A wife received news that her husband died of heart failure and called her family to come to the hospital. She angrily tells the nurse who cared for him, "He would still be alive if you had given him your undivided attention." Select the nurse's best intervention.

Correct Answer: A

Rationale: In this scenario, the correct intervention for the nurse is option A: Say to the wife, "I understand you are feeling upset. I will stay with you until your family comes." This response demonstrates empathy, active listening, and a commitment to providing emotional support to the grieving wife. Option B is not the best choice as it focuses on providing medical information rather than addressing the wife's emotional needs. Option C may escalate the situation by involving the healthcare provider without addressing the immediate emotional distress of the wife. Option D, while offering physical comfort, lacks verbal acknowledgment of the wife's emotional state and may not effectively address her need for emotional support in this moment of crisis. Educationally, this question highlights the importance of therapeutic communication and empathy in nursing practice, especially in sensitive and emotionally charged situations such as dealing with grief and loss. Nurses must prioritize emotional support and effective communication to build trust and rapport with patients and their families during times of distress. This intervention also aligns with the principles of patient-centered care, which emphasize holistic support for patients and their families.

Correct Answer: A

Rationale: Acute stress disorder, depersonalization disorder, and PTSD can involve dissociative elements, such as numbing, feeling unreal, and being amnesic for traumatic events. All three disorders are also responses to acute stress or trauma, which has occurred here. The distracters are disorders not evident in this patient's presentation. Generalized anxiety disorder involves extensive worrying that is disproportionate to the stressors or foci of the worrying. Reactive attachment disorder and disinhibited social engagement disorder are problems of childhood.

Correct Answer: D

Rationale: Illness anxiety disorder (hypochondriasis) involves preoccupation with fears of having a serious disease even when evidence to the contrary is available. The preoccupation causes impairment in social or occupational functioning. Somatic symptom disorder involves fewer symptoms. Dysthymic disorder is a disorder of lowered mood. Antisocial disorder applies to a personality disorder in which the individual has little regard for the rights of others. See relationship to audience response question.

Correct Answer: C

Rationale: Somatic symptom disorders are commonly associated with complicated reactions to stress. These reactions are accompanied by muscle tension and pain. Relaxation can diminish the patient's perceptions of pain and reduce muscle tension. The distracters are modalities useful in treating selected anxiety disorders.

Correct Answer: A

Rationale: In this scenario, the most appropriate type of therapy that might promote the greatest change in the adolescent's behavior is family therapy (Option A). Family therapy is designed to address issues within the family system, improve communication, and facilitate understanding among family members. In this case, the adolescent's behavior could be a result of feeling neglected and overshadowed by a sibling, leading to feelings of anger and acting out. Family therapy can help the adolescent and their parents explore and resolve these underlying issues, improve their relationships, and create a more supportive and nurturing environment for the adolescent. Bibliotherapy (Option B), play therapy (Option C), and art therapy (Option D) are valuable therapeutic approaches in different contexts, but they may not directly address the root cause of the adolescent's behavior as effectively as family therapy. Bibliotherapy involves using books to help individuals understand and cope with emotional issues, play therapy uses play to help children express their thoughts and emotions, and art therapy utilizes art as a means of communication and self-expression. While these therapies can be beneficial for emotional expression and coping skills development, they may not directly address the family dynamics and interpersonal relationships contributing to the adolescent's behavior in this specific case. Educationally, understanding the rationale behind choosing family therapy over other options is crucial for nurses specializing in behavioral health. It is essential for them to be able to identify the most appropriate therapeutic interventions based on the unique needs and circumstances of their patients. By recognizing the importance of family dynamics in influencing individual behavior, nurses can advocate for holistic and comprehensive treatment approaches that address not only the symptoms but also the underlying causes of behavioral issues.