A male patient has recently been diagnosed with type II diabetes. His family is having trouble incorporating the dietary and exercise regimen prescribed by his physician into their daily routines. They tell the nurse that they are all tired when they return home from school and work and that the last thing any of them want to do is go on a walk. In addition, the patient's wife discloses that she is unable to prepare any sugar-free or low-sugar foods that her husband enjoys eating. Based on this information, which nursing diagnosis would be most appropriate for this family?

Correct Answer: D

Rationale: The correct answer is D: Ineffective Family Therapeutic Regimen Management. This nursing diagnosis is appropriate because it addresses the family's struggle in incorporating the prescribed dietary and exercise regimen for the patient's type II diabetes. The family's inability to adjust to the new routine and the wife's difficulty in preparing suitable meals indicate ineffective management of the therapeutic regimen. Choice A, Interrupted Family Processes, is incorrect because there is no evidence of a disruption in family dynamics. Choice B, Ineffective Denial, is incorrect as the family is not in denial but rather facing practical challenges. Choice C, Caregiver Role Strain, is not the most appropriate diagnosis as the main issue lies in the family's ability to manage the therapeutic regimen, not in the caregiver's emotional strain. In summary, the correct nursing diagnosis, D, directly addresses the family's challenges in following the prescribed regimen, making it the most appropriate choice in this scenario.

Correct Answer: B

Rationale: The correct answer is B: Munchausen's syndrome by proxy. This is a form of abuse where the caregiver fabricates or induces illness in someone under their care to gain attention or sympathy. In this scenario, the client's repeated attempts to harm the child for attention align with this syndrome. The other options do not fit the situation: A (Schizoid personality traits) doesn't involve intentional harm, C (Functional neurologic symptoms) is not related to fabricating illness in another, and D (Borderline personality disorder) doesn't typically involve this specific type of behavior.

Correct Answer: A

Rationale: Correct Answer: A Rationale: Setting strict limits and communicating them to all staff members is the most appropriate response as a milieu manager. In an inpatient psychiatric unit, creating a structured and consistent environment is crucial for managing challenging behaviors, such as those exhibited by a client with borderline personality disorder. By setting clear boundaries and ensuring all staff members are aware of them, the nurse establishes a safe and therapeutic milieu for all clients. This approach helps maintain a stable and supportive setting, promoting positive interactions among clients and staff. Summary: - Choice B (Using role-play): While role-play can be a valuable therapeutic technique, it may not directly address the immediate need to manage challenging behaviors in the milieu. - Choice C (Seeking orders for forced medications): This is not the appropriate course of action as forcing medications should be a last resort and should only be considered in situations where the client is at imminent risk of harm. - Choice D (Holding a group session on relationship skills): While group sessions

Correct Answer: B

Rationale: Correct Answer: B (Oliguria) Rationale: 1. Oliguria (decreased urine output) is a classic sign of decreased cardiac output due to poor perfusion to the kidneys. 2. Decreased cardiac output results in reduced blood flow to the kidneys, leading to decreased urine production. 3. Shivering is a common postoperative response, not directly related to cardiac output. 4. Bradypnea (slow breathing) and constricted pupils are not typical signs of decreased cardiac output.

Correct Answer: B

Rationale: The correct answer is B: Pubescent individuals. Hebephilia is a paraphilic disorder characterized by a primary or exclusive sexual interest in individuals who are in the early stages of puberty, typically around the ages of 11 to 14. This is different from pedophilic disorder, which involves a sexual preference for prepubescent children. Choice A (Infants) is incorrect as infants are prepubescent. Choice C (Teens between the ages of 15 and 19) is incorrect as these individuals are typically considered adolescents rather than pubescent. Choice D (Males only) is incorrect as hebephilia can occur in individuals of any gender.

Correct Answer: D

Rationale: The correct answer is D: DSM-5. The DSM-5 is the Diagnostic and Statistical Manual of Mental Disorders, which is the standard classification of mental disorders used by mental health professionals. It provides criteria for diagnosing specific psychiatric disorders based on symptoms, behaviors, and other clinical features. By using the DSM-5, the nursing student can accurately identify which symptoms are present in a specific psychiatric disorder. A: Nursing Interventions Classification (NIC) and B: Nursing Outcomes Classification (NOC) are not specifically designed to identify symptoms of psychiatric disorders. NIC focuses on nursing interventions, while NOC focuses on nursing outcomes. C: NANDA-I nursing diagnoses provide a framework for identifying nursing problems and developing care plans but do not provide specific information on symptoms of psychiatric disorders. In summary, the DSM-5 is the most appropriate resource for identifying symptoms of psychiatric disorders, while the other choices are not specifically designed for this purpose.

Correct Answer: C

Rationale: The correct answer is C because paranoid delusions of being followed by alien monsters indicate severe psychosis and a distorted perception of reality, leading to potential violent behavior. Delusions involving external threats are associated with a higher risk of aggression. A: Major depressive disorder with delusions of worthlessness may lead to self-harm but not necessarily violence towards others. B: Obsessive-compulsive disorder with rituals is more about controlling anxiety and unlikely to result in violent behavior. D: Completed alcohol withdrawal and starting a rehabilitation program suggest the individual is seeking help and support, which reduces the risk of violence towards others.

Correct Answer: B

Rationale: The correct answer is B because the Patient Self-Determination Act emphasizes the importance of discussing end-of-life choices with family or a designated surrogate. This question aligns with the act's goal of promoting patient autonomy and ensuring that patients have a say in their healthcare decisions. Choices A, C, and D are incorrect because they do not directly address the act's focus on end-of-life planning and decision-making with family or a designated surrogate. A focuses on access to medical information, C on informed decision-making about treatment, and D on helping the patient feel comfortable, which are important but not specifically related to the Patient Self-Determination Act.

Correct Answer: A

Rationale: The correct answer is A: antisocial personality disorder is most likely to be associated with illegal activity. Individuals with this disorder often exhibit a disregard for the rights of others, impulsivity, and a lack of remorse, making them prone to engaging in criminal behavior. Borderline personality disorder (B) is characterized by unstable relationships and emotions, but not necessarily criminal behavior. Dependent personality disorder (C) involves an excessive need to be taken care of, and schizoid personality disorder (D) is characterized by social detachment, both of which are not typically associated with illegal activity.