Age Specific Care Competency

Age Specific Care Competency Related

Review Age Specific Care Competency related questions and content

A newly admitted patient diagnosed with paranoid schizophrenia is hypervigilant and constantly scans the environment. He states that he saw two doctors talking in the hall and knows they were plotting to kill him. When charting, how should the nurse identify this behavior?

  • A. Idea of reference
  • B. Delusion of infidelity
  • C. Auditory hallucination
  • D. Echolalia
Correct Answer: A

Rationale: The correct answer is A: Idea of reference. This patient's belief that the doctors were plotting to kill him is an example of an idea of reference, a symptom of paranoia common in paranoid schizophrenia. This term refers to the belief that neutral actions or events are directed at oneself. Delusion of infidelity (B) involves false beliefs about a partner's infidelity, not relevant here. Auditory hallucination (C) is false perception of sound, not applicable. Echolalia (D) is the repetition of words or phrases, not seen in this scenario. Identifying the behavior as an idea of reference helps the nurse understand the patient's distorted perception and tailor interventions effectively.

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Which of the following may occur in Expressive Language Disorder?

  • A. Limited amount of speech
  • B. Difficulty learning new words
  • C. Difficulty finding the right word
  • D. All of the above
Correct Answer: D

Rationale: Expressive Language Disorder: A specific learning disability in which scores on tests of expressive language development are substantially below those for chronological age, intelligence, and educational level.

Which of the following medications would NOT be recommended for prescription by a Family Doctor for a depressed adolescent who also has panic attacks?

  • A. Sertraline
  • B. Amitriptyline
  • C. Propranolol
  • D. Lorazepam
Correct Answer: D

Rationale: Lorazepam, a benzodiazepine, is not recommended for adolescents due to dependency risks; SSRIs like Sertraline are preferred.

A patient diagnosed with a serious mental illness died suddenly at age 52. The patient lived in the community for 5 years without relapse and held supported employment the past 6 months. The distressed family asks, 'How could this happen?' Which response by the nurse accurately reflects research and addresses the family's question?

  • A. A certain number of people die young from undetected diseases, and its just one of those sad things that sometimes happen.'
  • B. Mentally ill people tend to die much younger than others, perhaps because they do not take as good care of their health, smoke more, or are overweight.'
  • C. We will have to wait for the autopsy to know what happened. There were some medical problems, but we were not expecting death.'
  • D. We are all surprised. The patient had been doing so well and saw the nurse every other week.'
Correct Answer: B

Rationale: The family is in distress. Because they do not understand his death, they are less able to accept it and seek specific information to help them understand what happened. Persons with serious mental illness die an average of 25 years prematurely. Contributing factors include failing to provide for their own health needs (e.g forgetting to take medicine), inability to access or pay for care, higher rates of smoking, poor diet, criminal victimization, and stigma. The most accurate answer indicates that seriously mentally ill people are at much higher risk of premature death for a variety of reasons. Staff would not have been surprised that the patient died prematurely, and they would not attribute his death to random, undetected medical problems. Although the cause of death will not be reliably established until the autopsy, this response fails to address the familys need for information.

A 38-year-old woman, who had a subtotal thyroidectomy 8 years previously, is again thyrotoxic. Which one of the following is the most appropriate management?

  • A. Perform total thyroidectomy after preparation with carbimazole.
  • B. Radioactive iodine after preparation with oral iodine treatment.
  • C. Prescribe immunosuppressive treatment with azathioprine.
  • D. Control with cardimazole and then administration of radioactive iodine.
Correct Answer: D

Rationale: Recurrent thyrotoxicosis post-subtotal thyroidectomy is best managed with carbimazole to control symptoms, followed by radioactive iodine (D) for definitive treatment. Total thyroidectomy (A) is more invasive, iodine alone (B) is incorrect, immunosuppression (C) is irrelevant, and beta-blockers (E) are symptomatic only.

The chief distinguishing feature of psychotic disorders is

  • A. confusion of fantasy and reality
  • B. antisocial conduct
  • C. overwhelming anxiety
  • D. obsessive behavior
Correct Answer: A

Rationale: Psychotic disorders are characterized by a loss of reality testing, such as hallucinations and delusions, distinguishing them from other conditions.

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