A nurse is caring for a client who has antisocial personality disorder who requests to smoke outside of scheduled smoke breaks.
Which of the following is an appropriate response by the nurse?
"Let me check with the charge nurse to see if your smoke breaks can be adjusted.”
"Why do you feel we should allow you extra smoke breaks?”
"I can give you an extra smoke break if you agree to participate in group therapy.”
"The smoking times on the unit are after each meal.”
The Correct Answer is A
Choice A rationale:
The appropriate response by the nurse in this situation is to consider the client's request and check with the charge nurse to see if it's possible to adjust the smoke breaks. This response demonstrates a willingness to listen to the client's request and explore the possibility of accommodating their needs within the unit's policies and routines. It does not immediately grant the request but shows respect for the client's concerns and attempts to find a compromise.
Choice B rationale:
Asking the client why they feel extra smoke breaks should be allowed is not the best response. It may come across as confrontational and defensive, which can escalate the situation. Clients with antisocial personality disorder may have difficulty adhering to rules, so it's essential to approach their requests with a collaborative and problem-solving attitude.
Choice C rationale:
Offering an extra smoke break in exchange for participation in group therapy is not an appropriate response. It can be seen as manipulating the client or using rewards to control their behavior. It's essential to maintain clear boundaries and not use rewards or punishments as a means of managing clients with personality disorders.
Choice D rationale:
Telling the client the smoking times on the unit are after each meal is not an appropriate response either. It doesn't address the client's request and simply restates the unit's policy. It's important to engage in a more therapeutic and client-centered approach when responding to requests from individuals with personality disorders.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Allowing the patient to lift the CPM machine onto the bed is not a safe practice. Arthroscopic surgery may result in limited mobility and discomfort for the patient. Lifting heavy equipment could potentially strain the surgical site or lead to injury.
Choice B rationale:
Telling the patient that CPM will not hurt at all is not accurate. While CPM is a passive motion technique aimed at preventing joint stiffness, some discomfort or mild pain may be experienced, especially during the initial sessions. Managing the patient's pain is essential to ensure compliance with the CPM exercises.
Choice C rationale:
Suggesting that the patient does not need to do CPM exercises is incorrect. CPM exercises are often prescribed after joint surgery to prevent joint stiffness, improve circulation, and aid in recovery. Discouraging the patient from participating in these exercises would be detrimental to their postoperative outcome.
Choice D rationale:
Administering an opioid analgesic to the client 30 minutes before initiating CPM exercises is the correct choice. CPM exercises can be uncomfortable for some patients, especially in the initial stages, and providing adequate pain relief before starting the exercises promotes patient comfort and compliance. It helps ensure that the patient can perform the exercises effectively without undue pain, reducing the risk of complications and promoting a successful recovery.
Correct Answer is B
Explanation
Choice A rationale:
Sarcoptes scabiei is the causative agent of scabies, a contagious skin infestation. While scabies is a communicable disease, it is typically not a reportable disease to the state health department. Scabies is usually treated at the individual or community level, and reporting to the state health department is not required.
Choice B rationale:
Neisseria gonorrhoeae is the bacterium responsible for gonorrhea, a sexually transmitted infection. Gonorrhea is a notifiable disease, and healthcare providers are required to report cases of gonorrhea to the state health department. This is because gonorrhea is a significant public health concern due to its potential complications and the need for contact tracing and prevention.
Choice C rationale:
Human papillomavirus (HPV) is a very common sexually transmitted infection, but it is typically not a reportable disease to the state health department. HPV can lead to various health issues, including genital warts and certain types of cancer. However, reporting HPV cases is not a standard practice because it is highly prevalent and usually managed at the individual level through screening and vaccination programs.
Choice D rationale:
Impetigo contagiosa is a bacterial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes. While it is contagious, impetigo is not typically a reportable disease to the state health department. Like scabies, impetigo is usually managed at the individual or community level, and reporting is not a standard requirement.
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