Question about maslow

  1. [color=#990000]question... i dont know if anyone has came across this before in the kaplan review book. on pg 85 the question says : a client with a hx of bipolar disorder is admitted to the psych hospital. she was found by the police attempting to climb onto the wing of a plane at the airport... her husband states she hasn't eaten or slept in 2 days and suspects she quit taking her meds. on admission, the nurse places highest priority on which of her needs? they leave you with 2 that dont make any sense... and then 2. provide the pt with a safe environment, and 3. arranging for food and rest for the patient... well according to kaplan they say that food/rest comes before safety, but wouldn't you first want to get the patient out of danger and make sure they are safe and then go ahead with food, fluids, rest, etc?


    im getting more and more confused as the days draw near! :/
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  2. 13 Comments

  3. by   elkpark
    As I recall, Maslow also said that physiological needs (oxygen, water, food, rest) come before safety needs, so that would be the "textbook" answer.

    I agree that many of the test questions can seem to come down to "hair-splitting," and sometimes you have to go with what you believe is the correct answer in the theoretical/"textbook" sense rather than what seems to make the most common sense.

    Besides, if you think about it, just the fact that she's been admitted to a psych unit means that she's already in a pretty safe environment without your even doing anything (a whole lot safer than the wing of an airplane! :chuckle )

    Best wishes on your exam --
  4. by   happylush
    Quote from elkpark
    As I recall, Maslow also said that physiological needs (oxygen, water, food, rest) come before safety needs, so that would be the "textbook" answer.

    I agree that many of the test questions can seem to come down to "hair-splitting," and sometimes you have to go with what you believe is the correct answer in the theoretical/"textbook" sense rather than what seems to make the most common sense.

    Besides, if you think about it, just the fact that she's been admitted to a psych unit means that she's already in a pretty safe environment without your even doing anything (a whole lot safer than the wing of an airplane! :chuckle )

    Best wishes on your exam --
    Thanks so much! I will just have to remember its not the " real world" and have to assume that unless it specifically states that the patient is still unsafe in the question, to assume otherwise and not read too much into the question. If I get questions like that on the test, obviously I know ABC's come first, and then maslow, which would be oxygen, food, water, rest, then safety....... does pain fall into that same category, or would food, fluid, rest come before, then safety, then pain? Sorry for all the questions !
  5. by   elkpark
    Since Maslow was mostly thinking of healthy people when he developed the needs hierarchy, pain isn't specifically included. I, personally, would include it under physiological needs, but other people might have different opinions about that. (Or, there may be a definitive answer about that out in the literature somewhere, that I don't know about. :chuckle )
  6. by   happylush
    lol just read your post from above...
    Thanks so much for your advice. I have to remember to keep my real world work separate from the test, and assume I have all the staff, supplies, etc by my side....
    Wish me luck
  7. by   happylush
    so, safety would be a top priority if it was an immediate threat, as in like a suicide attempt for example.... and pain management would fall under " immediate post-op priority" for example because electrolyte/fluid balance takes awhile to take effect, and the patient wouldn't eat/drink/etc if they were in pain.... am I correct?
  8. by   elkpark
    Remember that Maslow based his theories on healthy people out in the community -- when he talks about "safety" needs, he's talking about "safe" in the larger sense, as in stable community, functional family relationships, etc. Not "safety" as in "bleeding freely from both wrists at the moment" ... Any needs related to actually keeping the person physically alive would count as "physiological" in Maslow's terms. "Safety" needs would be outside issues like whether you're living in a war zone, whether you're in an abusive relationship, whether you're homeless and living on the street, whether the state police might break in at any moment and drag you off to prison for no reason, whether you're unable to exercise good judgment about whether your behaviors are dangerous or not because of mental illness (to refer back to your original example), that sort of thing ...

    So, I would say that actually climbing up on the wing of an airplane would count as a "physiological need" because she's actually putting herself in physiological danger at that time -- but, once she's down off the plane and in a psych unit (and therefore, presumably, out of immediate physical danger), her ongoing mental illness would be a "safety need" because she's unable to make good decisions about her behavior.

