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A patient in an abusive relationship is hospitalized with abdominal and head trauma caused by their partner. The partner sends flowers to the patient and pizzas for all the staff. Via video chat, the partner tearfully begs the patient to forgive them and not press charges. The partner states, “I just want you, me, and the kids to be together. You know you do too.” What conclusions can the nurse make about this scenario? (Select All That Apply)

The patient’s partner’s act of sending flowers is an example of undoing.

The patient and partner are in the honeymoon phase of intimate partner violence.

The patient has a submissive personality and depression.

Since the injuries have caused hospitalization, the patient will end the relationship.

The partner may be trying to manipulate the staff by buying pizza.

Answer and Explanation

Correct Answer : A,B,E

The correct answer is a, b, and e.

Choice A Reason:

The patient’s partner’s act of sending flowers is an example of undoing. Undoing is a defense mechanism where a person tries to cancel out or remove an unhealthy, destructive, or otherwise threatening thought or action by engaging in contrary behavior. In this case, the partner is attempting to make amends for the abuse by sending flowers, which is a common tactic used by abusers to mitigate their guilt and manipulate the victim into forgiving them.

Choice B Reason:

The patient and partner are in the honeymoon phase of intimate partner violence. The cycle of abuse in intimate partner violence typically includes a honeymoon phase, where the abuser may apologize, show remorse, and promise to change. This phase often involves gestures of affection and kindness, such as sending flowers or gifts, to win back the victim’s trust and prevent them from leaving.

Choice C Reason:

The patient has a submissive personality and depression. While it is possible that the patient may have a submissive personality and depression, this conclusion cannot be definitively made based on the given scenario alone. Submissive personality traits and depression are complex and require thorough psychological evaluation to diagnose accurately.

Choice D Reason:

Since the injuries have caused hospitalization, the patient will end the relationship. This conclusion is not necessarily accurate. Victims of intimate partner violence often face significant psychological, emotional, and practical barriers to leaving an abusive relationship, even after severe incidents that result in hospitalization. The decision to leave an abusive relationship is influenced by various factors, including fear, financial dependence, emotional attachment, and lack of support.

Choice E Reason:

The partner may be trying to manipulate the staff by buying pizza. Manipulative behavior is common in abusive relationships. By buying pizza for the staff, the partner may be attempting to create a favorable impression and gain sympathy, which can influence the staff’s perception of the situation and potentially affect their support for the patient.

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Correct Answer is C

Explanation

Conduct Disorder

Choice A Reason: Childhood Depression

Childhood depression is a mood disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest in activities. Symptoms can include changes in appetite, sleep disturbances, and difficulty concentrating. While depression can lead to behavioral issues, it is less likely to be associated with the specific behaviors described in the scenario, such as running away and being abusive towards parents. These behaviors are more indicative of a disruptive behavior disorder rather than a mood disorder.

Choice B Reason: Oppositional Defiant Disorder

Oppositional Defiant Disorder (ODD) is characterized by a pattern of angry, irritable mood, argumentative/defiant behavior, or vindictiveness. Children with ODD often lose their temper, argue with adults, and refuse to comply with rules. While ODD can involve some of the behaviors described, such as being abusive towards parents, it typically does not include the more severe behaviors like running away or engaging in illegal activities such as prostitution. Therefore, ODD is not the most fitting diagnosis in this case.

Choice C Reason: Conduct Disorder

Conduct Disorder is a more severe behavioral disorder characterized by a repetitive and persistent pattern of behavior that violates the rights of others or major age-appropriate societal norms or rules. Symptoms include aggression towards people and animals, destruction of property, deceitfulness or theft, and serious violations of rules, such as running away from home and engaging in illegal activities like prostitution. Given the behaviors described in the scenario, Conduct Disorder is the most appropriate diagnosis. Adolescents with Conduct Disorder often exhibit a lack of remorse or guilt and may have a history of problematic behaviors that escalate over time.

Choice D Reason: Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a developmental disorder characterized by difficulties with social interaction, communication, and repetitive behaviors. While individuals with ASD may exhibit challenging behaviors, these are typically related to difficulties in understanding social norms and communication rather than intentional defiance or rule-breaking. The behaviors described in the scenario, such as running away and engaging in prostitution, are not characteristic of ASD, making it an unlikely diagnosis in this context.

Correct Answer is ["125"]

Explanation

Calculation Steps

Step 1: Convert 1 liter to milliliters (mL).

1 liter = 1000 mL

Result: 1000 mL

Step 2: Determine the total time in hours.

Total time = 8 hours

Result: 8 hours

Step 3: Calculate the infusion rate in milliliters per hour (mL/hr).

Infusion rate = Total volume (mL) ÷ Total time (hours)

Step 4: Perform the division.

1000 mL ÷ 8 hours = 125 mL/hr

Result: 125 mL/hr

Therefore, the nurse should set the infusion pump to 125 mL/hr.

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Naxlex Comprehensive Predictor Exams

A fifteen-year-old was referred to the adolescent mental health clinic after being arrested for prostitution. The client’s parents reported that they have run away several times and are abusive towards them. The nurse should anticipate that the diagnosis will be:

Correct Answer is C

Explanation

One liter of normal saline is to infuse over 8 hours. At what rate will the nurse set the infusion pump?

Correct Answer is ["125"]

Explanation

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