During a grief-processing group, an elderly patient stated, “For the first time since my husband died, I’m having more good days than bad.” This statement suggests that the patient has:

Correct Answer: C

Rationale: The correct answer is C: Completed her "grief work" successfully. This statement indicates progress in the grieving process, moving towards acceptance and healing. The patient acknowledging having more good days than bad reflects a positive shift in coping with the loss, indicating that she has processed her grief and is beginning to adapt to life without her husband. This suggests that the patient has worked through her emotions, memories, and adjustments related to the loss, reaching a point where she is experiencing more peace and acceptance. Summary: A: Reestablishment is not the correct choice as it does not specifically address the completion of the grief work. B: Determining readiness to terminate the support group is premature, as the patient may still benefit from continued support. D: Replacing old memories with new ones is not supported by the patient's statement and does not necessarily indicate successful grief processing.

Correct Answer: D

Rationale: The correct answer is D because the DSM-IV-TR criteria for moderate mental retardation includes an IQ range of 35-49, which typically corresponds to functioning at around the level of a 6 to 9-year-old. Choice D best fits this criteria as the individual has advanced to the sixth grade level academically, indicating a level of functioning consistent with moderate mental retardation. Choices A, B, and C do not meet the criteria as they suggest a higher level of functioning and independence than what is typically associated with moderate mental retardation.

Correct Answer: B

Rationale: Correct Answer: B (Shock and disbelief) Rationale: 1. The wife's blank stare and statement "It can’t be" suggest a state of disbelief and being stunned by the news of her husband's death, indicating shock. 2. Shock is a common initial reaction to unexpected and distressing events, such as the sudden death of a loved one. 3. This choice is the most fitting based on the wife's reaction of disbelief and being unable to accept the reality of the situation. Summary: A: Despair and protest - Despair involves a sense of hopelessness, not evident in the wife's initial reaction. Protest implies a more active response, while the wife's reaction is passive. C: Anger and hostility - There is no indication of anger or hostility in the wife's initial response; rather, it is characterized by disbelief. D: Disorganization and confusion - While the wife may feel disorganized and confused later, her initial response reflects more shock and disbelief than disorganization

Correct Answer: A

Rationale: The correct answer is A: Ambivalence and low self-esteem. The member's statement reflects conflicting emotions (ambivalence) about her worth compared to her husband's. This indicates low self-esteem, as she believes she is less valuable. Unresolved anger (B) would involve blaming her husband, not herself. A need for attention (C) is not evident, as she is sharing personal feelings. Depression (D) may be present, but the statement specifically points to self-deprecation, not just a general feeling of sadness.

Correct Answer: B

Rationale: The correct answer is B because it shows empathy and active listening. By encouraging the patient to share their feelings, the nurse validates their emotions and builds a therapeutic relationship. This approach helps the nurse understand the patient's perspective and provides an opportunity for emotional support. Choice A does not actively invite the patient to share their feelings and may come off as dismissive. Choice C ignores the patient's emotional distress and may seem invalidating. Choice D, while positive, fails to address the patient's emotional concerns and misses an opportunity for meaningful communication.

Correct Answer: B

Rationale: The correct answer is B: Older adults. OBRA primarily focuses on setting standards of care for older adults in long-term care facilities, ensuring their safety and well-being. This is because older adults are a vulnerable population requiring specialized care and attention. Choices A, C, and D are incorrect because OBRA does not specifically address very young individuals, those with intellectual communication difficulties, or individuals without medical insurance. The Act mainly pertains to the care and rights of older adults in long-term care settings.

Correct Answer: D

Rationale: The correct answer is D because evaluating patient behaviors to reward economic tokens appropriately is a key aspect of behavioral therapy. By assessing and reinforcing positive behaviors with rewards, nurses can encourage patients to continue working towards their therapy goals. Administering medications accurately (choice A) is important but not directly related to behavioral therapy goals. Interacting effectively with the health care team (choice B) is important for overall patient care but does not specifically address behavioral therapy. Being aware of therapeutic modalities (choice C) is important but does not directly contribute to implementing behavioral therapy goals like choice D does.

Correct Answer: C

Rationale: The correct answer is C: Completed her "grief work" successfully. This statement indicates progress in the grieving process, moving towards acceptance and healing. The patient acknowledging having more good days than bad reflects a positive shift in coping with the loss, indicating that she has processed her grief and is beginning to adapt to life without her husband. This suggests that the patient has worked through her emotions, memories, and adjustments related to the loss, reaching a point where she is experiencing more peace and acceptance. Summary: A: Reestablishment is not the correct choice as it does not specifically address the completion of the grief work. B: Determining readiness to terminate the support group is premature, as the patient may still benefit from continued support. D: Replacing old memories with new ones is not supported by the patient's statement and does not necessarily indicate successful grief processing.

Correct Answer: C

Rationale: The correct answer is C: Sometimes demonstrated. The rationale is that the patient is not consistently meeting the desired outcome of sleeping for a minimum of 5 hours nightly within 7 days. Although the patient is sleeping for an average of 4 hours nightly, the 2-hour afternoon nap indicates that the patient is not achieving the desired outcome consistently. Therefore, the nurse would document the outcome as "Sometimes demonstrated" to reflect that the patient is making progress towards the goal but has not fully achieved it. Choices A, B, and D are incorrect because the patient's sleep behavior does not align with being consistently, often, or never demonstrated based on the desired outcome criteria.