Which person has the greatest potential for developing dysfunctional grief?

Correct Answer: D

Rationale: The person with the greatest potential for developing dysfunctional grief is an adult who has dealt with the loss of several family members over their lifetime. Losing multiple family members can create a cumulative effect, leading to unresolved grief and complicated bereavement reactions. These repeated losses can overwhelm an individual's coping mechanisms and increase the risk of developing dysfunctional grief patterns. The ongoing experience of loss and grief can make it challenging for the individual to process their emotions effectively and adjust to their new reality, potentially leading to prolonged and complicated mourning.

Correct Answer: B

Rationale: In this scenario, the correct answer is option B) Consistently offering praise. Operant conditioning involves modifying behavior through reinforcement or punishment. For a 6-year-old child, positive reinforcement in the form of praise is more effective than punishment. Praising the child for desired behaviors, such as completing puzzles, will increase the likelihood of them repeating those behaviors in the future. Option A) Periodically asking the child to attempt increasingly difficult puzzles may be a form of shaping behavior but lacks the immediate positive reinforcement that is crucial in operant conditioning for young children. Option C) Expecting the child to rinse and place their dirty dishes in the sink is not directly related to operant conditioning and does not provide clear reinforcement for the desired behavior. Option D) Conditioning the child to expect punishment when misbehaving is based on punishment rather than reinforcement, which is less effective in promoting positive behavior change, especially in young children. In an educational context, it is essential for nurses to understand the principles of behavior modification, such as operant conditioning, when caring for pediatric patients. By utilizing positive reinforcement strategies like offering praise, nurses can help promote desired behaviors and create a positive and supportive environment for children to learn and grow.

Correct Answer: B, C

Rationale: The correct answers are options B and C - the patient managing multiple sclerosis since age 30 and chronic Graves' disease for 36 years. These conditions support the immunologic theory of aging, which posits that age-related changes in the immune system contribute to the aging process. In multiple sclerosis, the immune system attacks the central nervous system, leading to inflammation and nerve damage. This chronic autoimmune condition reflects dysregulation of the immune system, a key aspect of the immunologic theory of aging. Similarly, Graves' disease is an autoimmune disorder where the immune system mistakenly attacks the thyroid gland, causing hyperthyroidism. The prolonged immune system activation in chronic Graves' disease aligns with the concept of immune dysregulation associated with aging. Option A, having type 2 diabetes at age 64, does not directly relate to the immunologic theory of aging. While diabetes can have immune system implications, it is primarily characterized by metabolic dysregulation rather than immune system dysregulation. Option D, experiencing symptoms of rheumatoid arthritis, involves autoimmune processes but does not directly align with the immunologic theory of aging, which focuses on broader immune system changes associated with aging rather than specific autoimmune diseases. In an educational context, understanding how chronic autoimmune conditions like multiple sclerosis and Graves' disease relate to the immunologic theory of aging can help students grasp the complex interplay between the immune system and aging processes, highlighting the importance of immune system health in overall aging outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Examine interventions for possible revision of the target date. The rationale behind this choice is to ensure that the patient's care plan is effective in addressing the desired outcome of achieving a minimum of 5 hours of sleep nightly. By reviewing the patient's sleep data and considering the fact that they are taking a 2-hour afternoon nap, it is evident that the current plan may not be sufficient in meeting the desired goal. Option A) Continuing the current plan without changes may not lead to the desired outcome as the patient is not meeting the sleep goal. Option B) Removing the nursing diagnosis from the plan of care without addressing the issue would neglect the patient's needs. Option C) Writing a new nursing diagnosis may not be necessary if the current diagnosis is still relevant and the issue lies in the effectiveness of the interventions. Educationally, this question highlights the importance of continuous evaluation and adjustment of care plans based on patient responses and data. It emphasizes the need for critical thinking and flexibility in nursing practice to ensure optimal patient outcomes.

Correct Answer: C

Rationale: In this scenario, the correct initial nursing intervention for a 34-year-old male with catatonic schizophrenia who has been mute and motionless for several days is to establish a nonthreatening relationship (Option C). This is the most appropriate choice because individuals with catatonic schizophrenia may be experiencing extreme withdrawal and communication difficulties, and establishing a trusting and nonthreatening relationship can help create a sense of safety and security for the patient. Option A, orienting the patient to the unit, may not be the most immediate priority as the patient's primary need at this stage is to establish a connection before introducing new information. Option B, reinforcing reality with the patient, may not be effective initially as the individual may not be in a state where they can readily comprehend or engage with external stimuli. Administering prescribed medications or interventions (Option D) is important in the overall management of catatonic schizophrenia; however, in this case, establishing a relationship to assess the patient's current state and needs is the most critical first step before proceeding with medical interventions. Educationally, this question highlights the importance of therapeutic communication and relationship-building in psychiatric nursing. It emphasizes the need to prioritize interventions based on the individual's current presentation and needs, considering their unique symptoms and condition. Understanding the rationale behind each option enhances a nurse's ability to provide patient-centered care in mental health settings.