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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 D

Explanation

Choice A Reason: Anchovies

Anchovies are a type of small, oily fish that are often used in various dishes for their strong flavor. They are rich in omega-3 fatty acids and other nutrients. However, there is no known interaction between anchovies and disulfiram. Disulfiram specifically interacts with alcohol and alcohol-containing products, causing unpleasant reactions. Therefore, anchovies are not a food item that needs to be avoided while taking disulfiram.

Choice B Reason: Spinach

Spinach is a leafy green vegetable that is high in vitamins, minerals, and antioxidants. It is generally considered a healthy food and does not have any known interactions with disulfiram. Patients taking disulfiram do not need to avoid spinach as it does not contain alcohol or any substances that would cause a reaction with the medication.

Choice C Reason: Grapefruit Juice

Grapefruit juice is known to interact with various medications by affecting the enzymes that metabolize these drugs in the liver. However, there is no specific interaction between grapefruit juice and disulfiram. While grapefruit juice can affect the metabolism of certain medications, it does not cause the same type of reaction that alcohol does when taken with disulfiram. Therefore, it is not necessary for patients on disulfiram to avoid grapefruit juice.

Choice D Reason: Alcoholic Beverages

Alcoholic beverages are the primary substance that must be avoided while taking disulfiram. Disulfiram works by inhibiting the enzyme acetaldehyde dehydrogenase, which is involved in metabolizing alcohol. When alcohol is consumed, acetaldehyde accumulates in the body, leading to unpleasant symptoms such as nausea, vomiting, headache, and flushing. This reaction is intended to deter individuals from drinking alcohol. Therefore, it is crucial for patients taking disulfiram to avoid all forms of alcohol, including alcoholic beverages, to prevent these adverse reactions.

A. Apple pie and coffee B. A bagel with cream cheese and tea C. Pepperoni pizza and red wine D. Potato chips and diet cola

Correct Answer is C

Explanation

The correct answer is c. Pepperoni pizza and red wine.

Choice A Reason:

Apple pie and coffee are generally safe to consume while taking MAOIs. These foods do not contain high levels of tyramine, which is the substance that can cause dangerous interactions with MAOIs. Tyramine is found in aged, fermented, or cured foods, and neither apple pie nor coffee falls into these categories.

Choice B Reason:

A bagel with cream cheese and tea is also considered safe for individuals taking MAOIs. Cream cheese is a fresh cheese and does not contain high levels of tyramine. Tea, while containing caffeine, does not pose a significant risk of tyramine interaction.

Choice C Reason:

Pepperoni pizza and red wine are high in tyramine and should be avoided by individuals taking MAOIs. Pepperoni is a cured meat, and red wine is a fermented beverage, both of which can lead to a hypertensive crisis when consumed with MAOIs. This combination can cause a dangerous spike in blood pressure, making it the correct answer to the question.

Choice D Reason:

Potato chips and diet cola do not contain high levels of tyramine and are generally safe to consume while taking MAOIs. Potato chips are not aged or fermented, and diet cola, although containing caffeine, does not pose a significant risk of tyramine interaction.

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Naxlex Comprehensive Predictor Exams

The nurse is providing discharge instructions to the client taking disulfiram. Which of the following items should the nurse teach the client to avoid?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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