The nurse reports to the interdisciplinary team that an antisocial patient lies to other patients, verbally abuses a patient with Alzheimer's disease, flatters his primary nurse, and is detached and superficial during counseling sessions. Which behavior should be the priority focus of limit setting?

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Health Care Utilization by Age Group Questions

Question 1 of 5

The nurse reports to the interdisciplinary team that an antisocial patient lies to other patients, verbally abuses a patient with Alzheimer's disease, flatters his primary nurse, and is detached and superficial during counseling sessions. Which behavior should be the priority focus of limit setting?

Correct Answer: C

Rationale: The priority focus of limit setting should be on verbally abusing other patients (Choice C) because it directly harms others and creates a hostile environment. This behavior is not only detrimental to the well-being of other patients but also disrupts the therapeutic milieu. Limiting this behavior is crucial to ensure the safety and emotional health of all patients in the care setting. Lying to other patients (Choice A), flattering the nursing staff (Choice B), and being superficial during counseling sessions (Choice D) are concerning behaviors as well, but they do not pose an immediate risk to the safety and well-being of others in the same way that verbal abuse does. It is important to address all inappropriate behaviors, but the priority should be given to the behavior that has the most significant negative impact on the therapeutic environment.

Question 2 of 5

A family has noted the following behaviors in one of their elderly parents: periodic indecisiveness, forgetfulness, mild transient confusion, occasional misperception, distractibility, and occasional unclear thinking. Where on the continuum of cognitive responses would this patient be?

Correct Answer: B

Rationale: The correct answer is B: At point 2. This patient's symptoms indicate mild cognitive impairment, which falls between normal age-related decline (point 1) and dementia (point 3). Mild cognitive impairment involves noticeable cognitive changes but does not significantly interfere with daily functioning. Point 1 is too mild for the symptoms described, and point 3 is too severe as the patient's symptoms are not indicative of full-blown dementia. Therefore, the patient is best placed at point 2 on the continuum of cognitive responses.

Question 3 of 5

The mother of a teen with an eating disorder tells the nurse, "Our family is pretty well adjusted. It's hard for me to imagine what we could have done to have this happen." The nurse can promote more complete understanding of the etiology of eating disorders by mentioning that young women are also influenced by:

Correct Answer: B

Rationale: The correct answer is B: the fashion industry's idealization of thinness. This is because the fashion industry often promotes thinness as the ideal body type, leading to societal pressure on young women to conform to this standard. This can contribute to the development of eating disorders as individuals may engage in unhealthy behaviors to achieve or maintain a thin body shape. A: the abundance of nutritious foods available - While access to nutritious foods is important for overall health, it does not directly influence the development of eating disorders. C: competition in the work place - While workplace competition may contribute to stress, it is not a primary factor in the development of eating disorders. D: the biologic tendency to be underweight - While genetic factors can play a role in susceptibility to eating disorders, it is not the primary influence in the development of these disorders in young women.

Question 4 of 5

The family of a client mentions to the nurse, 'The family therapist talked to us about enmeshment. We're not sure we understood what it meant.' The nurse should base a response on knowledge that an enmeshed family is a unit in which:

Correct Answer: B

Rationale: The correct answer is B: boundaries are poorly defined. In an enmeshed family, boundaries between family members are blurred, leading to a lack of individual autonomy and independence. Enmeshment can result in difficulties in establishing personal identities and healthy relationships. Choices A, C, and D are incorrect because individuality is not encouraged, conflict is not effectively resolved, and social acceptance is not necessarily deemed unimportant in an enmeshed family dynamic.

Question 5 of 5

Which measure is critical to achieving desired outcomes in the nurse-client relationship? The nurse:

Correct Answer: B

Rationale: The correct answer is B: uses autodiagnosis. Autodiagnosis is critical in the nurse-client relationship as it involves self-awareness and reflection by the nurse to understand their own biases, emotions, and reactions. This self-awareness allows the nurse to effectively manage their responses, maintain professionalism, and provide quality care to the client. By being aware of their own thoughts and feelings, nurses can better empathize with the client, build trust, and communicate effectively. This approach helps prevent potential conflicts and misunderstandings, leading to better outcomes in the nurse-client relationship. Summary: A: Developing trust in the client is important but not the most critical measure. C: Relying on the client liking the nurse is not professional and may compromise boundaries. D: Analyzing biologic, familial, and sociocultural factors is important but not as critical as self-awareness through autodiagnosis.

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