Nokea
A newly admitted elderly client seems to become confused and agitated every evening after dinner. This client most likely is suffering from:
- A. Alzheimer's disease
- B. Acute dementia
- C. Sundown syndrome
- D. Delirium
Correct Answer: C
Rationale: The correct answer is C: Sundown syndrome. This is a condition where elderly individuals experience confusion and agitation in the evening. The symptoms are typically more pronounced during this time of day. It is not Alzheimer's disease (A) as that is a progressive neurodegenerative disorder. Acute dementia (B) is not a recognized medical term and does not accurately describe the symptoms. Delirium (D) is an acute state of confusion that can occur at any time of day, not just in the evening like sundown syndrome.
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The medication donepezil (Aricept) frequently is used to treat the early-stage symptoms of Alzheimer's disease. When administering this particular medication, the nurse should be especially alert to assess the client for:
- A. Weight changes
- B. Tremors
- C. Increased sweating
- D. Alterations in blood pressure
Correct Answer: D
Rationale: The correct answer is D: Alterations in blood pressure. Donepezil can cause changes in blood pressure as a side effect. Nurses should monitor for orthostatic hypotension and changes in blood pressure to prevent adverse effects. Weight changes (A), tremors (B), and increased sweating (C) are not commonly associated with donepezil and are less likely to be significant concerns when administering this medication for Alzheimer's disease.
The nurse is working with a patient diagnosed with bulimia nervosa. Which assessment is most important?
- A. Monitor electrolyte levels and cardiac function.
- B. Observe for compulsive eating behaviors.
- C. Track the patient's ability to self-regulate food intake.
- D. Assess for symptoms of depression and anxiety.
Correct Answer: A
Rationale: The correct answer is A because patients with bulimia nervosa are at risk for electrolyte imbalances and cardiac issues due to purging behaviors. Monitoring electrolyte levels and cardiac function is crucial for early detection and intervention. Option B is incorrect as it focuses on behaviors rather than potential medical complications. Option C is less critical than monitoring electrolytes and cardiac function. Option D, although important, is not as immediately critical as monitoring electrolyte levels and cardiac function in this context.
What behavior signals that a nurse caring for a patient with bulimia nervosa is experiencing rescue feelings? The nurse:
- A. Makes nonjudgmental comments.
- B. Refers the patient to a self-help group for persons with eating disorders.
- C. Teaches the patient about signs of increased anxiety and ways to intervene.
- D. Determines the patient has poor eating habits and provides a diet to follow.
Correct Answer: D
Rationale: The correct answer is D because providing a diet to follow indicates a rescuer mentality, where the nurse is assuming the role of fixing the patient's eating habits without addressing the underlying emotional issues. A, B, and C focus on supportive and empowering approaches which are more appropriate for helping the patient with bulimia nervosa.
The following descriptions of a client's experience and behavior can be assessed as an illusion.
- A. The client tries to hit the clinical officer when vital signs must be taken
- B. The client says, 'I keep hearing a voice telling me to run away'
- C. The clients becomes anxious whenever the clinical officer leaves the bedside
- D. The client looks at the shadow on a wall and tells the clinical officer she sees frightening faces on the wall
Correct Answer: D
Rationale: An illusion involves misinterpreting a real stimulus (e.g., seeing faces in a shadow), unlike hallucinations, which involve perceiving something not present.
A patient with bipolar disorder has rapid cycles. To prepare teaching materials, the nurse anticipates which medication will be prescribed?
- A. Clonidine (Catapres)
- B. Phenytoin (Dilantin)
- C. Carbamazepine (Tegretol)
- D. Chlorpromazine (Thorazine)
Correct Answer: C
Rationale: Rationale: Carbamazepine (Tegretol) is commonly used in treating rapid cycling bipolar disorder due to its mood stabilizing properties. It helps regulate mood swings and prevent manic or depressive episodes. It is effective in managing rapid cycling symptoms. Clonidine (A) is used for ADHD and hypertension, not bipolar disorder. Phenytoin (B) is an anticonvulsant, not typically used for bipolar disorder. Chlorpromazine (D) is an antipsychotic mainly for schizophrenia, not specifically indicated for rapid cycling in bipolar disorder.