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A family has noted the following behaviors in one of their elderly parents: periodic indecisiveness, forgetfulness, mild transient confusion, occasional misperception, distractibility, and occasional unclear thinking. Where on the continuum of cognitive responses would this patient be?
- A. At point 1
- B. At point 2
- C. At point 3
- D. There is insufficient information to make a determination.
Correct Answer: B
Rationale: The correct answer is B: At point 2. This patient's symptoms indicate mild cognitive impairment, which falls between normal age-related decline (point 1) and dementia (point 3). Mild cognitive impairment involves noticeable cognitive changes but does not significantly interfere with daily functioning. Point 1 is too mild for the symptoms described, and point 3 is too severe as the patient's symptoms are not indicative of full-blown dementia. Therefore, the patient is best placed at point 2 on the continuum of cognitive responses.
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A client with borderline personality disorder is having difficulty with memories of sexual abuse. She has a history of suicidal gestures, self-mutilation, sexual addiction, and substance addiction. She complains of vague pains, menstrual problems, and headaches. She entered the partial hospital program to prevent another suicide gesture or self-mutilation. The nurse recognizes that collaborative therapy may be helpful for this client and knows that the most useful collaboration in this case would be the client, the nurse, and the:
- A. Occupational therapist exploring ways to reduce stress
- B. Physical therapist exploring ways to reduce back pain
- C. Acupuncturist exploring ways to reduce pain
- D. Sexologist exploring healthy sexuality and safe sex
Correct Answer: A
Rationale: The correct answer is A: Occupational therapist exploring ways to reduce stress. In the case of a client with borderline personality disorder experiencing trauma-related symptoms, such as memories of sexual abuse, the focus is on addressing underlying emotional issues and coping strategies. Collaborative therapy involving the client, nurse, and occupational therapist can be beneficial. The occupational therapist can help the client develop coping skills, manage stress, and improve daily functioning. This approach targets the root of the client's difficulties and provides holistic support.
Summary:
- Choice B (Physical therapist exploring ways to reduce back pain): This option does not directly address the client's primary concerns related to trauma and emotional distress.
- Choice C (Acupuncturist exploring ways to reduce pain): While pain management is important, it does not address the client's complex psychological needs and trauma history.
- Choice D (Sexologist exploring healthy sexuality and safe sex): While important in some cases, focusing solely on sexuality does not address the broader range of issues the client
The highest priority for assessment by nurses caring for older adults who self-administer medications is
- A. use of multiple drugs with anticholinergic effects.
- B. overuse of medications for erectile dysfunction.
- C. missed doses of medications for arthritis.
- D. trading medications with acquaintances.
Correct Answer: A
Rationale: The correct answer is A: use of multiple drugs with anticholinergic effects. This is the highest priority because anticholinergic medications are commonly prescribed to older adults and can lead to serious adverse effects such as confusion, memory issues, and falls. Nurses must assess for these effects to prevent harm.
Choice B (overuse of medications for erectile dysfunction) is not as high a priority as anticholinergic effects, as it is not as common and typically has less immediate serious consequences for older adults.
Choice C (missed doses of medications for arthritis) is important but not as critical as assessing for anticholinergic effects, as missed doses can generally be managed through education and adherence support.
Choice D (trading medications with acquaintances) is a serious concern but is not as high a priority as assessing for anticholinergic effects, as the immediate risks associated with anticholinergic medications are more severe.
In the UK, the Special Education Needs & Disability Act of 2001 extended the rights of individuals with intellectual disabilities to be educated in mainstream schools. Schools are now required to draw up which of the following in order to facilitate the inclusion of pupils with intellectual disabilities and to make reasonable adjustments so that they are not disadvantaged?
- A. Inclusion strategies
- B. Facilitation strategies
- C. Accessibility strategies
- D. Availability strategies
Correct Answer: C
Rationale: Accessibility Strategies: Programmes extending rights of individuals with intellectual disabilities to be educated according to their needs in mainstream schools.
A history reveals that a patient virtually stopped eating 5 months ago and lost 25% of body weight. The nurse says, 'Describe what you think about your present weight and how you look.' Which response would be most consistent with anorexia nervosa?
- A. I'm fat and ugly.'
- B. What I think about myself is my business.'
- C. I'm grossly underweight, but I cover it well.'
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A. This response is most consistent with anorexia nervosa because it reflects a distorted body image common in individuals with this condition. Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image, leading to extreme weight loss and restrictive eating habits. Choice B suggests a lack of insight or denial, which is not typical of anorexia nervosa. Choice C acknowledges being underweight but does not reflect the negative body image associated with anorexia nervosa. Choice D is incorrect as option A aligns with the characteristic body image distortion seen in anorexia nervosa.
Which of the following is the most effective strategy to prevent relapse in anorexia nervosa?
- A. Focusing solely on weight gain.
- B. Providing a structured meal plan and ongoing emotional support.
- C. Encouraging weight loss to maintain control.
- D. Limiting the patient's exposure to food-related discussions.
Correct Answer: B
Rationale: The correct answer is B because providing a structured meal plan and ongoing emotional support addresses both the physical and psychological aspects of anorexia nervosa. Structured meal plans help establish healthy eating habits, while emotional support addresses underlying triggers and promotes mental well-being. Focusing solely on weight gain (A) neglects the emotional component of the disorder. Encouraging weight loss (C) reinforces harmful behaviors. Limiting food-related discussions (D) does not address the root causes of anorexia nervosa. In summary, B is the most effective strategy as it tackles both the physical and emotional aspects of the disorder.