A nurse is providing care to several chronically ill children. Which of the following would the nurse identify as having the greatest risk for developing a psychiatric problem?

Correct Answer: B

Rationale: The correct answer is B: 5-year-old with cerebral palsy. Children with cerebral palsy often face challenges in mobility, communication, and social interactions, which can contribute to the development of psychiatric problems. The physical limitations and the impact on daily activities can lead to feelings of frustration, isolation, and low self-esteem, increasing the risk of psychiatric issues. The other choices (A, C, D) do not inherently pose the same level of risk for developing psychiatric problems as cerebral palsy. Children with diabetes mellitus (A) can manage their condition with proper care, children with chronic renal disease (C) may face physical health challenges but not necessarily psychiatric problems, and a heart murmur (D) is a physical condition that typically does not directly affect mental health.

Correct Answer: C

Rationale: The correct answer is C: A urinary tract infection. Nancy's mother's symptoms such as nonsensical speech, disheveled appearance, strong urine smell, and stain on dressing gown are indicative of a urinary tract infection. UTIs in the elderly can cause confusion, delirium, and incontinence. By recognizing these symptoms, Nancy can suspect a UTI as the cause and seek medical treatment promptly to address the infection. Incorrect choices: A: Early onset dementia - Symptoms of UTI are acute and temporary, not indicative of a chronic condition like dementia. B: A mild cognitive disorder - UTI symptoms are not typically associated with mild cognitive disorders. D: Skipping breakfast - Skipping breakfast does not explain the range of symptoms observed in Nancy's mother.

Correct Answer: C

Rationale: The nurse would include improved access to less costly services as the main focus as it aligns with the goal of managed care in mental health, which emphasizes providing quality care in a cost-effective manner. By focusing on improving access to less costly services, the nurse can educate the women's club on how managed care models aim to reduce healthcare costs while still ensuring appropriate and timely mental health services for individuals. Choice A (Cost savings) is too broad and doesn't specifically address mental health services. Choice B (Consistent third-party reimbursement) is important but not the main focus of managed care in mental health. Choice D (Individualized care for additional inpatient stays) is not typically a primary focus of managed care which aims to promote outpatient and less costly services.

Correct Answer: D

Rationale: Step-by-step rationale for why answer D is correct: 1. Women and men experience anger differently due to societal norms and expectations. 2. Research shows women may express anger less overtly but experience it at similar rates. 3. Recognizing gender differences in anger is crucial for healthcare professionals. 4. Answer D is correct as it highlights the importance of understanding gender disparities in anger expression. Summary: A: Incorrect - Anger, aggression, and violence are related but not necessarily points along a continuum. B: Incorrect - Precision of terms is not the main focus when discussing anger, aggression, and violence. C: Incorrect - Anger is not always a knee-jerk reaction; it can be complex and multifaceted. D: Correct - Women experience anger differently from men, making this statement appropriate for nursing education.

Correct Answer: A

Rationale: The correct answer is A. This is because providing clear reasons for policies and procedures helps establish transparency and fosters trust in the nurse-client relationship. By explaining the rationale behind actions taken, the nurse shows respect for the client's autonomy and promotes understanding. Choice B focuses on interpersonal communication but may not directly contribute to trust-building. Choice C involves empathy but does not necessarily directly address trust. Choice D involves collaboration but may not specifically address trust-building through transparent communication.