Crisis 1 Final Book Questions

When planning a substance abuse information program for a local university, the nurse will prioritize which screening? A. Alcohol B. Stimulants C. Hallucinogens D. Inhalants

A. Alcohol Alcohol use disorder is the most common substance-use problem in the United States. The prevalence of alcohol use in the United States affects approximately 16.6 million people. While the other options identify substances being abused within our population, none are as prevalent as is alcohol abuse.

Which statement indicates the existence of a codependent relation between a client diagnosed with substance abuse and their life partner? A. "I'm always so angry about how the addiction controls our lives." B. "Everyone knows about the addiction and it is so very embarrassing." C. "All our savings have been spent on rehab treatment." D. "They are the love of my life but it's so hard living together."

A. "I'm always so angry about how the addiction controls our lives. Codependent individuals find their moods being influenced by the situation and the emotions of the abuser. While the other options reflect common characteristics of a relation involving substance abuse, they do not necessarily demonstrate a codependency.

After the admission interview and assessment, the emergency department nurse has reason to believe that a child is being abused physically. Which intervention will the nurse implement to best determine if the child has been abused? A. Insist that the child be further assessed without the parents being present. B. Delay the assessment until the appropriate child protection authorities are present. C. Allow the child to pick one parent to be present during the remaining examination. D. Provide the child with suggestions of other possible examples of abuse.

A. Insist that the child be further assessed without the parents being present. In the case of suspected child abuse, after the initial interview with the parents, the child should be seen alone giving him or her a chance to disclose mistreatment. The child should not be prompted about possible abuse nor should the examination be delayed since these actions can affect the outcome of the assessment.

A nurse is managing the care of a 19-year-old adult diagnosed with Level 1 autism spectrum disorder. Which intervention will the nurse include in the client's plan of care? A. Organization and planning strategies B. Boundary setting to manage aggressive behavior C. Group therapy that focuses on social skills D. Techniques to help manage repetitive ritualistic behaviors

A. Organization and planning strategies The severity of autism spectrum disorder is categorized into levels based on functional ability. In Level 1, there is noticeable social deficit, but language and speech are normal. Individuals have difficulty switching between activities, and they struggle with organization and planning. In Level 2, there is noticeable deficit in both verbal and nonverbal social and communication skills. Social impairment and repetitive behaviors are obvious to others. These individuals do not tend to initiate social interactions, and change in routine causes distress. In Level 3, social deficits are severe, with communication being limited and needs-based. Individuals may be nonverbal, speak in few-word sentences, be difficult to understand, make odd noises, echo a word or sentence over and over, or use overly literal language. Repetitive and restrictive behaviors markedly interfere with functioning in all spheres. Changing focus, action, or routine causes great distress. Aggression toward self or others is more common at this level.

A client with a history of being bullied has been admitted to the hospital for treatment of anger issues. Which classic reaction will the nurse address in the client's plan of care? A .Suicidal ideations B. Hallucinations C. Somatic pain D. Paranoia

A. Suicidal ideations Those who are bullied are prone to negative feelings about self, humiliation, poor self-concept, and great emotional pain, and many can suffer severe reactions that may last a lifetime, such as depression, posttraumatic stress disorder (PTSD), anxiety disorders, and even attempted or completed suicide. The remaining options are not necessarily associated with the client's diagnosis.

A client is seeking treatment in the emergency department (ED) after a sexual assault. Which notation made by the ED nurse demonstrates appropriate nonjudgmental documentation? A. An alleged sexually assaulted inside a local parking garage was made by the client. B. Physical evidence supports that vaginal penetration occurred. C. Treatment for facial abrasions was refused. D. No acute emotional distress during assessment was noted.

B. Physical evidence supports that vaginal penetration occurred. Pejorative terms often reflect old myths and a lack of knowledge and understanding regarding the rape victim's experience and need for immediate intervention. Words and phrase like "alleged," "refused," "intercourse," and "no acute distress" all minimize the devastation of the event. Penetration is the preferred term when describing the sexual aspects of the assault.

