Population Specific Care

Population Specific Care Related

Review Population Specific Care related questions and content

A client with obsessive-compulsive personality disorder is described by other staff as being perfectionistic, inflexible, and a 'master at procrastination.' The nurse learns that the client is nearly immobilized during times that call for the client to make a decision. The nurse realizes that the most likely hypothesis is this behavior is related to:

  • A. A need to make others uncomfortable
  • B. Needing to be the center of attention
  • C. Wanting someone else to be responsible
  • D. Fear of making a mistake
Correct Answer: D

Rationale: The correct answer is D: Fear of making a mistake. This is because individuals with obsessive-compulsive personality disorder often have an intense fear of making errors or mistakes. This fear can lead to indecisiveness and procrastination when faced with decision-making tasks. The client's behavior of being nearly immobilized during times requiring decision-making is characteristic of this fear of making a mistake.

Incorrect choices:
A: A need to make others uncomfortable - This is not related to the fear of making a mistake commonly seen in individuals with obsessive-compulsive personality disorder.
B: Needing to be the center of attention - This is not a typical characteristic of individuals with obsessive-compulsive personality disorder.
C: Wanting someone else to be responsible - This is not directly related to the fear of making a mistake, which is a core feature of the disorder.

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A widow, aged 72 years, 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 son visited today, he found his mother confused and disoriented, with an unsteady gait. The nurse assessed the patient as having several cognitive problems, including memory and attention deficits and fluctuating levels of orientation. The nurse confirms that the patient's symptoms developed:

  • A. Over the past few days.
  • B. Over the past few weeks.
  • C. Over the past few months.
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A: Over the past few days. The sudden onset of confusion, disorientation, and cognitive deficits in the elderly patient suggests an acute change in her condition. This acute change is more indicative of a recent event or medication-related issue rather than a gradual decline over weeks or months. The sudden onset could be due to factors such as medication interactions, overdose, or underlying medical conditions. It is crucial to investigate recent changes in medications, lab results, or any other potential triggers that might have led to this acute cognitive decline. Choices B, C, and D are incorrect because they imply a gradual decline over weeks, months, or no specific timeframe, which does not align with the sudden onset observed in the patient.

A nurse is caring for a patient who is confused, disoriented in all three spheres, and experiencing visual hallucinations. While preparing to provide personal care, the nurse should:

  • A. ask the patient, "Do you remember who I am?"
  • B. speak minimally so as not to disturb the patient.
  • C. pat the patient on the forearm and say, "Let's get started."
  • D. explain to the patient what will happen during the care.
Correct Answer: D

Rationale: The correct answer is D because explaining to the patient what will happen during care is essential to provide a sense of orientation and reduce anxiety in a confused patient. This approach helps the patient understand the situation and feel more in control, which can decrease agitation. Choice A is incorrect as the patient's memory deficit may lead to further confusion. Choice B is incorrect as minimal communication may not address the patient's needs. Choice C is incorrect as physical touch without explanation may escalate the patient's hallucinations.

A client has just been diagnosed with mild Alzheimer's disease. A family member asks what medications are used for treatment. The nurse knows that which of the following medications are the ones most used for mild to moderate Alzheimer's disease? (Select all that apply.)

  • A. Haloperidol (Haldol)
  • B. Donepezil (Aricept)
  • C. Rivastigmine (Exelon)
  • D. Nonsteroidal antiinflammatory drugs
Correct Answer: B

Rationale: The correct answer is B: Donepezil (Aricept). Donepezil is a cholinesterase inhibitor commonly used to treat mild to moderate Alzheimer's disease by improving cognitive function. It is considered a first-line medication for Alzheimer's. Haloperidol (A) is an antipsychotic drug and not used for Alzheimer's treatment. Rivastigmine (C) is another cholinesterase inhibitor like donepezil, but it is more commonly used for moderate to severe Alzheimer's. Nonsteroidal anti-inflammatory drugs (D) are not typically used for Alzheimer's treatment. In summary, Donepezil is the preferred medication for mild to moderate Alzheimer's due to its effectiveness in improving cognitive symptoms.

An adult diagnosed with a serious mental illness says, I do not need help with money management. I have excellent ideas about investments. This patient usually does not have money to buy groceries by the middle of the month. The nurse assesses the patient as demonstrating:

  • A. rationalization.
  • B. identification.
  • C. anosognosia.
  • D. projection.
Correct Answer: C

Rationale: The patient shows anosognosia (C), an inability to recognize deficits due to illness, believing in their financial acumen despite evidence. This isn't rationalization (A), identification (B), or projection (D).

A new nurse asks, 'My elderly patient has Lewy body disease. What should I do about assessing for pain?' Select the best response from the nurse manager.

  • A. Ask the patients 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. Lets review how to use them.'
  • D. The perception of pain is diminished by this type of dementia. Focus your assessment on the patients mental status.'
Correct Answer: C

Rationale: Lewy body disease is a form of dementia. There are special scales to assess the presence and severity of pain in patients with dementia. The Pain Assessment in Advanced Dementia Scale evaluates breathing, negative vocalizations, body language, and consolability. A patient with dementia would be unable to use a visual analog scale. The family may be able to help the nurse gain perspective about the pain, but this strategy alone is inadequate. The other distracters are myths.

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