Age Specific Patient Care

Age Specific Patient Care Related

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A 72-year-old widow has just returned home after 2 weeks in the hospital after a fall. She lives alone and is visited weekly by her son. She takes digoxin, hydrochlorothiazide, and an antihypertensive drug. She also has a prescription for diazepam (Valium) as needed for moderate to severe anxiety. When the visiting nurse stopped by 2 days after discharge, he found the woman confused and disoriented, with an unsteady gait. The patient asks him who he is and why he is there. The nurse correctly deduces that the most likely cause for the changes seen in the patient is:

  • A. Delirium.
  • B. Dementia.
  • C. Drug toxicity.
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A: Delirium. The patient's sudden onset of confusion, disorientation, and unsteady gait after discharge from the hospital suggests delirium. Delirium is an acute change in mental status with fluctuating symptoms, often caused by underlying medical conditions, medications (such as diazepam), or environmental factors. In this case, the recent hospitalization, multiple medications, and potential stressors like living alone and recent fall increase the risk for delirium.

Incorrect choices:
B: Dementia is a chronic, progressive condition characterized by memory loss and cognitive decline. The sudden onset of symptoms in this case is not consistent with dementia.
C: Drug toxicity could be a possibility given the patient's medication list, but delirium is a more likely explanation due to the acute onset of symptoms post-hospitalization.
D: None of the above is incorrect because delirium is the most likely cause based on the patient's presentation and risk factors.

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What is the primary goal for a nurse treating a patient with anorexia nervosa?

  • A. To help the patient achieve optimal body weight quickly.
  • B. To restore the patient's nutritional balance and weight.
  • C. To involve the patient in daily exercise routines to improve physical health.
  • D. To encourage the patient to undergo intensive psychotherapy.
Correct Answer: B

Rationale: The primary goal for a nurse treating a patient with anorexia nervosa is to restore the patient's nutritional balance and weight. This is because individuals with anorexia nervosa often have severe malnutrition and weight loss, which can lead to serious health complications. By focusing on restoring nutritional balance and weight, the nurse can help improve the patient's physical health and overall well-being. Encouraging the patient to achieve optimal body weight quickly (choice A) may not be realistic or safe, as rapid weight gain can have negative consequences. Involving the patient in daily exercise routines (choice C) may exacerbate the patient's compulsive behaviors around food and exercise. Encouraging the patient to undergo intensive psychotherapy (choice D) is important, but it is not the primary goal in the initial treatment of anorexia nervosa.

Which of the following is a priority intervention for a patient with bulimia nervosa who is experiencing electrolyte imbalances?

  • A. Encourage the patient to drink fluids and increase food intake.
  • B. Monitor the patient's heart rate and electrolyte levels closely.
  • C. Provide high-protein foods to help restore energy.
  • D. Instruct the patient to avoid any form of physical exercise.
Correct Answer: B

Rationale: The correct answer is B. Monitoring the patient's heart rate and electrolyte levels closely is crucial in managing electrolyte imbalances in patients with bulimia nervosa. Electrolyte imbalances, often caused by purging behaviors, can lead to serious complications like cardiac arrhythmias. Close monitoring allows for timely interventions such as electrolyte replacement therapy to prevent cardiac issues.

A: Encouraging the patient to drink fluids and increase food intake is not the priority when dealing with electrolyte imbalances as it may worsen the imbalance.
C: Providing high-protein foods may be beneficial for overall nutrition but does not address the immediate need to correct electrolyte imbalances.
D: Instructing the patient to avoid physical exercise is not directly related to managing electrolyte imbalances and may not address the underlying issue effectively.

Fragile X syndrome is associated with which of the following?

  • A. Language impairment
  • B. Behavioural problems
  • C. Moderate levels of intellectual disability
  • D. All of the above
Correct Answer: D

Rationale: Fragile X Syndrome: A chromosomal abnormality causing intellectual disability, language impairment, and behavioral issues.

An emergency department nurse prepares to assist with evidence collection for a sexual assault victim. Prior to photographs and pelvic examination, what documentation is important?

  • A. The patient's vital signs
  • B. Consent signed by the patient
  • C. Supervision and credentials of the examiner
  • D. Storage location of the patient's personal effects
Correct Answer: B

Rationale: The correct answer is B: Consent signed by the patient. This is crucial as it ensures the patient's autonomy and willingness to undergo evidence collection. Without proper consent, the procedure would be unethical and potentially illegal. Vital signs (A) may be important for overall assessment but are not directly related to evidence collection. Supervision and credentials of the examiner (C) are necessary but not the most important documentation. The storage location of personal effects (D) is relevant for patient safety but not essential for evidence collection.

The mother of a client newly diagnosed with schizophrenia is a nurse. She unhappily tells the nurse on the unit, 'I've tried to be a good mother, but my daughter still developed schizophrenia. When I was in school, we were taught that it was the mother's fault if a child became schizophrenic. I wish I knew what I did wrong.' The response that would help the mother evaluate models explaining schizophrenia would be:

  • A. I can see how you would be upset over this turn of events.'
  • B. New findings suggest this disorder is biologic in nature.'
  • C. Don't be so hard on yourself; your daughter needs you to be strong.'
  • D. It's difficult to see that double-bind communication produces stress for the child at the time it's occurring.'
Correct Answer: B

Rationale: Correct answer: B

Rationale:
1. This response acknowledges the mother's distress but shifts the focus to new findings suggesting schizophrenia is biologic in nature.
2. It provides the mother with updated information that contradicts the outdated belief that mothers are to blame for schizophrenia.
3. By highlighting the biological basis of the disorder, it helps the mother understand that it is not her fault.
4. This response encourages the mother to consider scientific evidence rather than blaming herself, promoting a more accurate understanding of the condition.

Summary:
- Choice A validates the mother's feelings but doesn't offer factual information to challenge her belief.
- Choice C aims to provide emotional support but doesn't address the mother's need for accurate information.
- Choice D introduces the concept of double-bind communication, which is not directly relevant to helping the mother understand the biological nature of schizophrenia.

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