A nurse is discussing the possible existence of abuse related to a 4 year old currently being treated in the emergency department. Which statement by the nurse requires immediate intervention? A. We don't need physical proof of injury to report this situation." B. "A 4 year old can be an unreliable source since they have such wonderful imaginations." C. "It's up to the state's child protection agency to determine if our fears are valid." D. "I'm absolutely sure every state requires that we report our concerns."

B. "A 4 year old can be an unreliable source since they have such wonderful imaginations." When child abuse is suspected, persons in authority including nurses, teachers, spiritual leaders, coaches, counselors, and child care providers are legally responsible for reporting to the appropriate child protective agency. Each state mandates that a report must be filed when suspected abuse or neglect is encountered. It is not necessary to have proof of the abuse. If there is a suspicion or the child says something is happening, that is enough grounds to report. It is then up to the CPS agency to investigate and make a determination.

A patient tells the nurse, "After many years, finally quit smoking. Now I use e-cigarettes only." Which response should the nurse provide? a. "Using e-cigarettes is now more socially acceptable than using traditional cigarettes." b. "Congratulations on quitting, but e-cigarettes contain nicotine and other hazardous chemicals." c. "Nicotine is a powerful addiction. Quitting smoking is a big step toward adopting a healthier lifestyle. D. "I am glad you have quit smoking. Your loved ones will no longer be exposed to the hazards o secondhand smoke."

B. "Congratulations on quitting, but e-cigarettes contain nicotine and other hazardous chemicals." The nurse should educate the patient. E-cigarettes are advertised as safe; however, they contain nicotine as well as other hazardous chemicals

Which statement made by a client receiving treatment for a substance abuse problem best indicates an understanding of relapse prevention? A. "A good time always meant being with friends who abused like I did." B. "I abuse when I'm bored or lonely but now I know how to keep busy." C. "My family has helped me so much in staying sober." D. "I want so much to stop abusing."

B. "I abuse when I'm bored or lonely but now I know how to keep busy." The goal of relapse prevention is to help individuals identify their "trigger situations" so that periods of sobriety can be lengthened over time and lapses and relapses are not viewed as total failures. Identifying both the trigger and a plausible strategy makes that option the best one. The remaining options are more associated with the client's feelings about the addiction.

Which statement, by a child who recently lost "Sammy" a beloved pet, best demonstrates the parent's role in nurturing the child's resiliency? A. "It's sad but Dad said that pets die every day." B. "Mom, Dad, and I talk about how much fun we had with Sammy." C. "Dad gave me a picture of Sammy when he was just a puppy." D. "Mom promised that I can get another pet really soon."

B. "Mom, Dad, and I talk about how much fun we had with Sammy." Resiliency helps protect children and adolescents in a stressful situation. Temperament, problem-solving skills, and the support of a nurturing adult contribute to resiliency and successful navigation of stressful events. The correct option shows the parents helping the child through the grieving process. While the remaining options are not inappropriate, they are not focused on successfully managing the grief associated with the death of a loved one.

A client became angry with a staff member and began throwing objects at others in the unit. Which question will the nurse manager ask the staff in order to address the goals of the debriefing of the incident that focuses on client care? A. "What injuries resulted from the violence?" B. "Were the unit's policies on managing violence followed?" C. "What was the client's reasoning for the violent behaviors?" D. "When did the violence begin?"

B. "Were the unit's policies on managing violence followed?" Staff analysis of an episode of violence, referred to as critical incident debriefing, is crucial for a number of reasons. First, a review is necessary to ensure that quality care was provided to the patient. Staff members need to critically examine their response to the patient and so identifying policy-driven responses is a part of the process. While the remaining questions are appropriate, they are not associated with the debriefing process.

1. An emergency department nurse assesses a woman suspected of being abused by an intimate partner. Which assessment finding most clearly confirms the suspicion? a. Leathery facial tone b. Injuries in a bikini pattern c. Reluctance to be examined d. Lack o eye contact with the nurse

B. Injuries in a bikini pattern The majority o the victims of reported intimate partner violence are women. Intimate partner violence is the number one cause of emergency department visits by women. Patterns of damage are often in locations that cannot be noticed easily, such as the torso, back, upper arms, upper legs, inside body orifices, and under the hair.

