated several times for substance addiction but has relapsed?
- A. One-week detoxification program
- B. Long-term outpatient therapy
- C. Twelve-step self-help program
- D. Residential program
Correct Answer: D
Rationale: The correct answer is D: Residential program. This option is most appropriate because a residential program provides a highly structured environment with 24/7 support and supervision, which is crucial for individuals with antisocial tendencies and a history of relapse. This intensive setting helps address the complex needs of the patient, including addiction and behavioral issues. On the other hand, A (One-week detox program) is too short and does not address the underlying issues. B (Long-term outpatient therapy) may not provide sufficient support and monitoring for someone with a high risk of relapse. C (Twelve-step self-help program) can be beneficial but may not offer the level of supervision and intensive treatment needed for this patient.
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A new patient in an alcoholism rehabilitation program says, 'I’m just a social drinker. I usually have a drink or two at brunch, a few cocktails in the afternoon, wine at dinner, and a few drinks in the evening.' Which response by the nurse will help the patient view the drinking more honestly?
- A. I see,' and use interested silence.
- B. I think you may be drinking more than you report.'
- C. Being a social drinker involves having a drink or two once or twice a week.'
- D. You describe drinking steadily throughout the day and evening. Am I correct?'
Correct Answer: D
Rationale: Step 1: The nurse needs to provide a reflection that highlights the patient's patterns of drinking.
Step 2: Option D reflects the patient's drinking pattern accurately and objectively.
Step 3: By repeating the patient's own words back to them, the nurse helps the patient see the extent of their drinking.
Step 4: This response encourages the patient to reflect on their alcohol consumption more honestly.
Step 5: Option D is correct as it addresses the patient's behavior directly and prompts self-reflection.
Summary:
- Option A is passive and does not challenge the patient's perception.
- Option B is confrontational and may lead to defensiveness.
- Option C provides a generalized definition of social drinking, not addressing the patient's specific behavior.
The nurse demonstrates an understanding of effective data collection when interviewing a client regarding a family history when:
- A. Basing the assessment on a universally accepted definition of family.
- B. Constructing a genogram as a basis for documenting the information gathered.
- C. Recognizing that the Family Apgar tool is used for assessing single parent families.
- D. Gathering information on at least four generations of the client's family members.
Correct Answer: B
Rationale: The correct answer is B because constructing a genogram is an effective way to visually represent a client's family history, including relationships and health conditions. Genograms provide a comprehensive overview of family dynamics and can aid in identifying patterns of health issues. This method allows for organized documentation of information gathered, enhancing data accuracy and analysis.
Choice A is incorrect as there is no universally accepted definition of family, which can vary culturally and individually. Choice C is incorrect as the Family Apgar tool assesses family functioning, not specific family structures. Choice D is incorrect because gathering information on at least four generations may not always be necessary or feasible, and the depth of information is more important than the number of generations.
The Montessori classrooms are
- A. Teacher-centered
- B. Child-centered
- C. Curriculum-centered
- D. Activity-centered
Correct Answer: B
Rationale: Montessori classrooms prioritize the child's autonomy and exploration.
The nurse demonstrates appropriate Asian-American cultural sensitivity when:
- A. Substituting the word 'sadness' for depression when participating at a health fair at a local Asian-American senior center.
- B. Anticipating that the Asian-American teenager is well educated concerning the dangers of tobacco and marijuana abuse.
- C. Being particularly interested in the older Asian-American's view regarding the role of alcohol in managing stress.
- D. Evaluating the critical thinking skills and short-term recall abilities of the Asian-American female over the age of 70.
Correct Answer: A
Rationale: The correct answer is A because using the term 'sadness' instead of 'depression' shows cultural sensitivity. In many Asian cultures, mental health terms like 'depression' can carry stigma and be taboo. By using a milder term like 'sadness,' the nurse acknowledges and respects the cultural nuances around mental health. This approach can help build trust and rapport with the Asian-American community.
Choices B, C, and D are incorrect because they do not directly address cultural sensitivity in the same way as choice A. Anticipating an Asian-American teenager's education level or focusing on an older person's views on alcohol and evaluating cognitive abilities do not demonstrate the same level of cultural sensitivity as being mindful of the language used when discussing mental health.
Which of the following terms is used to describe the sound, timely, smooth, unfragmented and seamless transition of the client from one level of acuity to another?
- A. Case management
- B. Continuity of care
- C. Medical necessity
- D. Critical pathway
Correct Answer: B
Rationale: Continuity of care emphasizes smooth transitions across levels of care.