Age Specific Care Competency

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A client with obsessive-compulsive personality disorder seeks treatment for depression after the recent breakup of a relationship. The client constantly procrastinated about proposing marriage and said his girlfriend complained that he did not show her affection and that he was too controlling. Now he describes inability to sleep, poor concentration, and loss of energy since the breakup. Which outcome is a priority for the client? The client will:

  • A. Demonstrate assertive behavior
  • B. Express hope for developing a new relationship in the future
  • C. Identify feelings of sadness related to the failed relationship
  • D. List three new ways to reduce stress
Correct Answer: C

Rationale: Rationale: The correct answer is C: Identify feelings of sadness related to the failed relationship. This is the priority outcome because the client is experiencing symptoms of depression following the breakup, such as insomnia, poor concentration, and loss of energy. By identifying and processing the feelings of sadness related to the failed relationship, the client can begin to work through the grief and start the healing process.

Summary:
A: Demonstrating assertive behavior may be beneficial for the client in the long term but is not the priority at this stage when dealing with depression.
B: Expressing hope for a new relationship may provide temporary relief but does not address the underlying issues of depression and unresolved feelings from the breakup.
D: Listing new ways to reduce stress is important for overall well-being but does not address the primary concern of processing feelings of sadness and grief related to the failed relationship.

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The mother of a 2-year-old tells the nurse at the well-child clinic that her child likes to take a blanket wherever he goes. The mother asks if she should take the blanket away from the child. The nurse counsels the mother to allow the child to have the blanket because it reminds him of his mother and comforts him. The basis for this counseling is:

  • A. Mahler's theory of object relations
  • B. Freud's developmental theory
  • C. Kernberg's conceptualization object constancy
  • D. Sullivan's theory of 'good me'
Correct Answer: A

Rationale: The correct answer is A: Mahler's theory of object relations. Mahler's theory focuses on the development of a child's sense of self and relationships. In the scenario provided, the child's attachment to the blanket can be seen as a transitional object, which is a source of comfort and security, similar to the mother. This concept aligns with Mahler's theory that objects like blankets can serve as symbols of the mother and aid in the child's emotional development.

Incorrect choices:
B: Freud's developmental theory primarily focuses on psychosexual stages of development, which do not directly address the use of transitional objects.
C: Kernberg's conceptualization of object constancy pertains to personality disorders and the ability to maintain stable relationships, not the use of transitional objects.
D: Sullivan's theory of 'good me' is centered around interpersonal relationships and self-esteem, which are not directly related to the use of transitional objects in early childhood development.

The average time that a person with Alzheimer's disease lives after diagnosis is:

  • A. 2 years
  • B. 8 years
  • C. 10 years
  • D. 20 years
Correct Answer: B

Rationale: The correct answer is B: 8 years. Alzheimer's disease typically progresses slowly, with individuals living an average of 8 years after diagnosis. This is due to the degenerative nature of the disease, leading to gradual decline in cognitive function. Choice A (2 years) is too short for Alzheimer's progression. Choice C (10 years) is close but slightly overestimates the average. Choice D (20 years) is too long, as Alzheimer's typically does not allow for such a long survival time post-diagnosis. Therefore, B is the most accurate option based on the typical progression and outcomes of Alzheimer's disease.

An appropriate outcome for a patient with a personality disorder and a nursing diagnosis of Ineffective coping as evidenced by use of manipulation would be that the patient will:

  • A. refrain from manipulative behavior at all times
  • B. use manipulation only to get legitimate needs met
  • C. acknowledge manipulative behavior when it is pointed out
  • D. identify when he is experiencing feelings of anger
Correct Answer: C

Rationale: Rationale: Choice C is correct as it focuses on the patient acknowledging manipulative behavior when pointed out. This is important for growth and self-awareness in handling emotions and behaviors effectively. Choices A and B are extreme and unrealistic expectations, as complete cessation or selective use of manipulation may not be achievable. Choice D is irrelevant to the nursing diagnosis and does not address the core issue of ineffective coping through manipulation.

A nurse is anxious about assessing the sexual history of a patient who is considerably older than the nurse is. Which statement would be most appropriate for obtaining information about the patient's sexual practices?

  • A. Some people are not sexually active, others have a partner, and some have several partners. What has been your pattern?
  • B. Sexual health can reflect a number of medical problems, so I'd like to ask if you have any sexual problems you think we should know about.
  • C. It's your own business, of course, but it might be helpful for us to have some information about your sexual history. Could you tell me about that, please?
  • D. I would appreciate it if you could share your sexual history with me so I can share it with your health care provider. It might be helpful in planning your treatment.
Correct Answer: A

Rationale: The correct answer is A because it acknowledges the diversity of sexual practices and respects the patient's autonomy in sharing their sexual history. It also allows the patient to openly discuss their pattern without feeling pressured.

Choice B is incorrect because it focuses on potential medical problems rather than directly asking about the patient's sexual practices.

Choice C is incorrect as it may come across as too intrusive and lacks a non-judgmental approach.

Choice D is incorrect as it implies the patient's information will be shared without their consent, which violates patient confidentiality.

How the child's development is influenced by the school and the teacher?

  • A. mental
  • B. social
  • C. emotional
  • D. all of these
Correct Answer: D

Rationale: Schools and teachers shape children holistically. Mental development occurs through intellectual stimulation (A), social development via peer interactions (B), and emotional development through resilience and self-awareness (C). 'All of these' (D) reflects their comprehensive influence.

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