There is reason to believe that a client unknowingly ingested flunitrazepam prior to being sexually assaulted. Which intervention will the nurse implement in order to confirm this suspicion? A. Obtain a bedside electrocardiogram. B. Obtain a urine sample. C. Assess what the client drank before the assault. D. Assess the client's pupils.

B. Obtain a urine sample. Assessment for "date rape" drugs like flunitrazepam should be included if description of the event indicates that possibility (loss of consciousness, vomiting). In such a case, a urine sample may be obtained. The remaining options are not directly associated with such an assessment.

When considering substance abuse, which individual is at the greatest risk for developing functional deficits in the future? A. The 45 year old with a 10-year history of heroin abuse B. The 15 year old abusing cannabis C. The 60 year old who has been dependent on sedatives for 15 years D. The 28 year old with a cocaine habit

B. The 15 year old abusing cannabis While the substance abuse identified in all the clients has resulted in some form of dysfunction, the teenager is at greatest risk for developing functional deficients. The brain doesn't fully mature until the mid-twenties; therefore, substances of abuse can interfere with brain ability to function in the future. Ingestion of drugs during youth and teenage years can also interfere with psychological/social growth, decrease the potential for a productive future, and terminate the life span of too many children and teenagers.

A client, being cared for in the emergency department (ED) after a sexual assault, asks that a friend be allowed to stay in the examination room while waiting for the SANE nurse to arrive. The client is observably anxious and states, "I don't want to be alone." What response will the ED nurse make in order to best assure the client's safety and emotional health? A. "I understand. I'll stay with you." B. "Are you thinking about hurting yourself?" C. "Certainly; whatever makes you feel safe." D. "Do you want to talk to a psychiatrist?"

C. "Certainly; whatever makes you feel safe." Having someone stay with the patient (friend, neighbor, sexual assault advocate, or staff member) while waiting to be treated is a priority intervention. People in high levels of anxiety need someone with them until their anxiety level is down to moderate. Never leave the individual alone. While the remaining options may become appropriate, the client has not yet demonstrated behaviors to warrant implementing either one.

A client has been receiving treatment for posttraumatic stress disorder (PTSD) after experiencing a sexual assault. Which statement supports that the client is able to resume pre-trauma function? A. I really like my therapist." B. "I'm hopeful that life will get back to normal." C. "I'm being considered for a promotion at work." D. "I'm feeling less anxious among strangers."

C. "I'm being considered for a promotion at work." Most patients will be able to eventually resume their previous lives after supportive services and crisis counseling or therapy. If survivors are relatively free of signs of PTSD and their lifestyles are close to their lifestyles before the rape, the recovery is considered successful. Being considered for a promotion indicates the client is able to effectively work and engage in areas of interest. The remaining options, while positive statements, lack tangible proof of resuming pre-trauma levels of functioning.

Which statement, by a client diagnosed with poor impulse control, indicates an improved prognosis? A. "My children will stop loving me if I continue to act this way." B. "I feel so badly when I act on my anger." C. "I've learned to walk away when I start feeling angry." D. "Being angry is ruining my life."

C. "I've learned to walk away when I start feeling angry." An improved prognosis requires proof the behaviors are being managed or eliminated. The patient will recognize when anger and aggressive tendencies begin to escalate and employ at least one new tension-reducing behavior at that time (time outs, deep breathing, talking to a previously designated person, employing an exercise such as jogging). While the remaining options demonstrate self-awareness, they lack a strategy to manage the behavior.

A nurse teaches a patient diagnosed with an alcohol addiction about a new prescription or naltrexone (ReVia, Vivitrol). Which comment by the patient indicates the teaching was effective? a. "This medicine will stop my cravings or alcohol." b. "I should take this medication only when I eel cravings to drink alcohol." c. "This medicine is one part of a bigger treatment plan to help me stay sober." d. "I should not use products that contain alcohol, such as cough medicine and aftershave lotion."

C. "This medicine is one part of a bigger treatment plan to help me stay sober." Naltrexone (ReVia, Vivitrol) reduces the desired pleasant feelings related to alcohol or opioid intake and helps to reduce drug cravings. It is part of a total program or maintaining sobriety.

Which client-focused change will the nurse identify as a sign of possible escalation of anger? A. An impulsive client demonstrates introspection. B. A depressed client begins to cry. C. A quiet client becomes talkative and loud. D. A manic client becomes withdrawn.