    Again, that's my best understanding as a psych CS -- if someone wants to correct me, that's fine.
  9. by   happylush
    Quote from elkpark
    Remember that Maslow based his theories on healthy people out in the community -- when he talks about "safety" needs, he's talking about "safe" in the larger sense, as in stable community, functional family relationships, etc. Not "safety" as in "bleeding freely from both wrists at the moment" ... Any needs related to actually keeping the person physically alive would count as "physiological" in Maslow's terms. "Safety" needs would be outside issues like whether you're living in a war zone, whether you're in an abusive relationship, whether you're homeless and living on the street, whether the state police might break in at any moment and drag you off to prison for no reason, whether you're unable to exercise good judgment about whether your behaviors are dangerous or not because of mental illness (to refer back to your original example), that sort of thing ...

    So, I would say that actually climbing up on the wing of an airplane would count as a "physiological need" because she's actually putting herself in physiological danger at that time -- but, once she's down off the plane and in a psych unit (and therefore, presumably, out of immediate physical danger), her ongoing mental illness would be a "safety need" because she's unable to make good decisions about her behavior.

    Again, that's my best understanding as a psych CS -- if someone wants to correct me, that's fine.
    Hmm, I think I am going to try not to read into the question too much... Because the question stated that she was admitted to the hosp, and her husband MADE the statement that she hadn't ate or slept in 2 days I am going to go with the fact that she is safe where she is, and rest/comfort/food would be a priority, because 2 days without any is a pretty long time. Now if I sat and thought about it, I would think that she still was not safe, being her mental state, and that she could possibly hurt herself in the hospital, but wouldn't that be reading into the question too much? I dunno... they say to go with the facts given and not to assume anything, even if what your assuming makes PERFECT sense, and thats what is confusing me!
  10. by   happylush
    Quote from happylush
    Hmm, I think I am going to try not to read into the question too much... Because the question stated that she was admitted to the hosp, and her husband MADE the statement that she hadn't ate or slept in 2 days I am going to go with the fact that she is safe where she is, and rest/comfort/food would be a priority, because 2 days without any is a pretty long time. Now if I sat and thought about it, I would think that she still was not safe, being her mental state, and that she could possibly hurt herself in the hospital, but wouldn't that be reading into the question too much? I dunno... they say to go with the facts given and not to assume anything, even if what your assuming makes PERFECT sense, and thats what is confusing me!
    Ok, now what about a question where it asks which patient would you attend to first? a guy that just had lasix and needs to pee, or a lady 2 days postop that is having pain? Do you assume you have all the staff there and can delegate someone to help the guy out while you as the RN go and assess the lady in pain, or do you just take the question as it is, and go help the guy first, since food/fluid/elimination is first according to maslow?
  11. by   happylush
    Quote from happylush
    Ok, now what about a question where it asks which patient would you attend to first? a guy that just had lasix and needs to pee, or a lady 2 days postop that is having pain? Do you assume you have all the staff there and can delegate someone to help the guy out while you as the RN go and assess the lady in pain, or do you just take the question as it is, and go help the guy first, since food/fluid/elimination is first according to maslow?
    Hmm, any takers?
    This question is still confusing me! LOL:uhoh21:
  12. by   chris_at_lucas_RN
    On the guy who needs to pee versus the lady in pain, take care of the pee problem first, but don't dawdle around, just give him the urinal and then get to the lady with the pain. Bladders can be damaged from being overfull, but a few more minutes before pain meds kick in is mostly just uncomfortable. We had this question on an Excelsior exam.

    On the lady with bipolar disorder, she's safe once she is on the psych unit.... Remember she's not on the plane anymore.

    Don't know if that helps. I find recalling Maslow and sticking with the hierarchy of needs is helpful, and also remembering ABC first--airway, breathing and circulation..... Nothing in there about food....

    Good luck!
  13. by   happylush
    Thanks chris! I am just getting confused because I keep thinking when they say " nclex is a perfect world" that you have the extra staff to bring the guy the urinal, etc while you attend/assess your patient in pain and that is why I am getting all confused!
  14. by   ADNCyn
    Hi...
    Last edit by ADNCyn on Jun 23, '04 : Reason: NEVERMIND!!!

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