Health Care Utilization by Age Group

Health Care Utilization by Age Group Related

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A client has been diagnosed with a dementia secondary to cerebral disease. The family members note the client 'has not been as sharp as he once was' and that he has developed urinary incontinence and a gait disturbance. They attributed the first symptom to normal aging but were alarmed by the latter two symptoms. Based on this history, which of the following should come to mind?

  • A. Normal pressure hydrocephalus
  • B. Vitamin B12 deficiency
  • C. Hepatic disease
  • D. Tuberculosis
Correct Answer: A

Rationale: Step 1: The client presents with urinary incontinence and a gait disturbance, suggestive of normal pressure hydrocephalus (NPH) due to cerebral disease.
Step 2: NPH is characterized by the triad of cognitive decline, gait disturbances, and urinary incontinence.
Step 3: Symptoms of NPH can mimic normal aging but are distinct from other conditions.
Step 4: Vitamin B12 deficiency (B) primarily presents with anemia and neurological symptoms, not the triad seen in NPH.
Step 5: Hepatic disease (C) typically presents with symptoms related to liver dysfunction, not the triad of NPH.
Step 6: Tuberculosis (D) manifests with respiratory symptoms and constitutional symptoms, not the cognitive decline and gait issues seen in NPH.

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A client admitted with delusions, hallucinations, and thought disorder has the admitting diagnosis schizophreniform disorder R/O organic pathology. Based on this information, the nurse can expect that the client will:

  • A. Undergo an MRI test
  • B. Have psychological testing
  • C. Have an immunologic assay performed
  • D. Participate in a dexamethasone suppression test
Correct Answer: A

Rationale: Step 1: The client is admitted with symptoms suggestive of a psychotic disorder, specifically schizophreniform disorder.
Step 2: The admitting diagnosis includes ruling out organic pathology, indicating a need to investigate potential physical causes.
Step 3: An MRI test is a non-invasive imaging procedure that can help identify any structural abnormalities in the brain.
Step 4: This test is appropriate in ruling out organic causes of the symptoms presented by the client.
Step 5: Psychological testing (Choice B) is more focused on assessing cognitive and emotional functioning, not ruling out organic pathology.
Step 6: Immunologic assay (Choice C) is used to detect antibodies or antigens in the blood, not typically relevant in this context.
Step 7: Dexamethasone suppression test (Choice D) is used to assess for abnormalities related to cortisol levels in conditions like depression, not specific to ruling out organic pathology in psychotic disorders.

Summary: Choice A is correct because an MRI test is the most relevant

The following condition is an indication for electroconvulsive therapy (ECT)

  • A. Serene depression
  • B. Schizophrenia
  • C. Autistic disorders
  • D. Tourettes syndrome
Correct Answer: A

Rationale: Severe (likely intended as 'serene') depression, especially when treatment-resistant, is a primary indication for ECT due to its rapid efficacy.

A consumer at a rehabilitative psychosocial program says to the nurse, 'People are not cleaning up behind themselves in the bathrooms. The building is dirty and cluttered.' How should the nurse respond?

  • A. Encourage the consumer to discuss it at a meeting with everyone
  • B. Hire a professional cleaning service to clean the restrooms
  • C. Address the complaint at the next staff meeting
  • D. Tell the consumer, 'Thats not my problem'
Correct Answer: A

Rationale: Consumer-run programs range from informal clubhouses, which offer socialization and recreation, to competitive businesses, such as snack bars or janitorial services, which provide needed services and consumer employment while encouraging independence and building vocational skills. Consumers engage in problem solving under the leadership of staff.

An elderly woman is brought to the clinic by her daughter. The client states that she has had a cold for several days. Her daughter states that her mother has been confused about when her routine medications are to be taken and that her mother has never experienced confusion about her medications before. Based on this information, it is important that the nurse ask the client whether:

  • A. There is a history of mental illness in the family
  • B. She has been given a diagnosis of a mental health disorder in the past
  • C. She can recall her last visit to a physician
  • D. She has taken any over-the-counter medications for her cold
Correct Answer: D

Rationale: The correct answer is D: She has taken any over-the-counter medications for her cold. It is important for the nurse to ask this question because over-the-counter medications can sometimes interact with prescription medications, leading to confusion or other cognitive issues in elderly patients. By identifying any OTC medications the client has taken, the nurse can assess potential drug interactions that may be contributing to the confusion.

Choices A, B, and C are incorrect. History of mental illness in the family or a previous diagnosis of mental health disorder may not directly address the current issue of confusion related to medication management. Asking about the last visit to a physician is also less relevant compared to inquiring about current medication use for a potential cause of confusion.

What is a key consideration when treating a patient with anorexia nervosa?

  • A. Addressing the patient's weight first and foremost.
  • B. Focusing on nutrition and caloric intake without addressing underlying issues.
  • C. Addressing the psychological and emotional factors that contribute to the disorder.
  • D. Providing strict dietary restrictions to help the patient regain control over food.
Correct Answer: C

Rationale: The correct answer is C because addressing the psychological and emotional factors is crucial in treating anorexia nervosa. This disorder is not solely about weight or food intake; it often involves deeper psychological issues such as body image distortion, low self-esteem, and control issues. By focusing on the underlying psychological and emotional factors, therapists can help patients understand and cope with these issues, leading to more effective and sustainable recovery. Choices A, B, and D are incorrect because they overlook the complexity of anorexia nervosa and may even exacerbate the patient's condition by neglecting the root causes of the disorder.

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