C. A quiet client becomes talkative and loud. Anger involves an increase in energy. Signs and symptoms of anger may involve changes in mood and behavior from quiet to talkative and loud, from talkative to silent and withdrawn, from calm to angry, or from depressed to elated. The remaining options lack the demonstration of increased energy.

When considering oppositional defiance disorder (ODD), which behavior will be viewed as a mandatory diagnostic criteria? A. Ran away from home twice in the last 6 weeks. B. Was discovered attempting to drown the neighbor's cat. C. Hid the backpack of a classmate who refused to give up answers to a test. D. Repeatedly refuses to follow family rules about completing chores.

C. Hid the backpack of a classmate who refused to give up answers to a test. While all children will test limits or have tantrums, ODD goes beyond the normal scope of these behaviors. Symptoms must be displayed with at least one person who is not a sibling and include at least four of the criteria: often loses temper, easily annoyed, angry, argues with authority figures, defies or refuses rules, deliberately annoys others, blames others for mistakes or misbehavior, vindictive. The remaining options are associated with the more severe diagnosis of conduct disorder.

The nurse at a local medical clinic reviews phoned-in requests rom patients or prescription re ills. As the nurse confers with the health care provider about which prescription re ill requests should be authorized, which re ill request should be considered first? a. Codeine 10 mg PO q4h PRN or an adult with a persistent cough b. Hydroxyzine (Vistaril) 25 mg PO TID PRN or an adult who experiences uncomfortable muscle spasms c. Lorazepam (Ativan) 1 mg PO BID or an adult who has taken it daily or 3 years or episodes of anxiety d. Paregoric (camphorated tincture of opium) 2 mg PO q6h PRN or an adult experiencing severe diarrhea

C. Lorazepam (Ativan) 1 mg PO BID or an adult who has taken it daily or 3 years or episodes of anxiety Lorazepam is a benzodiazepine. Sudden withdrawal rom this class of medications has medical complications, including the possibility of death; hence this refill request has priority

Which intervention will the nurse identify for the care plan of a client diagnosed with a moderate form of intellectual disability? A. Discussing options for vocational training B. Providing choices for independent living C. Re-enforcing the concepts of money management D. Discussing the choices related with buying a home

C. Re-enforcing the concepts of money management The moderate form of intellectual disability constitutes 10% of the cases. These children develop communication, social, and academic skills slowly. Conceptual domain is at an elementary school level, with reading commonly at a first to third grade level. Although able to perform activities of daily living, ongoing assistance is needed for conceptual tasks of daily life. They may have long-term intimate relationships and friends but may not interpret social cues accurately. Support is needed to obtain success in employment, in areas such as transportation and money management skills. The client with the mild form of intellectual disability is able to perform self-care and may be capable of vocational training and independent living. More than half of these individuals will own a home, marry, and have children.

A nurse is conducting a family assessment to identify possible triggers for abusive behaviors. Which family characteristic will the nurse identify as such a trigger? A. The father is the "stay-at-home parent." B. The parents are of different ethnic and religious backgrounds. C. The parents were teenagers when the children were born. D. The family only socializes with other immigrant families.

C. The parents were teenagers when the children were born. The classic frustration-aggression hypothesis proposes that when frustration is high in response to negative societal situations, frustration may lead to aggression. Early parenthood is considered such a stressor. None of the other options are recognized as triggers for possible family-centered abuse.

A young adult tells the nurse, "I have a new prescription or medical marijuana. I use it several times a day or my frequent muscle spasms." What in formation should the nurse provide first to this patient? a. Guidance that the prescription should not be shared with peers b. Directions to weigh self once a week and maintain a log of the results c. Instructions about safety issues associated with driving or operating machinery d. In formation about the potential or a motivational syndrome and memory problems

C.. Instructions about safety issues associated with driving or operating machinery All o the options are correct, but safety is the nurse's first concern. Marijuana is a psychoactive substance. Effects include euphoria, sedation, perceptual distortions, and hallucinations; there ore driving or operating machinery may be hazardous

Which action is an example of anger? A. Setting fire to the business that hires illegal immigrants B. Proposing radical changes to the way police manage public protesters at a town meeting C. Slapping a spouse in the face during an argument about the family budget D. Writing a scathing letter to the local newspaper regarding corrupt local politicians

C> Slapping a spouse in the face during an argument about the family budget Anger is an unplanned reaction to a stressor. Although we are all familiar with the feelings of anger, not everyone responds to anger with aggression or violence in the same way. Anger becomes unhealthy if it gets in the way of a person's functioning or relationships or puts others at risk. Slapping in the midst of an argument is usually unplanned and an example of anger. The remaining options include planned expressions of frustration and/or aggression.

