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Your patient attends to see you for a routine visit but mentions his problem dealing with gambling impulses. After probing further, you conclude that the patient is an at-risk gambler. He seems reluctant to admit and does not want to be referred for counselling. You affirm his gambling problem, and should take the following steps EXCEPT:
- A. Advice on limiting the money spent when gambling.
- B. Advice on reducing the time and days spent gambling.
- C. Berate him for his lack of self control.
- D. Discourage the notion of gambling as a means of making money.
Correct Answer: C
Rationale: Berating the patient is counterproductive and unprofessional; supportive strategies like limiting money and time are more effective.
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Select the most appropriate outcome for a patient completing the fourth alcohol detoxification program in 1 year. Before discharge, the patient will
- A. use rationalization in healthy ways.
- B. state, 'I see the need for ongoing treatment.'
- C. identify constructive outlets for expression of anger.
- D. develop a trusting relationship with one staff member.
Correct Answer: B
Rationale: The correct answer is B because stating 'I see the need for ongoing treatment' demonstrates insight and willingness to engage in further treatment, indicating a readiness for change. This is crucial for someone who has completed multiple detox programs in a short period. Choice A (using rationalization in healthy ways) may not address the underlying issues leading to repeated detox programs. Choice C (identifying constructive outlets for expression of anger) is important but not the most urgent concern after detox. Choice D (developing a trusting relationship with one staff member) is beneficial but does not address the need for ongoing treatment.
Describe some of the environmental factors affecting families.
- A. Poverty, housing, community violence
- B. Personal beliefs, moral values
- C. Individual talents, personal goals
- D. Therapist biases, session frequency
Correct Answer: A
Rationale: Environmental factors like poverty and violence directly impact family functioning.
he theorist who believes that human behavior is determined is
- A. Sigmund Freud
- B. Carl Rogers
- C. B.F. Skinner
- D. Albert Bandura
Correct Answer: C
Rationale: B.F. Skinner's behaviorism views behavior as determined by environmental consequences.
A health care worker is exposed to blood from a patient who has HIV. What action should the worker take after the exposure?
- A. Apply alcohol to the site.
- B. Cleanse the site with soap and water.
- C. Flush the site with hot running water.
- D. Apply a topical antibiotic to the site.
Correct Answer: B
Rationale: The correct answer is B: Cleanse the site with soap and water. This is because soap and water effectively clean and disinfect the wound, reducing the risk of infection. Alcohol may not be as effective in removing bloodborne pathogens like HIV. Flushing with hot water can cause tissue damage and is not recommended. Applying a topical antibiotic is not necessary for blood exposure and may not prevent HIV transmission. Proper cleansing with soap and water is crucial to minimize the risk of infection following exposure to bloodborne pathogens like HIV.
A patient who was admitted for a heroin overdose received naloxone (Narcan), which improved the breathing pattern. Two hours later, the patient reports muscle aches, abdominal cramps, gooseflesh and says, 'I feel terrible.' Which analysis is correct?
- A. The patient is exhibiting a prodromal symptom of seizures.
- B. An idiosyncratic reaction to naloxone is occurring.
- C. Symptoms of opiate withdrawal are present.
- D. The patient is experiencing a relapse.
Correct Answer: C
Rationale: The correct analysis is C: Symptoms of opiate withdrawal are present. The patient's presentation of muscle aches, abdominal cramps, gooseflesh, and feeling terrible are classic symptoms of opiate withdrawal. Naloxone, as an opioid antagonist, reversed the effects of heroin leading to withdrawal symptoms. This is a typical response seen in patients who have been given naloxone to counteract opioid overdose. Choices A and B are incorrect as they do not align with the patient's clinical presentation and pharmacological understanding. Choice D is also incorrect as there is no indication that the patient has resumed heroin use.