Age Specific Considerations in Patient Care

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A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. He occasionally curses or calls another client a 'jerk' without provocation. The nurse asks the client how he is feeling, and he responds, 'Everybody picks on me. They frobitz me.' The nurse would assess 'frobitz' as:

  • A. Circumstantial speech
  • B. Loose associations
  • C. Evidence of delusional thinking
  • D. A neologism
Correct Answer: D

Rationale: The correct answer is D: A neologism. A neologism is a newly coined word or expression that is not easily understood by others. In this case, the client's use of the word 'frobitz' is not a recognized word, indicating it may be a neologism. This is commonly seen in individuals with schizophrenia who create new words or distort existing ones.

A: Circumstantial speech involves excessive and unnecessary details before reaching the main point. The client's response is not characterized by this.
B: Loose associations involve a lack of logical connections between thoughts. The client's response is not demonstrating this.
C: Evidence of delusional thinking would involve fixed, false beliefs that are not based in reality. The client's use of 'frobitz' does not necessarily indicate a delusion.

In summary, the use of 'frobitz' by the client is indicative of a neologism, as it is a new and potentially meaningless

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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

Which theorist emphasized the role of social interaction in mental development?

  • A. Piaget
  • B. Vygotsky
  • C. Erikson
  • D. Freud
Correct Answer: B

Rationale: Vygotsky (B) emphasized social interaction and the Zone of Proximal Development in mental growth, unlike Piaget (A, cognitive stages), Erikson (C, psychosocial), or Freud (D, psychosexual).

The experienced nurse assessing a battered woman client uses many open-ended questions during the interview. The rationale for this is that:

  • A. The woman will feel more in charge of the interview
  • B. Such questions allow for simple yes or no answers when the client is upset
  • C. The questions are direct and easily understood by anxious individuals
  • D. Clients can refuse to answer when sensitive information is being probed
Correct Answer: A

Rationale: The correct answer is A because using open-ended questions allows the client to express themselves freely, promoting a sense of control and empowerment. This approach helps build trust and rapport, enabling the client to share their experiences more openly. Choice B is incorrect because closed-ended questions limit the client's ability to fully express themselves. Choice C is incorrect as open-ended questions encourage deeper reflection and discussion, which may not be easily understood by anxious individuals. Choice D is incorrect because while clients can refuse to answer sensitive questions, open-ended questions actually encourage them to share more, rather than withhold information.

A 35-year-old woman is being assessed related to suspected battering. In interviewing this patient, it is important for the nurse to keep in mind that: (Select all that apply.)

  • A. The nurse's demeanor should be one of concern and caring.
  • B. Professional terminology should be used and taught to the patient.
  • C. All noted injuries should be thoroughly and explicitly documented.
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A because when assessing a patient related to suspected battering, the nurse should demonstrate concern and caring to establish trust and encourage the patient to open up. This approach helps build rapport and facilitates communication, leading to a more accurate assessment and better support for the patient. Choice B is incorrect because using professional terminology might intimidate the patient and hinder effective communication. Choice C is incorrect because documenting injuries without sensitivity and consideration for the patient's emotional well-being can further traumatize the individual. Choice D is incorrect as the nurse's demeanor and approach are crucial in addressing cases of suspected battering.

A nurse would conclude that a patient with an eating disorder is exhibiting a cognitive distortion after hearing the patient make which statement?

  • A. I see now that I need to establish my own preferences and routines.'
  • B. Bingeing makes my feelings of both isolation and loneliness go away.'
  • C. Controlling what I eat has been a way for me to exert control over my life.'
  • D. I need to watch for hunger and fatigue as triggers for my eating disorder.'
Correct Answer: B

Rationale: The correct answer is B because the statement reflects emotional reasoning, a common cognitive distortion in eating disorders. The patient believes that bingeing is an effective way to cope with feelings of isolation and loneliness, which is not a healthy or rational belief. This cognitive distortion can perpetuate the cycle of disordered eating behavior.

A: This choice shows a healthy realization and decision-making process, indicating a positive step towards recovery.
C: While controlling food intake may be a coping mechanism, it doesn't necessarily indicate a cognitive distortion.
D: This choice demonstrates awareness of triggers, which is important for managing the disorder, but it doesn't necessarily indicate a cognitive distortion.

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