A grief support group is held at the local community center to assist persons who are dealing with issues of loss. Which remark by one of the members would the nurse interpret as indicating unresolved feelings of guilt?

Questions 29

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Kaplan and Sadocks Synopsis of Psychiatry Test Bank Questions

Question 1 of 9

A grief support group is held at the local community center to assist persons who are dealing with issues of loss. Which remark by one of the members would the nurse interpret as indicating unresolved feelings of guilt?

Correct Answer: C

Rationale: The correct answer is C because the statement indicates feelings of guilt about not getting help sooner, suggesting the member may blame themselves for the loss. This remark reflects a sense of responsibility and regret, common in unresolved guilt. Choice A expresses acceptance, B reflects natural grief progression, and D highlights difficulty during specific times, not necessarily linked to guilt. By analyzing the content of each statement, the nurse can identify cues related to unresolved feelings of guilt.

Question 2 of 9

An 85-year-old has difficulty walking after a knee replacement. The patient tells the nurse, “It’s awful to be old. Every day is a struggle. No one cares about old people.” Select the nurse’s best response.

Correct Answer: B

Rationale: The correct answer is B because it shows empathy and active listening. By encouraging the patient to share their feelings, the nurse validates their emotions and builds a therapeutic relationship. This approach helps the nurse understand the patient's perspective and provides an opportunity for emotional support. Choice A does not actively invite the patient to share their feelings and may come off as dismissive. Choice C ignores the patient's emotional distress and may seem invalidating. Choice D, while positive, fails to address the patient's emotional concerns and misses an opportunity for meaningful communication.

Question 3 of 9

A child who has been physically abused becomes emotionally distressed when told that the parent will no longer be allowed to visit. Which principle of social learning theory explains the child’s response?

Correct Answer: C

Rationale: The correct answer is C: The child believes they are responsible for the parent being punished. According to social learning theory, individuals learn behaviors through observation and modeling. In this scenario, the child has internalized the belief that they are the cause of the parent's punishment due to the abuse. This leads to feelings of guilt and distress when the parent is no longer allowed to visit. A: The child does not view abuse as desirable; it is a harmful behavior. B: While fear may be present, the core issue lies in the child's belief of responsibility. D: The parent blaming the child for the abuse does not align with the principles of social learning theory.

Question 4 of 9

Select the best outcome for a patient with the nursing diagnosis: "Impaired social interaction related to sociocultural dissonance as evidenced by stating, 'Although I’d like to, I don’t join in because I don’t speak the language very well.'” Patient will:

Correct Answer: D

Rationale: The correct answer is D: Select and participate in one group activity per day. This outcome directly addresses the nursing diagnosis of impaired social interaction by encouraging the patient to engage in a specific social activity daily. This goal promotes social interaction, helps the patient overcome language barriers, and gradually enhances their social skills. It provides a structured approach to improve the patient's sociocultural integration. A: Show improved use of language - This choice focuses solely on language skills but does not directly address the social interaction issue. B: Demonstrate improved social skills - While this choice is related to the nursing diagnosis, it is too broad and lacks specificity compared to choice D. C: Become more independent in decision-making - This choice is not directly related to addressing impaired social interaction caused by language barriers.

Question 5 of 9

After undergoing two of nine electroconvulsive therapy (ECT) procedures, a client states, "I can’t even remember eating breakfast, so I want to stop the ECT." Which is the most appropriate nursing reply?

Correct Answer: C

Rationale: The correct answer is C. It acknowledges the client's autonomy while also addressing their concerns. First, it recognizes the client's right to discontinue treatment. Second, it opens the door for a discussion to explore the client's worries and provide support. This response shows empathy and respects the client's decision-making. Choice A is incorrect because it dismisses the client's autonomy and fails to address their concerns. Choice B is not as appropriate as it suggests only talking to the doctor, missing the opportunity for the nurse to provide immediate support. Choice D is incorrect as it invalidates the client's experience of memory loss and fails to address their concerns.

Question 6 of 9

A teenage boy has lost his best friend as a result of a hunting accident. His parents report that he is eating and sleeping very little and expresses little interest in school. They are concerned that he talks about the accident repeatedly. These behaviors are generally seen as:

Correct Answer: C

Rationale: The correct answer is C: Expressions of a normal grief reaction. The teenage boy's behaviors of poor appetite, insomnia, lack of interest in school, and repetitive discussions about the accident are common manifestations of grief. This grief reaction is a normal response to losing a close friend in a traumatic manner like a hunting accident. It is important to acknowledge and validate his emotions during this difficult time. Incorrect Choices: A: Expressing responsibility for his friend's death - This choice suggests guilt or blame on the part of the boy, which is not evident in the scenario. B: Attempts to avoid dealing with his pain - The boy's behaviors indicate he is processing his grief rather than avoiding it. D: Indications of a risk for self-harm - While it is important to monitor for signs of self-harm, the behaviors described are more indicative of grief rather than immediate self-harm risk.

Question 7 of 9

A 70-year-old male has the nursing diagnosis of situational low self-esteem related to forced retirement. Using Maslow’s hierarchy, the nurse is confident the patient is meeting self-worth outcomes when the patient:

Correct Answer: D

Rationale: The correct answer is D because volunteering at the local homeless shelter fulfills the self-actualization need in Maslow's hierarchy. By helping others and contributing to the community, the patient gains a sense of purpose and fulfillment, boosting self-esteem. A: Moving to a secure apartment building addresses safety needs, not self-esteem. B: Exercising with friends promotes social belonging but does not directly address self-esteem. C: Attending grandchildren's functions fosters social connections, but it may not directly impact self-esteem like volunteering does.

Question 8 of 9

Which of the following meets the DSM-IV-TR criteria for moderate mental retardation?

Correct Answer: D

Rationale: The correct answer is D because the DSM-IV-TR criteria for moderate mental retardation includes an IQ range of 35-49, which typically corresponds to functioning at around the level of a 6 to 9-year-old. Choice D best fits this criteria as the individual has advanced to the sixth grade level academically, indicating a level of functioning consistent with moderate mental retardation. Choices A, B, and C do not meet the criteria as they suggest a higher level of functioning and independence than what is typically associated with moderate mental retardation.

Question 9 of 9

The nurse is determining whether the patient’s needs could be best met in a task or a process group. The decision is based on the understanding that a task group focuses on:

Correct Answer: A

Rationale: The correct answer is A: The "here and now." In a task group, the focus is on addressing specific goals, tasks, and problem-solving in the present moment. This approach helps members work together efficiently to achieve objectives. Communication styles (B) are more relevant in a group focused on improving communication skills. Relations among the members (C) are typically emphasized in a process group, where the focus is on interpersonal dynamics and relationships. Choice D is incomplete and does not align with the purpose of a task group.

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