Which question demonstrates the nurse's understanding of the need to assess a client who has been physically abused for additional forms of trauma? A. "What types of injuries have you received as a result of the physical abuse? B. "Do you know what triggers the physical abuse?" C. Did your abuser ever intimidate or threaten you with physical harm?" D. "Can you tell me when the physical abuse began?"

D. "Can you tell me when the physical abuse began?" The physical damage caused by physical abuse is usually accompanied by emotional abuse. Emotional abuse includes threats and intimidation. The remaining options focus on the physical abuse/trauma.

A client has expressed great concern over "feeling like I'm going crazy" since experiencing anxiety, depression, and nightmares after being sexually assaulted. What response will the nurse make initially to address the client's concerns? A. "What you are experiencing is common among assault victims. It's not a result of going crazy." B. "Let's talk about how these symptoms are making you feel and especially how they are making you feel crazy." C. "These are common feelings after being assaulted. Fortunately you are not going crazy so try not to worry." D. "What you are experiencing must be frightening. These symptoms are shared by many who have been sexually assaulted."

D. "What you are experiencing must be frightening. These symptoms are shared by many who have been sexually assaulted." Many individuals think they are going crazy and are not aware that this is a process that many people in their situation have experienced. Explain to the patient that the signs and symptoms that many people experience during the long-term phase include nightmares, anxiety, and depression. The correct option is the only one that gives the client the needed information while also acknowledging his or her feelings.

A young adult has heavily abused alcohol and prescription drugs since mid-adolescence. This individual now has an ataxic gait and uses a cane. Which comment by the nurse presents reality while demonstrating compassion? a. "I know you must eel self -conscious about using a cane at your age, but it will help prevent falls." b. "Addiction is a fatal disease. I you continue to drink like you have done in past, you will not live another 10 years." c. "It's time to ace your addiction. You are disappointing your family and must stop drinking or the sake o the people who love you." d. "Addiction is powerful. You are young yet cannot walk without a cane. I you don't make changes, your health will continue to suffer."

D. Addiction is powerful. You are young yet cannot walk without a cane. I you don't make changes, your health will continue to suffer." The correct response recognizes the power of addiction but presents the reality of the consequences of continued use.

To monitor for a significant health risk, the nurse will prepare to implement which intervention for a client admitted for alcohol detoxification? A. 24-hour urine test B. Nutritional consult C. Falls assessment D. Cardiac consult

D. Cardiac Consult Patients with a co-occurring/comorbid dual diagnosis have more severe symptoms, experience more crises, and require longer treatment. Cardiovascular risks are also significant. Alcohol can raise the levels of triglycerides in the blood. Excessive alcohol intake results in stroke, cardiomyopathy, cardiac dysrhythmia, and sudden cardiac death. While the remaining options may not be inappropriate for some clients being admitted for alcohol-related treatment, the cardiac risks are the most significant.

A client is diagnosed as a child with attention-deficit/hyperactivity disorder (ADHD). Achieving which long-term goal will best indicate personal effective condition management as an adult? A. Demonstrates effective time management and organizational skills. B. Absence of classic fidgety physical activity. C. Mental focus that allows for completion of tasks. D. Medication therapy discontinued by health care provider.

D. Medication therapy discontinued by health care provider. Nonstimulant (atomoxetine, guanfacine) and stimulant medications (methylphenidate, d-, l-amphetamine, lisdexamfetamine) may be needed during elementary and high school. Some individuals learn to compensate and no longer need medication in adulthood. This would be the best demonstration of effective condition management by the client. The remaining options, while demonstrating effective treatment, all are reliant upon medication therapy adherence.

