An 80-year-old woman who lives alone has begun calling friends ...

[jasdeep_brar]

An 80-year-old woman who lives alone has begun calling friends and complaining in an exaggerated
  fashion about minor aches and pains.
 
  Her physician found no significant medical problems. Over the
  course of a month, she obtained a number of prescriptions for pain medication, none of which
  seemed to be effective. Friends counseled her that aches are a normal part of life for the elderly and
  tried unsuccessfully to involve her in activities. She often suggested that she would be better off
  dead, to which one friend responded Well, perhaps. It would get you out of your misery.. As she
  became increasingly needy and demanding of attention, friends agreed that her behavior made
  them uncomfortable and began to call and visit less. The woman took four pain pills and called a
  neighbor, saying she had overdosed. After medical clearance, the client will be monitored at the
  mental health clinic. Nursing interventions that have been agreed on for the client include hope
  instillation, coping enhancement, and support system enhancement. Measures designed to enhance
  the client's support system include (more than one answer may be correct)
  A. providing services in a caring manner.
  B. providing a referral to a self-help group.
  C. teaching cognitive restructuring.
  D. encouraging relationships with friends.
  E. identifying areas of hope in life.
  F. arranging situations that foster autonomy.

Question 2

The nurse at the clinic is interviewing a client who offers a number of vague somatic complaints that
  might not ordinarily prompt a visit to a caregiver, such as fatigue, back pain, headaches, and sleep
  disturbance.
 
  The client seems tense, and after having spoken of her symptoms seems reluctant to
  provide more information and is in a hurry to leave. The nurse can best serve the client by
  a. asking if the client has ever had psychiatric counseling.
  b. having the client fill out an abuse assessment screen.
  c. exploring the possibility of client social isolation.
  d. asking the client to disrobe so the nurse can look for signs of physical abuse.

[batool]

Answer to Question 1

A, B, D
Rationale: These options are relevant to support system enhancement. Option C relates to changing
faulty cognitive patterns. Option E relates to hope instillation. Option F relates to coping
enhancement.

Answer to Question 2

B
In this situation the nurse should consider the possibility that the client is a victim of domestic
violence. Although the client is reluctant to discuss issues, she may be willing to fill out an abuse
assessment screen, which would then open the door to discussion. Option A is prejudicial. Option C
is only one area for assessment and may be seen by the client as irrelevant and increase her
reluctance to disclose. Option D will be threatening to the client and probably be met with refusal.