A patient begins a new program to assist with building social skills. In which part of the plan of care should a nurse record the item, "Encourage patient to attend one psychoeducational group daily"?

Correct Answer: B

Rationale: The correct answer is B: Implementation. In the nursing process, implementation involves carrying out the plan of care. Encouraging the patient to attend a psychoeducational group daily is an action that is part of implementing the care plan to improve social skills. This step focuses on putting the plan into action and actively supporting the patient in achieving the desired outcomes. A: Assessment is incorrect because assessment involves collecting data and information about the patient's condition, not actively implementing interventions. C: Analysis is incorrect as it involves interpreting and making sense of the assessment data to identify problems and strengths, not implementing interventions. D: Evaluation is incorrect because it involves assessing the effectiveness of the interventions implemented, not actively carrying out the interventions themselves.

Correct Answer: B

Rationale: The correct answer is B: Implementation. In the nursing process, implementation involves carrying out the plan of care. Encouraging the patient to attend a psychoeducational group daily is an action that is part of implementing the care plan to improve social skills. This step focuses on putting the plan into action and actively supporting the patient in achieving the desired outcomes. A: Assessment is incorrect because assessment involves collecting data and information about the patient's condition, not actively implementing interventions. C: Analysis is incorrect as it involves interpreting and making sense of the assessment data to identify problems and strengths, not implementing interventions. D: Evaluation is incorrect because it involves assessing the effectiveness of the interventions implemented, not actively carrying out the interventions themselves.

Correct Answer: C

Rationale: The correct answer is C because Lewy body disease can affect a patient's ability to communicate pain, making specialized pain assessment tools crucial. Special scales designed for patients with dementia can help in accurately assessing pain levels. These tools consider non-verbal cues and behavioral changes that may indicate pain. Asking the patient's family (A) may not always provide an accurate assessment of pain perception. Using a visual analog scale (B) may be challenging for a patient with cognitive impairment. Focusing solely on mental status (D) may overlook important indicators of pain in patients with Lewy body disease.

Correct Answer: C

Rationale: The correct answer is C because the patient who started drinking daily after retirement as a coping mechanism for arthritis has the highest risk for alcohol abuse. This behavior indicates a potential dependence on alcohol to manage physical and emotional discomfort, leading to increased consumption and potential addiction. Choice A is not the correct answer because consuming 1 glass of wine nightly with dinner is generally considered moderate drinking and does not necessarily indicate alcohol abuse. Choice B is also not the correct answer as social drinking throughout adult life, even if justified as a reward, does not inherently suggest alcohol abuse without further evidence of problematic drinking patterns. Choice D is incorrect as the patient has a history of alcohol abuse but currently abstains and seeks support through AA, indicating active efforts to maintain sobriety and reduce the risk of alcohol abuse.

Correct Answer: A

Rationale: The correct answer is A because prescribing antianxiety agents may mask the woman's grief instead of allowing her to process and work through it naturally. This could potentially prolong her grief by avoiding the necessary emotional processing. The other choices, B, C, and D, all involve support that can help the woman cope with her loss in a healthy way. B offers emotional support and companionship, C helps with practical tasks, and D provides assistance in managing practical matters, all of which can facilitate the grieving process rather than prolong it.

Correct Answer: D

Rationale: The correct answer is D: Ask clear, simple questions using concrete language. This strategy is most helpful because older adults with schizophrenia may have cognitive impairments that affect their ability to process complex information. Clear and simple questions using concrete language can help the patient understand and respond effectively. Choice A (Ask questions that can be answered with yes or no) limits communication and may not provide enough information for the nurse to assess the patient's condition comprehensively. Choice B (Use silence often and let the patient take the lead) may not be effective as the patient may struggle to communicate effectively due to cognitive impairments. Choice C (Use open-ended, indirect questions) may lead to confusion or misinterpretation for a patient with cognitive challenges.

Correct Answer: B

Rationale: The correct answer is B: Concrete operational. At this developmental level, children typically exhibit the ability to focus, coordinate, and imagine a series of events. This stage, according to Piaget's theory, usually occurs around ages 7 to 11. Children at this stage can perform logical operations, understand conservation, and think more systematically. A: Preoperational - Children at this stage (ages 2-7) lack the ability to perform logical operations and struggle with understanding conservation and cause-and-effect relationships. C: Formal operational - This stage (typically starting around age 11) involves abstract thinking, hypothetical reasoning, and problem-solving beyond the concrete level. D: Postoperational - This term is not a recognized developmental stage in Piaget's theory.

Correct Answer: B

Rationale: The correct answer is B because it shows empathy and encouragement for the patient to express their feelings. By asking what prompted the artwork, the nurse demonstrates understanding and willingness to explore the patient's emotions. Choice A is judgmental and dismissive, not fostering a therapeutic relationship. Choice C is directive and may pressure the patient. Choice D makes an assumption about the patient's emotions without allowing them to share their perspective.

Correct Answer: A

Rationale: The correct answer is A because the patient whose 16-year-old daughter was raped and killed while going on an errand for the patient is at highest risk for dysfunctional grief. This traumatic and unexpected loss of a child to a violent act can lead to complicated or prolonged grief reactions. The sudden and violent nature of the death, along with the added trauma of rape, can significantly impact the grieving process. The intense emotions and feelings of guilt, anger, and helplessness may complicate the bereavement process and lead to dysfunctional grief reactions. Summary: Choice B is incorrect because the death of an 86-year-old mother after a long illness, although sad, does not necessarily indicate a higher risk of dysfunctional grief. Choice C is incorrect as attending a support group and receiving assistance from hospice are positive factors that can support healthy grieving. Choice D is incorrect as attending a bereavement group and learning to express feelings after the deaths of twin daughters indicate active engagement in the grieving process, which is