A woman who is a victim of severe emotional violence tells the nurse that her husband abuses her most often when he is intoxicated, just as his father had beaten him and his mother. The woman is aware of the location of a safe house and has considered leaving home with her two children, but she cites being brought up to believe 'you keep quiet and stay together, no matter what happens.' She states the husband is always apologetic and remorseful after an incident. The nurse responds, 'You cannot live like this; you have to defend yourself and your children.' Which statement most accurately describes the nurse's response?

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Question 1 of 5

A woman who is a victim of severe emotional violence tells the nurse that her husband abuses her most often when he is intoxicated, just as his father had beaten him and his mother. The woman is aware of the location of a safe house and has considered leaving home with her two children, but she cites being brought up to believe 'you keep quiet and stay together, no matter what happens.' She states the husband is always apologetic and remorseful after an incident. The nurse responds, 'You cannot live like this; you have to defend yourself and your children.' Which statement most accurately describes the nurse's response?

Correct Answer: D

Rationale: The correct answer is D because the nurse's response is not helpful. Here's a step-by-step rationale: 1. The nurse's response is human because she empathizes with the woman's situation. 2. However, the response is unprofessional as it is too directive and lacks a proper assessment or exploration of the woman's feelings and options. 3. Telling the woman to defend herself may put her at further risk and does not address the underlying issues of abuse and trauma. 4. The response fails to consider the complexities of the woman's situation, such as her cultural beliefs and the cycle of violence she is caught in. 5. Instead, a professional response would involve a more holistic approach, including safety planning, providing resources, and offering support without judgment or pressure.

Question 2 of 5

A catatonic patient admitted in a stuporous condition begins to demonstrate increased motor activity. During his assessment, the psychiatrist raises the patient's arm above his head and releases it. The patient maintains the position his arm was placed in, immobile in that position for 15 minutes, moving only when the nurse gently lowers his arm. What symptom is demonstrated by this assessment technique?

Correct Answer: B

Rationale: The correct answer is B: Waxy flexibility. This symptom is demonstrated by the patient's ability to maintain the position his arm was placed in, immobile, for an extended period of time. This is characteristic of catatonia, where individuals exhibit increased motor activity and abnormal posturing. Waxy flexibility refers to the tendency of catatonic patients to maintain positions that they are placed in by others, almost as if their limbs are made of wax and can be molded into different positions. Explanation for other choices: A: Echopraxia involves mimicking the movements of others, which is not demonstrated in this scenario. C: Depersonalization refers to feeling detached from oneself, which is not evident in the patient's behavior during the assessment. D: Thought withdrawal is a symptom of schizophrenia where thoughts are believed to be removed from one's mind by an external force, which is not relevant to the patient's motor behavior in this case.

Question 3 of 5

A male patient diagnosed with paranoid schizophrenia typically relates effectively with female staff but angrily tells the male nurse, 'You act like a homosexual. None of the men trust you or want to be around you.' The nurse, who is heterosexual, is perplexed by the patient's statements and discusses the event with his mentor. Which explanation most likely underlies the patient's behavior?

Correct Answer: D

Rationale: The correct answer is D because the patient is exhibiting the defense mechanism of projection by attributing his own uncomfortable feelings (homosexual urges) to the nurse. This defense mechanism allows the patient to disown his feelings and project them onto others. This behavior is common in individuals struggling with their own conflicting desires or impulses. Incorrect choices: A: Unconscious hostile feelings are not necessarily the root cause in this scenario. B: The patient's behavior is not about preemptively rejecting the nurse due to fear of rejection. C: While emotional intimacy may play a role, the patient's behavior is more about projection of his own feelings onto the nurse rather than distancing himself.

Question 4 of 5

A woman has been severely beaten by her husband, has no relatives or friends in the community, is afraid to return home, has no financial resources of her own, and has no job skills. Which would be the most important referral for the nurse to make?

Correct Answer: D

Rationale: The correct answer is D: Safe house or shelter. This option is the most important referral because the woman is in immediate danger and needs a safe place to stay away from her abusive husband. It prioritizes her safety and well-being. Referring her to a safe house can provide her with protection, resources, and support to help her escape the abusive situation. Choice A (Community food cupboard) is incorrect as it does not address the woman's immediate safety needs. Choice B (Vocational counseling) is also not the most urgent referral in this situation as the woman's safety should be the priority. Choice C (Law enforcement) might be necessary in the long run, but the immediate concern is ensuring the woman's safety by referring her to a safe house or shelter.

Question 5 of 5

A rape victim tells the nurse, "I should not have been out on the street alone." Select the nurse's most helpful response.

Correct Answer: D

Rationale: The correct answer is D because it acknowledges the victim's feelings without placing blame or judgment. By reflecting the victim's feelings back to them, the nurse validates their experience and shows empathy. This response encourages the victim to express their emotions and helps in building trust with the nurse. Other choices are incorrect: A: This choice does not address the victim's feelings of self-blame and does not provide the needed support. B: While this choice acknowledges the negative impact of self-blame, it does not directly address the victim's statement. C: This choice may be perceived as dismissive or blaming, which can further harm the victim's emotional well-being.

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