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A patient in an abusive relationship is hospitalized with abdominal and head trauma caused by their partner. The partner sends flowers to the patient and pizzas for all the staff. Via video chat, the partner tearfully begs the patient to forgive them and not press charges. The partner states, “I just want you, me, and the kids to be together. You know you do too.” What conclusions can the nurse make about this scenario? (Select All That Apply)

The patient’s partner’s act of sending flowers is an example of undoing.

The patient and partner are in the honeymoon phase of intimate partner violence.

The patient has a submissive personality and depression.

Since the injuries have caused hospitalization, the patient will end the relationship.

The partner may be trying to manipulate the staff by buying pizza.

Answer and Explanation

Correct Answer : A,B,E

The correct answer is a, b, and e.

Choice A Reason:

The patient’s partner’s act of sending flowers is an example of undoing. Undoing is a defense mechanism where a person tries to cancel out or remove an unhealthy, destructive, or otherwise threatening thought or action by engaging in contrary behavior. In this case, the partner is attempting to make amends for the abuse by sending flowers, which is a common tactic used by abusers to mitigate their guilt and manipulate the victim into forgiving them.

Choice B Reason:

The patient and partner are in the honeymoon phase of intimate partner violence. The cycle of abuse in intimate partner violence typically includes a honeymoon phase, where the abuser may apologize, show remorse, and promise to change. This phase often involves gestures of affection and kindness, such as sending flowers or gifts, to win back the victim’s trust and prevent them from leaving.

Choice C Reason:

The patient has a submissive personality and depression. While it is possible that the patient may have a submissive personality and depression, this conclusion cannot be definitively made based on the given scenario alone. Submissive personality traits and depression are complex and require thorough psychological evaluation to diagnose accurately.

Choice D Reason:

Since the injuries have caused hospitalization, the patient will end the relationship. This conclusion is not necessarily accurate. Victims of intimate partner violence often face significant psychological, emotional, and practical barriers to leaving an abusive relationship, even after severe incidents that result in hospitalization. The decision to leave an abusive relationship is influenced by various factors, including fear, financial dependence, emotional attachment, and lack of support.

Choice E Reason:

The partner may be trying to manipulate the staff by buying pizza. Manipulative behavior is common in abusive relationships. By buying pizza for the staff, the partner may be attempting to create a favorable impression and gain sympathy, which can influence the staff’s perception of the situation and potentially affect their support for the patient.

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Correct Answer is A

Explanation

Choice A Reason: Grandiose sense of self-importance

This is the hallmark characteristic of narcissistic personality disorder (NPD). Individuals with NPD often have an exaggerated sense of their own importance and abilities. They may believe they are superior to others and expect special treatment. This grandiosity is a core feature of the disorder and is often accompanied by fantasies of unlimited success, power, brilliance, beauty, or ideal love.

Choice B Reason: Pattern of intense and chaotic relationships

While individuals with NPD may have problematic relationships, this characteristic is more commonly associated with borderline personality disorder. People with NPD may exploit relationships for personal gain, but their relationships are not typically described as chaotic in the same way as those with borderline personality disorder.

Choice C Reason: Submissive and clinging behaviors

Submissive and clinging behaviors are characteristic of dependent personality disorder, not narcissistic personality disorder. Individuals with NPD are more likely to exhibit domineering and controlling behaviors rather than submissive ones.

Choice D Reason: Odd beliefs and magical thinking

Odd beliefs and magical thinking are more characteristic of schizotypal personality disorder. While individuals with NPD may have grandiose fantasies, these do not typically include the bizarre or eccentric beliefs seen in schizotypal personality disorder.

A. Is from another state and says they are here on a long vacation. B. Has a cell phone that is not working in the emergency department. C. Is accompanied by a family member who will not let the client answer questions. D. Speaks another language and is in need of an interpreter to translate. E. None F. None

Correct Answer is C

Explanation

d. Speaks another language and is in need of an interpreter to translate.

The correct answer is c. Is accompanied by a family member who will not let the client answer questions.

Choice A Reason: Is from another state and says they are here on a long vacation

This choice is not necessarily indicative of human trafficking. While being from another state and claiming to be on a long vacation might raise some questions, it is not a definitive sign of trafficking. Many people travel for various reasons, and this alone does not suggest that the person is a victim of human trafficking.

Choice B Reason: Has a cell phone that is not working in the emergency department

This choice is also not a strong indicator of human trafficking. A non-working cell phone can be due to many reasons, such as technical issues or lack of service. While traffickers may sometimes control their victims’ communication devices, this alone is not enough to suspect trafficking.

Choice C Reason: Is accompanied by a family member who will not let the client answer questions

This choice is a strong indicator of human trafficking. Traffickers often control their victims’ interactions with others, including healthcare providers. If a family member or companion is overly controlling and does not allow the client to speak for themselves, it raises a significant red flag for potential trafficking. This behavior is often seen in trafficking situations to prevent the victim from disclosing their true circumstances.

Choice D Reason: Speaks another language and is in need of an interpreter to translate

This choice is not a definitive sign of human trafficking. Many people who are not victims of trafficking may speak another language and require an interpreter. While language barriers can complicate communication, they do not alone indicate trafficking. However, if combined with other signs, it could contribute to a suspicion of trafficking.

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Naxlex Comprehensive Predictor Exams

When assessing a client diagnosed with narcissistic personality disorder, the nurse expects to identify which characteristic behavior?

Correct Answer is A

Explanation

A nurse is providing care for a client who is malnourished and appears exhausted. What data would cause the nurse to suspect the client is a victim of human trafficking? The client:

Correct Answer is C

Explanation

Several children come to the Emergency Department for treatment. The situation that would cause the nurse to have the highest suspicion of child abuse would be:

During intake assessment, the nurse is most likely to hear a client with major depressive disorder say which of the following statements about depression? (Select All that Apply.)

The nurse in the Emergency Department (ED) assesses a 17-year-old patient with blue-tinged lips, slowed respirations, and pinpoint pupils. The patient has no response to painful stimuli. Which of the following should be the nurse’s priority action?

A nurse is meeting with a 15-year-old client who has ADHD. The client and their parent state they would like their medications stopped due to the unpleasant side effects. Which of the following statements should the nurse make?

One liter of normal saline is to infuse over 8 hours. At what rate will the nurse set the infusion pump?

A nurse is caring for a client who has a binge-eating disorder. Which of the following statements should the nurse expect from this client?

A client prescribed lithium carbonate 300 mg twice daily a month ago comes to the Emergency Department with mental confusion, frequent urination in large amounts, and coarse tremors. Which lithium level would the nurse expect?