An older adult has experienced both physical and emotional abuse while living with a family member. The family member has been adherent with required therapy and at the client's request the two will again be living together. Which intervention will best assure that both the client and the family member's needs are being met? A. The family member is informed that criminal charges will be filed if any abuse occurs. B. The client agrees to report any incidences of abuse by the family member immediately. C. Initially, 7 days a week, 24-hour home aides are provided. D. The home will have regular but unscheduled visits by adult protective services agents.

D. The home will have regular but unscheduled visits by adult protective services agents. Follow-up is crucial in ensuring ongoing safety of the elderly patient and support of the caregiving system. None of the other options provide long-term support and supervision

A patient tells the nurse, "I was raped 8 years ago but never told anyone. Nevertheless, the memories haunt me every day. I should be over it by now." Which comment should the nurse offer next? a. "It sounds like you're judging yourself or continuing to struggle with your reaction." b. "Rape is criminal behavior. You should have reported the incident to law enforcement." c. "Are you now ready to engage in counseling to deal with your reactions to this experience?" d. "While it's important to learn rom such li e events, it's more important to put things in the past."

a. "It sounds like you're judging yourself or continuing to struggle with your reaction." The correct response demonstrates use of reflection, a therapeutic communication technique. Consequences of rape can cause serious, long-term psychological trauma. Rape-trauma syndrome is a common sequela. Later in this interaction, the nurse should encourage the patient to consider professional counseling

The parent of an adolescent recently diagnosed with schizophrenia says to the nurse, "This is entirely my fault. I should have spent more time with my child when he was a toddler." Which response by the nurse is correct? a. "Schizophrenia is genetically transmitted, so it was not in your control." b. "Your child's disorder is more likely the result of an undetected head injury." c. "Environmental toxins are directly implicated in the origins of schizophrenia." d. "Lack of prenatal care causes schizophrenia rather than early childhood events."

a. "Schizophrenia is genetically transmitted, so it was not in your control." Genetic actors have been implicated in a number o childhood mental disorders, including autism, bipolar disorders, schizophrenia, attention-deficit/hyperactivity disorder (ADHD), intellectual developmental disorders, and some others.

An emergency department nurse talks with a newly admitted victim of reported rape. Which communication should the nurse offer to comfort this patient? a. "You are safe now. I will stay with you in this private room." b. "Would you like your friend to stay with you during your examination?" c. "You made a good decision to come to the hospital after you were raped." d. "What questions do you have about your examination by the sexual assault nurse examiner?"

a. "You are safe now. I will stay with you in this private room." A sexual assault victim who arrives at the emergency department needs compassionate, supportive care and should not be left alone.

A university football coach invites the campus nurse to talk to the team about healthy relationships in the community. Which topic has priority or the nurse to include? a. Appropriate behavior with intimate partners b. University resources or counseling and support c. The importance of role modeling or children and teens d. Public recognition o children with life-threatening illnesses

a. Appropriate behavior with intimate partners While the nurse may include any of the topics, appropriate behaviors with intimate partners has priority. Characteristics o the game of football, the physical power required to be a player, and the risk or drug or alcohol misuse among this age group are actors that increase the risk or intimate partner violence.

In a hostile voice, a patient experiencing mania yells at the nurse: "You WILL listen to me and not interrupt. I have some really important stuff to say. I'm tired o you nurses and doctors acting like you have all the answers." To facilitate e effective communication, which initial response should the nurse provide? a. "You are our patient, so we always listen to you." b. "I can talk with you better i you use a calm voice." c. "It's our job to help you get through this manic episode." d. "Patients have an important role in treatment planning."

b. "I can talk with you better if you use a calm voice." The patient's behavior is aggressive. Aggressive behaviors reflect rage, hostility, and potential or physical assault or verbal destructiveness and can be directed at others or oneself . Aggression is a hostile reaction that occurs when control over anger is lost. It is used in an attempt to regain control over the stressor or flee the situation. By suggesting an appropriate behavior, the nurse offers an opportunity or the patient to regain control

A female nurse is appointed to a committee with seven men. At the beginning of the meeting, the chairman asks the nurse to be the secretary. The nurse responds, "No. You're just asking me to be secretary because I'm the only the woman here." Which response would have been more effective? a. "There are others more qualified than I am to be secretary." b. "I would be glad to perform another role or our committee." c. "I'm probably overreacting, but I find your request offensive." d. "Thank you or asking, but your request is sexually discriminatory."

