A Native American client describes having difficulty learning as ...

[KimWrice]

A Native American client describes having difficulty learning as a child, living on a reservation, and
  being sent away to the Native American boarding school.
 
  He began to use alcohol as a teenager to
  feel euphoria and escape the feelings of isolation. As an adult he states he feels stupid and good for
  nothing.. Gastritis forced him to give up drinking 10 years ago. Recently, he has found some
  comfort in tribal rituals. In planning care for this client the nurse should realize that he should be
  offered a program based on
  a. treatment for both depression and alcohol abuse.
  b. group discussion of posttraumatic stress disorder.
  c. holistic principles.
  d. psychoanalysis.

Question 2

The nurse assessing a client with a somatoform disorder is most likely to note that the client
 
  a. readily sees a relation between symptoms and interpersonal conflicts.
  b. rarely derives personal benefit from the symptoms.
  c. has little difficulty communicating emotional needs.
  d. has altered comfort and activity needs.

[laurnthompson]

Answer to Question 1

ANS: C
Native Americans, because of their beliefs in the interrelatedness of parts and about being in
harmony with nature, respond best to a holistic approach. Option A: No data are present to support
dual diagnosis because the client has resolved the problem of excessive alcohol use. Option B: No
data are present to support a diagnosis of posttraumatic stress disorder. Option D: Psychoanalysis is
a long-term therapy that is very expensive. Cognitive therapy might be a better choice.

Answer to Question 2

ANS: D
The client frequently has altered comfort and activity needs associated with the symptoms he or she
displays (fatigue, insomnia, weakness, tension, pain, etc.). In addition, hygiene, safety, and security
needs may also be compromised. Option A: The client is rarely able to see a relation between
symptoms and events in his or her life, which is readily discernable to health professionals. Option
B: Clients with somatoform disorders often derive secondary gain from their symptoms. Option C:
Clients with somatoform disorders have considerable difficulty identifying feelings and conveying
emotional needs to others.