An 82-year-old widow with Alzheimer's disease lives with her daughter's family, which owns a catering business. During the week, the patient attends a day care center for patients with dementia. During the evenings, members of the family care for the patient. One day, the nurse at the day care center notices the patient's appearance is disheveled and that she startles easily. She has a strong odor of urine, and her hair is uncombed. When the nurse escorts the patient to the bathroom, she notices bruises on her wrists and back. What most likely explains the nurse's observations?

Correct Answer: A

Rationale: The correct answer is A: The patient is being neglected and abused within the family. The nurse's observations of the patient's disheveled appearance, strong odor of urine, uncombed hair, and bruises indicate signs of neglect and abuse. Here's the rationale: 1. Disheveled appearance and strong odor of urine suggest lack of personal care. 2. Uncombed hair signals neglect in grooming. 3. Bruises on wrists and back are indicative of physical abuse. 4. Startling easily may be due to fear or anxiety from abuse. In summary, the other choices (B, C, D) are incorrect because they do not account for the combination of neglect, poor hygiene, and physical injuries seen in the patient, which are more indicative of abuse and neglect within the family.

Correct Answer: A

Rationale: The correct answer is A: The acute phase reaction. This behavior is characteristic of the immediate emotional response following a traumatic event like sexual assault. The victim may exhibit shock, disbelief, and emotional distress. In this scenario, the victim's reaction of disbelief and repetitive statements align with the acute phase reaction. The other options are incorrect because the angry stage (B) and delayed reaction (C) occur later in the trauma response process, while the long-term phase (D) reflects a more prolonged period of adjustment and coping.

Correct Answer: A

Rationale: The correct answer is A: The need for the batterer to control. This is the key component in wife battering, as it is rooted in the batterer's desire to establish power and dominance over their partner. Teaching batterers more effective ways to cope involves addressing this underlying need for control. Explanation of other choices: B: Alcohol abuse by the batterer - While alcohol abuse may exacerbate violent behavior, it is not the primary cause of wife battering. C: History of psychotic behavior - Psychotic behavior may contribute to violence, but it is not the key component in wife battering. D: Failure of the woman to assert herself - Blaming the victim is not appropriate; the responsibility lies with the batterer's need for control.

Correct Answer: A

Rationale: The correct answer is A because using open-ended questions allows the client to express themselves freely, promoting a sense of control and empowerment. This approach helps build trust and rapport, enabling the client to share their experiences more openly. Choice B is incorrect because closed-ended questions limit the client's ability to fully express themselves. Choice C is incorrect as open-ended questions encourage deeper reflection and discussion, which may not be easily understood by anxious individuals. Choice D is incorrect because while clients can refuse to answer sensitive questions, open-ended questions actually encourage them to share more, rather than withhold information.

Correct Answer: C

Rationale: The correct answer is C because normal pressure hydrocephalus (NPH) symptoms typically improve after a shunt is inserted to drain the excess cerebrospinal fluid, leading to a better prognosis. This intervention can help alleviate symptoms such as gait disturbances, cognitive impairment, and urinary incontinence associated with NPH. Choice A is incorrect as it inaccurately states that the prognosis is inevitably poor, which is not true for NPH with appropriate treatment. Choice B is incorrect because NPH symptoms can be effectively managed with treatment, so it is not accurate to say that there will always be good and bad days for the rest of the client's life. Choice D is incorrect as it does not provide specific information about the positive impact of shunt insertion on NPH symptoms and prognosis.