Age Specific Populations

Age Specific Populations Related

Review Age Specific Populations related questions and content

A client with borderline disorder tells the nurse, 'It's hard to figure out who I am. Sometimes I'm sexually attracted to women and sometimes to men.' The nurse using Freudian concepts can analyze this as a developmental problem related to:

  • A. Lack of separation-individuation
  • B. Isolation of affect during latency
  • C. Impaired development of sexual identity during the phallic stage
  • D. Overdevelopment of latency stage traits related to control issues
Correct Answer: C

Rationale: The correct answer is C: Impaired development of sexual identity during the phallic stage. According to Freudian theory, the phallic stage occurs around ages 3 to 6 and is when children become aware of their genitals. This stage is crucial for the development of sexual identity. In this case, the client's confusion about their sexual attraction to both men and women suggests a difficulty in establishing a clear sexual identity during this stage. This can lead to ongoing struggles with sexual orientation and identity.

Choice A (Lack of separation-individuation) is incorrect because this concept is related to the development of individuality and autonomy, not sexual identity.

Choice B (Isolation of affect during latency) is incorrect as it refers to a defense mechanism where emotions are separated from their associated ideas or events during the latency stage, not related to sexual identity development.

Choice D (Overdevelopment of latency stage traits related to control issues) is incorrect because it focuses on traits related to the

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When a patient with paranoid schizophrenia has a recurrence of positive symptoms after stopping his antipsychotic medication because of its postural hypotension (orthostasis) side effect, he is readmitted to the mental health unit. What measure should the nurse suggest to help the patient address this side effect?

  • A. Ask the doctor to prescribe an anticholinergic drug like trihexyphenidyl (Artane).
  • B. Chew sugarless gum or use sugarless hard candy to moisten your mouth.
  • C. Increase the amount of sleep you get, and try to take frequent rest breaks.
  • D. Wear elastic support hose, drink adequate fluids, and change position slowly.
Correct Answer: D

Rationale: The correct answer is D because orthostatic hypotension is a common side effect of antipsychotic medications. Elastic support hose can help improve venous return, adequate fluids can prevent dehydration which worsens hypotension, and changing position slowly can prevent sudden drops in blood pressure. This measure directly addresses the side effect.

A: Anticholinergic drugs can worsen orthostatic hypotension.
B: Chewing gum or using candy does not address the physiological issue of orthostatic hypotension.
C: Increasing sleep and rest breaks may help overall well-being but does not directly address orthostatic hypotension.

A new nurse asks, 'My elderly patient's CT scan of the head shows many Lewy bodies are present. What should I do about assessing for pain?' Select the best response from the nurse manager.

  • A. Ask the patient's family if they think the patient is experiencing pain.
  • B. Use a visual analog scale to help the patient determine the presence and severity of pain.
  • C. There are special scales for assessing patients with dementia. Let's review how to use them.
  • D. The perception of pain is diminished by this type of dementia. Focus your assessment on the patient's mental status.
Correct Answer: C

Rationale: The correct answer is C because patients with Lewy body dementia may have difficulty expressing pain. Special pain assessment scales designed for patients with dementia can help in accurately assessing pain levels. These scales take into account nonverbal cues and behavioral changes that may indicate pain. By using these specialized tools, the nurse can ensure a more comprehensive assessment of the patient's pain experience.

Choice A is incorrect because relying solely on family members' perceptions may not accurately reflect the patient's actual pain experience.

Choice B is not the best option because a visual analog scale may not be suitable for patients with dementia who may have cognitive impairments affecting their ability to use such tools effectively.

Choice D is incorrect as it assumes that pain perception is diminished in Lewy body dementia without considering that patients may still experience pain but have difficulty communicating it. Focusing solely on mental status may overlook important pain indicators.

A client with paranoid schizophrenia has said she feels like throwing a chair. The nurse in the dayroom hears this and wishes to encourage verbalization as a desecalation technique. Which response by the nurse would fulfill this plan?

  • A. Tell me what's going on.'
  • B. If you throw something, you will be restrained.'
  • C. Why are you so upset?'
  • D. It's time for group therapy. You can talk there.'
Correct Answer: A

Rationale: The correct answer is A because it encourages the client to express their feelings verbally, promoting communication and potentially preventing escalation of behavior. By saying "Tell me what's going on," the nurse acknowledges the client's emotions and creates a safe space for them to talk. Option B threatens restraint, likely increasing tension. Option C may come off as confrontational. Option D distracts from the immediate need for the client to process their feelings.

An elderly client who lives with her daughter and son-in-law and their three children reveals that her daughter sometimes slaps her when she does not move fast enough or spills things. The daughter is a mid-level business executive who is under considerable stress at work. The children are often left in the care of the elderly client. The husband is often out of town on business trips. The daughter states, 'I have so much to do that I become frustrated when my mother can't move fast enough or causes me extra work.' The nurse caring for the mother could appropriately suggest:

  • A. Family therapy.
  • B. Individual counseling for the daughter.
  • C. Respite care for the elderly client.
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A: Family therapy. Family therapy is the most appropriate suggestion because it addresses the dysfunctional dynamics within the family and provides an opportunity for all family members to work through their issues. In this scenario, the daughter's stress at work and lack of coping skills are contributing to the abuse of the elderly client. Family therapy can help the family communicate effectively, set boundaries, and address underlying issues causing the abuse.

Choice B (Individual counseling for the daughter) may help the daughter address her stress and coping mechanisms, but it does not address the family dynamics that are contributing to the abuse. Choice C (Respite care for the elderly client) provides temporary relief but does not address the root cause of the issue. Choice D (None of the above) is incorrect as family therapy is the most appropriate intervention in this case.

Which disorder is often difficult to detect and consequently often goes untreated?

  • A. Pica.
  • B. Bulimia.
  • C. Obesity.
  • D. Anorexia nervosa.
Correct Answer: B

Rationale: The correct answer is B: Bulimia. Bulimia is often difficult to detect as individuals may engage in secretive binge eating and purging behaviors. Unlike anorexia nervosa where visible weight loss may be noticeable, individuals with bulimia may maintain a normal weight, making it harder to identify. Bulimia also tends to be associated with feelings of shame and guilt, leading individuals to hide their behaviors. Pica (A) involves eating non-food items and can be more easily observed. Obesity (C) is often noticeable due to visible weight gain. Anorexia nervosa (D) is also easier to detect as individuals may exhibit extreme weight loss and visible physical symptoms.

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