A nurse prepares to assess a new patient who moved to the United States from Central America 3 years ago. After introductions, what is the nurse's next comment?

Correct Answer: D

Rationale: The correct next comment for the nurse is D: "Are you comfortable conversing in English, or would you prefer to have a translator present?" This is the best choice because it directly addresses the patient's language preference and ensures effective communication. By asking this question, the nurse demonstrates cultural sensitivity and respect for the patient's linguistic needs. It also shows a willingness to accommodate the patient's communication preferences, promoting trust and understanding in the healthcare setting. Choice A is incorrect as it focuses on the patient's journey to the U.S., which is unrelated to the immediate healthcare assessment. Choice B assumes the patient needs help from a family member without first assessing the patient's language proficiency. Choice C, while offering an interpreter, does not directly inquire about the patient's language preference, potentially overlooking the patient's comfort level with English.

Correct Answer: D

Rationale: The correct answer is D, "We can pray together if you'd like." This is the most appropriate spiritual nursing intervention because it acknowledges and respects the patient's faith, offers emotional support, and fosters a connection between the nurse and the patient. It shows empathy and understanding of the patient's spiritual needs during a challenging time. Explanation for why the other choices are incorrect: A: Taking the patient to visit the nurse's church may not align with the patient's faith and may not be comfortable for the patient. B: Requiring the patient to belong to the same church as the nurse to go to heaven is imposing the nurse's beliefs on the patient, which is inappropriate. C: Offering guided imagery may be helpful for relaxation, but it does not directly address the patient's spiritual needs or provide the emotional support that praying together can offer.

Correct Answer: D

Rationale: The correct answer is D because holding a care conference for a client who is having difficulty returning to school reflects service planning. This involves coordinating and organizing resources, collaborating with stakeholders, and developing a comprehensive plan to address the client's specific needs. Option A focuses on problem identification and seeking resources, not on planning services. Option B involves immediate follow-up but does not necessarily involve comprehensive planning. Option C focuses on a specific appointment with a nutritionist and does not encompass overall service planning for the client's needs.

Correct Answer: C

Rationale: The adult's statements indicate feelings of inadequacy and lack of confidence, which align with Erikson's stage of Autonomy versus shame and doubt. In this stage, individuals develop a sense of independence and self-assurance. The adult's expressions of self-doubt and disempowerment suggest an unresolved conflict from this stage. A: Initiative versus guilt - This stage pertains to developing a sense of purpose and direction in actions, not relevant to the adult's statements. B: Trust versus mistrust - This stage focuses on building trust in relationships, not directly related to the adult's self-perception issues. D: Generativity versus self-absorption - This stage involves contributing to society and future generations, not reflective of the adult's self-depreciating thoughts.

Correct Answer: A

Rationale: The correct answer is A: Category I. In the Quadrant Model of Integrated Healthcare, Category I refers to the treatment of co-occurring disorders in the primary care setting. This means that the client is receiving integrated care for both physical and mental health conditions in one location, promoting holistic and comprehensive treatment. Choices B, C, and D do not align with the specific scenario described and represent different levels or types of care in the Quadrant Model.

Correct Answer: C

Rationale: The correct answer is C: a combination of behavior therapy training that includes the child, the family, and the school. This is the most appropriate response because multisystemic treatment is a comprehensive approach involving various aspects of the adolescent's life. It targets behavior through therapy and involves not only the child but also the family and school to address underlying issues and promote positive change. Incorrect options: A: Immediate assessment for oppositional defiant disorder - This option focuses solely on a diagnosis and does not address the holistic approach of multisystemic treatment. B: Very upsetting, but just typical for teenagers - This option dismisses the seriousness of the situation and does not provide a constructive solution. D: A course of prescription medication - This option suggests a medical intervention, which is not typically the first-line approach for managing behavioral issues in adolescents.

Correct Answer: D

Rationale: The correct answer is D: Risk-taking behavior. Impulsiveness is a key characteristic of ADHD, and risk-taking behavior is a clear manifestation of impulsiveness in children with ADHD. Children displaying risk-taking behavior often act without considering consequences or engaging in dangerous activities. In contrast, choices A, B, and C are more indicative of hyperactivity and inattention rather than impulsiveness. Inability to wait his turn (A) is related to impulse control, restlessness (B) is associated with hyperactivity, and difficulty completing a task (C) is linked to inattention. Therefore, choice D is the most appropriate reflection of impulsiveness in a child with ADHD.

Correct Answer: C

Rationale: The correct answer is C because holding a focus group discussion about why students bring weapons to school doesn't directly address injury and violence prevention goals of Healthy People 2020. The other choices focus on early identification of risk factors, promoting a safe environment, and community engagement which align with the goals. Holding a focus group may provide insights but doesn't directly address prevention strategies.

Correct Answer: A

Rationale: Rationale: The correct answer is A. Malika's weight issues may be linked to emotional factors, such as depression or anxiety. SSRIs can help address these underlying emotional issues, leading to better adherence to weight loss interventions. Exercise alone may not address the root cause. Removing snack foods may help with weight loss but doesn't address emotional factors. Medication for hypertension only treats a symptom, not the underlying cause of weight gain.