b. "I would be glad to perform another role or our committee." In the original response, the nurse personalized the request and responded in an aggressive manner. The correct answer demonstrates an assertive response, which would have been more effective

An emergency department nurse assesses a child with a Fractured ulna. The nurse also observes yellow and purple bruises across the child's back and shoulders. Which comment by the parents should prompt the nurse to consider making a report to Child Protective Services? a. "We do not believe in immunization o our children." b. "This child is always creating problems or the family." c. "Our child would rather play alone than with other children." d. "We homeschool our children in order to include religious education."

b. "This child is always creating problems or the family." The acute injury, coupled with bruises o different ages, suggest that the child may be abused. Abusive parents may perceive the child as bad or evil or project blame. The nurse is required to report suspicions o abuse to child protective services

Which scenario presents the highest risk or a pregnancy resulting in of spring with an intellectual developmental disability (IDD)? a. 18-year-old mother who received no prenatal care b. 32-year-old woman diagnosed with anorexia nervosa c. 26-year-old father with a history o episodic alcohol abuse d. 38-year-old father diagnosed with generalized anxiety disorder

b. 32-year-old woman diagnosed with anorexia nervosa Causes of intellectual developmental disability may be a result of hereditary actors, alterations in early embryonic development, pregnancy and perinatal problems, and other actors such as trauma and poisoning.

A woman in a relationship characterized by a long history o battering and abuse tells the nurse, "We've had a rough time lately. I admit it: He beat me last night but then said he was sorry." Which event would the nurse expect to occur next in this relationship? a. Another beating by the abusive partner b. Love, gifts, and praise rom the abusive partner c. A brie period during which the partners ignore each other d. The abusive partner leaves the relationship or a short time

b. Love, gifts, and praise rom the abusive partner The cycle o violence consists of three phases: (1) tension-building phase, (2) acute battering phase, and (3) honeymoon phase. The question scenario shows acute battering, so a period o loving calm is likely to ollow

A nurse plans to lead a group in a residential facility or kindergarten-aged, abused children. Which strategy should the nurse incorporate? a. Building a house using blocks b. Telling a story about a child who felt sad c. Drawing pictures of fun activities at a park d. Reading and discussing a book about abused children

b. Telling a story about a child who felt sad Therapeutic interventions should be matched to the developmental level of the child. Abused children are likely to have problems with anxiety or depression. Storytelling is a form o bibliotherapy likely to appeal to kindergarten-aged children. Children unconsciously identify with the characters in the story, allowing self -expression in a safe environment to occur

A woman experienced a double mastectomy yesterday. Now she cheer fully says to the nurse, "I didn't need those things anyway. No more wet T-shirt contests or me!" How should the nurse interpret this comment? a. The patient is realistically accepting her loss. b. The comment is sarcastic, which may reflect anger . c. The patient is experiencing a distorted body image. d. The comment suggests guilt regarding prior behavior

b. The comment is sarcastic, which may reflect anger Sarcasm is a veiled form of anger.

An emergency department nurse prepares to discharge a victim of reported rape. Which comment by the victim indicates that the nurse's teaching was effective? a. "I should bathe frequently over the next week." b. "I am required to follow up with law enforcement." c. "It's important or me to follow up with counseling." d. "I should delay any sexual activity or at least 3 months."

c. "It's important or me to follow up with counseling." Prior to leaving the emergency department, the patient should have a scheduled follow-up appointment with a rape counselor or crisis counselor

The nurse interviews the parent of a 7-year-old child diagnosed with moderate autism spectrum disorder. Which comment rom the parent best describes autistic behavior? a. "My child occasionally has temper tantrums." b. "Sometimes my child wakes up with nightmares." c. "My child swings or hours on our backyard gym set." d. "Toilet training was more difficult or this child than my other children."

c. "My child swings or hours on our backyard gym set." Prominent behavioral characteristics of autism spectrum disorder (ASD) include motions repeated over and over (flaps hands, rocks body, spins self in circles, repeatedly turns light on and off), playing with toys the same way every time, getting upset by minor changes (changes furniture around, changes route going someplace familiar), and obsessive interests.

