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A 70-year-old woman is beginning to notice mild memory impairment. She fears she is developing dementia. What is the most likely cause of her memory impairment?
- A. Normal aging.
- B. Alzheimer's disease.
- C. Depression.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Alzheimer's disease. This is the most likely cause of memory impairment in a 70-year-old woman experiencing mild memory issues. Alzheimer's disease is a progressive neurodegenerative disorder that affects memory, thinking, and behavior. It is the most common cause of dementia in older adults. Normal aging (choice A) typically involves some mild memory decline, but significant impairment is not considered a normal part of aging. Depression (choice C) can also impact memory, but in this case, the woman's primary concern is memory impairment, not depressive symptoms. Choice D is incorrect as Alzheimer's disease is a possible explanation for her memory issues.
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A 72-year-old patient has the medical diagnosis of delirium secondary to anticholinergic medication toxicity. Family members are very anxious and express their concerns about the patient's condition. What information should serve as the basis for the nurse's reply?
- A. Provide education and information regarding the medical diagnosis, delirium secondary to anticholinergic medication toxicity.
- B. Reassure the family that the patient will recover fully.
- C. Suggest that the family consider nursing home placement.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A. The nurse should provide education and information about the medical diagnosis, delirium secondary to anticholinergic medication toxicity. This is important because it helps the family understand the condition, its causes, symptoms, and treatment. By educating the family, they can better support the patient and be involved in the care plan.
Choice B is incorrect because it provides false reassurance without addressing the underlying issue or providing necessary information.
Choice C is incorrect because suggesting nursing home placement is premature and not based on the patient's current condition or needs.
Therefore, the best approach is to choose option A to empower the family with knowledge and understanding to better assist the patient.
A nurse observes a patient who is sitting alone in a room put hands over both ears and vigorously shake her head as though saying, 'No.' Later the patient cries and mutters, 'You don't know what you're talking about! Leave me alone.' What assessment should the nurse attempt to validate?
- A. The patient is seeking the attention of staff.
- B. The patient is inappropriately expressing emotion.
- C. The patient is experiencing auditory hallucinations.
- D. The patient is displaying negative symptoms of schizophrenia.
Correct Answer: C
Rationale: The correct answer is C: The patient is experiencing auditory hallucinations. The patient's behavior of covering both ears and shaking her head as if responding to voices, along with muttering and crying, suggests a sensory perception that is not based on external stimuli. This aligns with the characteristic symptoms of auditory hallucinations, which are common in conditions like schizophrenia.
Choice A is incorrect because the patient's behavior is not necessarily seeking attention but rather responding to internal stimuli. Choice B is incorrect as the patient's emotional expression seems to be a result of the auditory hallucinations rather than being inappropriate. Choice D is incorrect as negative symptoms of schizophrenia typically involve a decrease or absence of normal functions, which is not clearly demonstrated in this scenario.
Which statement by a patient with an eating disorder reflects a correct understanding of the condition?
- A. Gaining 1 pound is as much of a disaster as gaining 100 pounds.
- B. I was happy when I was a size 4, so I must diet to that size.
- C. I've been coping with my feelings by overeating.
- D. Binging is the only way I can soothe myself.
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the emotional aspect of eating disorders. Coping with feelings by overeating indicates insight into using food to manage emotions, a common characteristic of eating disorders. This understanding is crucial for addressing the underlying issues contributing to the disorder.
A: Incorrect. This statement suggests an extreme and distorted view of weight gain, which is not reflective of a healthy understanding of an eating disorder.
B: Incorrect. This statement implies a fixation on a specific size for happiness, which may perpetuate disordered eating behaviors.
D: Incorrect. This statement indicates reliance on binging as the sole coping mechanism, overlooking the emotional aspect of the disorder.
A physical therapist recently convicted of multiple counts of Medicare fraud is brought to the emergency department after taking an overdose of sedatives. He tells the nurse, 'Sure I overbilled. Why not? Everybody takes advantage of the government. They have too many rules. No one can abide by all of them.' These statements can be assessed as showing:
- A. glibness and charm.
- B. superficial remorse.
- C. lack of guilt feelings.
- D. excessive suspiciousness.
Correct Answer: C
Rationale: The correct answer is C: lack of guilt feelings. The physical therapist's statements reveal a lack of remorse or guilt for committing Medicare fraud, indicating a disregard for ethical standards and a lack of moral responsibility. This behavior is indicative of a lack of guilt feelings, as the individual shows no remorse for their actions.
Summary of other choices:
A: Glibness and charm typically involve smooth talking and being persuasive, which is not demonstrated in the scenario.
B: Superficial remorse implies a shallow or insincere apology, but the individual does not express any form of remorse in this situation.
D: Excessive suspiciousness refers to being overly mistrustful or paranoid, which is not evident in the physical therapist's statements.
A patient admitted to the eating disorders unit has yellow skin, the extremities are cold, and the heart rate is 42 bpm. The patient weighs 70 pounds; height is 5 feet 4 inches. The patient is quiet during the assessment saying only, "I will not eat until I lose enough weight to look thin."Â Select the best initial nursing diagnosis.
- A. Anxiety related to fear of weight gain
- B. Disturbed body image related to weight loss
- C. Ineffective coping related to lack of conflict resolution skills
- D. Imbalanced nutrition: less than body requirements related to self-starvation
Correct Answer: D
Rationale: The correct initial nursing diagnosis is D: Imbalanced nutrition: less than body requirements related to self-starvation. The patient's presentation of yellow skin, cold extremities, bradycardia, low weight, and refusal to eat indicate severe malnutrition due to self-starvation. The key indicators are the physical signs of malnutrition and the patient's statement about not eating until they lose enough weight. Options A and B do not address the primary issue of malnutrition and self-starvation. Option C focuses on coping skills, which is not the priority in this case. Therefore, option D is the best initial nursing diagnosis to address the patient's life-threatening condition of malnutrition.