b. “What are your beliefs about a person’s right to take his or her own life?” c. “Do you think you are vulnerable to developing a depressed mood?” d. “If you felt suicidal, would you tell someone about your feelings?” ANS: B
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This question is clear, direct, and respectful. It will produce information relative to the acceptability of suicide as an option to the patient. If the patient deems suicide unacceptable, no further assessment is necessary. If the patient deems suicide as acceptable, the nurse can continue to assess intent, plan, means to carry out the plan, lethality of the chosen method, and so forth. The other options are less direct, may produce responses that may be unclear, or are appropriate for later in this discussion. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 31-8 (Evidence Based Practice), 20, 45 (Box 31-8) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
21. A community health nurse visits an elderly person whose spouse died 6 months ago. Two
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vodka bottles are in the trash. When the nurse asks about alcohol use, this person says, “I get lonely and drink a little to help me forget.” Select the nurse’s most therapeutic intervention. a. Assess whether this patient is drinking and driving. b. Advise the person not to drink alone because the risks for injury increase. c. Teach the person about risks for alcoholism and suggest other coping strategies. d. Arrange for the person to attend an AA meeting for older adults. ANS: D
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This person needs help with alcohol abuse as well as social involvement. An AA meeting for older adults will provide an opportunity for peer bonding as well as strategies for coping with stress without abusing alcohol. The distracters will not be therapeutic in this instance.
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PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Page 31-7 TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
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22. Discharge planning begins for an elderly patient hospitalized for 2 weeks diagnosed with
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major depressive disorder. The patient needs ongoing assessment and socialization opportunities as well as education about medication and relapse prevention. The patient lives with a daughter, who works during the week. Select the best referral for this patient. a. Behavioral health home care b. A skilled nursing facility c. Partial hospitalization d. A halfway house ANS: C
Partial hospitalization will provide services the patient needs as well as give supervision and meals to the patient while the daughter is at work. Home care would not provide socialization. The patient does not need the intensity of a skilled nursing facility. A halfway house provides 24-hour care and usually expects involvement in off-campus programs.
PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Page 31-26 TOP: Nursing Process: Planning MSC: Client Needs: Safe, Effective Care Environment
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