An 8-year-old tells a parent, "I like to scare kids at school by showing them pictures o clowns. Some kids are terrified." How should the nurse counsel the parents regarding this behavior? a. Recommend family therapy or the child, siblings, and parents. b. Suggest the parents enroll the child in an anger management program. c. Educate both parents about bullying, including possible origins and long-term effects. d. Teach the parents about the developmental phase and tasks or an 8-year-old child.

c. Educate both parents about bullying, including possible origins and long-term effects. Bullying is an intentional display and a use o violence, though it may appear mild in some instances. Bullying can be defined as an offensive, intimidating, malicious, condescending behavior designed to humiliate. The scenario identifies an instance of lateral bullying. All kinds o bullying behaviors create a toxic environment. Those who are bullied are prone to negative feelings about self , humiliation, poor self -concept, and great emotional pain, and many can suffer severe, long-term reactions. After educating the parents about bullying, the nurse should assist them in setting limits with the child

Select the completion o this sentence that demonstrates an adult is coping in a healthy way: "I am feeling so angry right now... a. I'm a raid I'm going to cry." b. I would like to punch something." c. I want to talk to someone about it." d. I want to curl up and sleep or a long time."

c. I want to talk to someone about it." Talking about one's feelings is healthier than violence or avoidance.

An elderly widow tells the nurse, "Since my sister-in-law's death, her husband has been making advances at me. He tried to come in my home with a bottle of wine. Even though he's family, I'm afraid of what might happen if I let him in." Which action should the nurse take first? a. Support the widow to clarify her thoughts and feelings about the situation. b. Explain to the widow how to obtain an order of protection (restraining order). c. Positively rein force the widow or addressing the problem with a caring professional. d. Educate the widow about sexual assault and violence, including the importance of prevention

c. Positively rein force the widow or addressing the problem with a caring professional. The scenario presents the risk or sexual assault. Many people are sensitive about sexual matters, so the nurse should first give recognition to the widow or her willingness to share the problem. The most common drug used to facilitate the crime o rape is alcohol. Sexual violence occurs across all ages to men, women, and children. Cultural and societal actors play a part in forming attitudes about sexual violence

The nurse assessed an elderly person who was abused by the caregiver. Afterward, which internal dialogue should prompt the nurse to seek guidance? a. "Sometimes I get so discouraged and frustrated with my job." b. "It's incredible that anyone could hurt a child or elderly person." c. "The abuser was probably a victim o abuse at some point in life." d. "I hope the abuser gets victimized so they know what it eels like."

d. "I hope the abuser gets victimized so they know what it eels like." Nurses must be self -aware, particularly in highly charged situations. Wishing harm on an abuser may be understandable, but it is an indicator of the nurse's need or guidance.

A victim of reported sexual assault tells the nurse, "This was entirely my fault. I should never have gone to that party alone." Which response by the nurse is most therapeutic? a. "This was a frightening experience or you." b. "What do you think you should have done differently?" c. "Would you like to tell me more about what happened?" d. "It sounds like you're blaming yourself or the assailant's behavior."

d. "It sounds like you're blaming yourself or the assailant's behavior." Common emotional reactions after a sexual assault include anger, ear, anxiety, guilt, humiliation, embarrassment, self -blame, and mood swings. Compassionate care involves approaching the person who has been sexually assaulted in a nonjudgmental and empathic manner. Patients need to hear and understand that the rape is not their fault. It is important to help survivors separate the issues of vulnerability from blame

A community mental health nurse talks with a 6-year-old child whose divorced parents have shared custody. Which initial question will best help the nurse explore the child's perception o home life? a. "Is your life different from your friends' lives?" b. "Are you happiest at your mother's or your father's house?" c. "Do you and it hard to move back and forth between two homes?" d. "What are some of the good and bad things about living in two places?"

d. "What are some o the good and bad things about living in two places?" Developmental level is an important part of the assessment with children, so the nurse should select terms the child will understand. A semistructured interview provides an opportunity or the child to express perceptions about life at home and life at school with teachers and peers. Severe marital discord is a actor that may contribute to mental illness in children.