A nurse assesses four patients between the ages of 70 and 80. Which patient has the highest risk for alcohol abuse? The patient who:
- A. consumes 1 glass of wine nightly with dinner
- B. began drinking alcohol daily after retirement and says, 'A few drinks keep my mind off my arthritis.'
- C. drank socially throughout adult life and continues this pattern, saying 'Ive earned the right to do as I please.'
- D. abused alcohol between the ages of 25 and 40 but now abstains and occasionally attends Alcoholics Anonymous (AA)
Correct Answer: B
Rationale: Alcohol abuse and dependence can develop at any age, and the geriatric population is particularly at risk. Losses, such as retirement, widowhood, and loneliness, are often related. The distracters describe patients with a lower risk for alcohol abuse.
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Which statement by the nurse indicates a good understanding of postpartum blues?
- A. You need to get involved with taking care of this baby.
- B. You are lucky to have a healthy baby. The patient in the next room would give anything to be in your place.
- C. You look tired. Why dont you rest for a bit and I will come back later to start some teaching.
- D. I will call the social worker to check into alternate caregiving for the new baby.
Correct Answer: C
Rationale: This response (C) indicates understanding that postpartum blues is transient and that time and rest are major healers. The other responses (A, B, D) are judgmental or inappropriate.
A nurse and social worker co-lead a reminiscence group for eight old-old and centenarian adults. Which activity is appropriate to include in the group?
- A. Mild aerobic exercise
- B. Singing a song from World War II
- C. Discussing national leadership during the Vietnam War
- D. Identifying the most troubling story in today's newspaper
Correct Answer: B
Rationale: The correct answer is B: Singing a song from World War II. This activity is appropriate because reminiscence therapy involves recalling past memories to enhance well-being in older adults. Singing a song from that era can help trigger positive emotions and memories for the participants.
A: Mild aerobic exercise may not be suitable for all participants due to physical limitations.
C: Discussing national leadership during the Vietnam War might evoke negative emotions or political disagreements.
D: Identifying the most troubling story in today's newspaper could lead to distress and is not conducive to the therapeutic nature of reminiscence therapy.
Sleep terrors usually occur only once a night, during stages 3 and 4 of NREM sleep. They are often accompanied by which physical sign?
- A. Intense stress.
- B. Sexual arousal.
- C. Physical strength.
- D. None of the above.
Correct Answer: D
Rationale: The correct answer is D: None of the above. Sleep terrors are not typically accompanied by intense stress, sexual arousal, or increased physical strength. Sleep terrors are characterized by sudden awakening from sleep with intense fear and a physical reaction, such as screaming or thrashing. These episodes occur during stages 3 and 4 of NREM sleep and are not associated with the physical signs mentioned in the other choices. Therefore, the correct answer is D, as sleep terrors do not necessarily involve any of the physical signs listed in the other options.
Adolescents often cite barriers for discussing psychosocial issues with their physician. If confidentiality is addressed, which of the following do adolescents NOT cite as a barrier:
- A. Non-judgemental approach of physician
- B. Personal embarrassment towards discussing sensitive topics
- C. Physician seems rushed
- D. Physician did not ask about sensitive topics
Correct Answer: A
Rationale: A non-judgmental approach facilitates discussion and is not a barrier, unlike embarrassment, time constraints, or perceived lack of understanding.
An 82-year-old widow with Alzheimer's disease lives with her daughter's family, which owns a catering business. During the week, the patient attends a day care center for patients with dementia. During the evenings, members of the family care for the patient. One day, the nurse at the day care center notices the patient's appearance is disheveled and that she startles easily. She has a strong odor of urine, and her hair is uncombed. When the nurse escorts the patient to the bathroom, she notices bruises on her wrists and back. What most likely explains the nurse's observations?
- A. The patient is being neglected and abused within the family.
- B. The dementia is progressing, reducing self-care and increasing falls.
- C. The patient is being inadequately cared for, resulting in accidents.
- D. The patient has developed delirium, resulting in poor hygiene and injuries.
Correct Answer: A
Rationale: The correct answer is A: The patient is being neglected and abused within the family. The nurse's observations of the patient's disheveled appearance, strong odor of urine, uncombed hair, and bruises indicate signs of neglect and abuse. Here's the rationale:
1. Disheveled appearance and strong odor of urine suggest lack of personal care.
2. Uncombed hair signals neglect in grooming.
3. Bruises on wrists and back are indicative of physical abuse.
4. Startling easily may be due to fear or anxiety from abuse.
In summary, the other choices (B, C, D) are incorrect because they do not account for the combination of neglect, poor hygiene, and physical injuries seen in the patient, which are more indicative of abuse and neglect within the family.