Age Specific Considerations in Patient Care

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A child, aged 11 years, has to stay home from school to care for his siblings while his mother works, because the family cannot afford a babysitter. The father appears to be emotionally abusive. Which intervention could be used for the primary prevention of problems such as these?

  • A. Involve the parents in a parenting support group, and help them find affordable childcare.
  • B. Meet with elected officials to lobby for subsidized childcare and increasing the minimum wage.
  • C. Screen for signs of abuse and neglect in all children so that it can be discovered and treated early.
  • D. Provide supportive counseling services for those who have survived neglect or abuse.
Correct Answer: B

Rationale: The correct answer is B because lobbying for subsidized childcare and increasing the minimum wage addresses the root causes of the family's situation, such as financial insecurity and lack of affordable childcare. This intervention aims to prevent similar situations from occurring by advocating for systemic changes that can support families in need.

Choice A focuses on providing support to the parents, which may not address the underlying issues of financial instability and emotional abuse. Choice C addresses detection and treatment after the abuse has occurred, rather than preventing it from happening in the first place. Choice D focuses on providing counseling services after abuse or neglect has already taken place, rather than preventing it through systemic changes like subsidized childcare and increased minimum wage.

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Which assessment findings would alert the nurse that an older patient may have an increased risk for development of geriatric alcohol abuse? Select one tha does not apply.

  • A. Mild recent memory impairment
  • B. Eighth grade education
  • C. Death of spouse
  • D. Retirement
Correct Answer: A

Rationale: Geriatric problem drinking often begins in response to stressors like retirement (D), loss of spouse (C), and loneliness (E), with risk factors including less than high school education (B). Mild memory impairment (A) is not a predisposing factor.

The first step in the treatment of incest is to:

  • A. believe the child who reports the activity
  • B. notify the proper authorities
  • C. objectively confront the accused family member
  • D. remove the child from the home
Correct Answer: A

Rationale: Believing the child establishes trust and validates their experience, forming the foundation for further protective and therapeutic actions.

The mother of a teenager diagnosed with an eating disorder asks, 'How long will my daughter have this problem?' The nurse answers with the knowledge that:

  • A. recovery is usual after one severe episode.
  • B. less than 30% show improvement after 5 years.
  • C. weight restoration is sufficient for recovery.
  • D. long-term therapy combined with medication results in the best outcomes.
Correct Answer: D

Rationale: The correct answer is D because long-term therapy combined with medication results in the best outcomes for individuals with eating disorders. Therapy helps address underlying psychological issues, while medication can help manage symptoms. Recovery is a complex process that often requires ongoing support. Choice A is incorrect as recovery is not always guaranteed after one severe episode. Choice B is incorrect as many individuals do show improvement over time. Choice C is incorrect as weight restoration alone may not address all aspects of the disorder.

What is the most appropriate nursing goal for a patient with bulimia nervosa?

  • A. To eliminate binge-purge episodes and restore healthy eating habits.
  • B. To focus on weight loss and body image issues.
  • C. To monitor calorie intake and restrict food consumption.
  • D. To encourage excessive exercise to maintain weight control.
Correct Answer: A

Rationale: The correct answer is A: To eliminate binge-purge episodes and restore healthy eating habits. This goal is appropriate as it addresses the core issue of bulimia nervosa, which is the cycle of bingeing and purging. By focusing on eliminating these episodes and promoting healthy eating habits, the patient can achieve long-term recovery.

Choices B, C, and D are incorrect because they do not address the underlying psychological and behavioral aspects of bulimia nervosa. Weight loss and body image issues (B) may exacerbate the disorder, monitoring calorie intake and restricting food consumption (C) can reinforce the cycle of bingeing and purging, and encouraging excessive exercise (D) can lead to further health complications.

In planning aftercare for a client with schizophrenia and whose insurance benefits have been exhausted, the nurse who is concerned about overcoming negative symptoms will make provisions for the client to have stimulation, structure, socialization, and support. Which option would best incorporate these factors?

  • A. Day hospitalization
  • B. Attending a psychosocial club
  • C. Living with his elderly mother
  • D. Spending free time in the mall
Correct Answer: B

Rationale: The correct answer is B: Attending a psychosocial club. This option best incorporates the necessary factors of stimulation, structure, socialization, and support for the client with schizophrenia.
- Stimulation: Psychosocial clubs offer various activities to engage the client's mind and keep them occupied.
- Structure: These clubs usually have regular schedules and routines, providing the client with a sense of order and predictability.
- Socialization: Interacting with others in the club can help the client improve social skills and combat feelings of isolation.
- Support: Being part of a community in the club can provide emotional support and encouragement for the client.

Incorrect Choices:
- A: Day hospitalization may offer structure and support but may lack the socialization and stimulation provided by a psychosocial club.
- C: Living with his elderly mother may provide support but may not offer the necessary stimulation, structure, and socialization outside of the home environment.
- D: Spending free time in the mall may offer

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