A rape victim visited a rape crisis counselor... Which comment best demonstrates reorganization was successful?

Correct Answer: C

Rationale: The correct answer is option C, "I’m sleeping better although I still have an occasional nightmare." This response demonstrates successful reorganization after the rape incident. It indicates progress in coping with the trauma as the individual is experiencing improved sleep, despite occasional nightmares, which is a common symptom following a traumatic event. This statement shows resilience and adaptation to the situation. Option A talks about a rash on the buttocks, which is not related to successful reorganization after a traumatic event and does not address the emotional impact of the assault. Option B mentioning triggering the attack implies self-blame, which is not indicative of successful reorganization. It suggests the individual is attributing fault to themselves for the assault, which is counterproductive in the healing process. Option D focuses on weight loss, which is unrelated to the emotional recovery process from a traumatic experience like rape. It does not provide any insight into the individual's emotional well-being or progress in coping with the aftermath of the assault. In an educational context, this question assesses the understanding of successful reorganization and coping mechanisms in psychiatric emergency nursing. It highlights the importance of recognizing positive signs of recovery and resilience in individuals who have experienced traumatic events such as rape. It also emphasizes the need for sensitive and supportive care for survivors of sexual assault in a psychiatric emergency setting.

Correct Answer: B

Rationale: In a psychiatric emergency involving an unconscious teenager, the priority action by the nurse should focus on maintaining physiologic stability, which is option B. This is the correct answer because ensuring the teenager's physiological stability is crucial for their immediate well-being and survival. Physiological stability encompasses monitoring vital signs, ensuring adequate oxygenation, and addressing any life-threatening issues promptly. Option A, preserving rape evidence, while important in cases of sexual assault, is not the priority in this scenario where the teenager's life is at immediate risk. Option C, determining what drugs were ingested, is also important but not the priority when the patient is unconscious and in need of stabilization. Option D, obtaining a description of the rape from a friend, is not a priority as the focus should be on the teenager's physiological needs first. In an educational context, it is essential for nurses to prioritize actions based on the urgency of the situation. Understanding the principles of emergency care and triage is fundamental for nurses working in psychiatric or any other healthcare setting to provide safe and effective care to patients in critical conditions. By prioritizing physiological stability, nurses can ensure the best possible outcomes for their patients in emergency situations.

Correct Answer: A

Rationale: In the context of a psychiatric emergency in the emergency department, the correct answer is A) Camera. The rationale behind this is that a camera would be essential for documenting any physical injuries or evidence of trauma on the patient's body. This documentation is crucial for legal and medical purposes, as well as for continuity of care. The incorrect options are B) Body map, C) DNA swabs, and D) Pulse oximeter. A body map is not as essential in an acute psychiatric emergency situation as immediate visual documentation with a camera. DNA swabs are not typically needed in a psychiatric emergency unless there is a specific legal or forensic requirement. A pulse oximeter, while useful in assessing vital signs, is not directly related to documenting physical evidence in a psychiatric emergency. In an educational context, understanding the rationale behind the need for specific equipment in different clinical situations is crucial for nurses to provide effective and comprehensive care. By knowing why certain equipment is necessary, nurses can prioritize their interventions and ensure they are meeting the needs of the patient in that particular scenario.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Cocaine. When assessing a patient in a psychiatric emergency with symptoms like abdominal pain, restlessness, irritability, and malnourishment, it is crucial to consider substance abuse as a potential cause. Cocaine is a stimulant drug that can cause abdominal pain, restlessness, and irritability, aligning with the patient's presentation. Alcohol (option A) could also cause abdominal pain and behavioral changes, but in this case, the patient's symptoms are more indicative of stimulant use rather than alcohol intoxication. Amphetamines (option B) can present similarly to cocaine but are less commonly associated with abdominal pain specifically. Cannabis (option C) is unlikely to cause the symptoms described in the scenario. Educationally, this question highlights the importance of considering substance abuse in psychiatric emergencies and the need to differentiate between various substances based on their effects and presentation. Understanding the signs and symptoms of different substances can help nurses provide appropriate care and interventions for patients presenting with similar complaints.

Correct Answer: A

Rationale: In this scenario, the most appropriate test to confirm Helicobacter pylori eradication in a 48-year-old man with a history of duodenal ulcer and prior treatment is option A) C13 urea breath test. This test is considered the gold standard for confirming eradication as it directly detects the presence of active H. pylori infection. The C13 urea breath test is non-invasive, accurate, and has high sensitivity and specificity. Option B) Faecal Helicobacter antigen is not the best choice in this case as it is more useful for diagnosing current H. pylori infection rather than confirming eradication after treatment. Option C) Gastric aspirate urease test is invasive and less commonly used in clinical practice due to its discomfort and inconvenience. Option D) Helicobacter pylori serology can detect antibodies to H. pylori, but it may remain positive even after successful eradication, leading to false-positive results. From an educational perspective, it is important for nurses and healthcare providers to understand the rationale behind selecting the appropriate diagnostic test based on the clinical scenario, patient history, and treatment context. By choosing the C13 urea breath test in this case, healthcare professionals can accurately confirm the eradication of H. pylori infection and guide further management decisions effectively.