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A nurse assessing an elderly patient for depression and suicide potential should include questions about mood as well as: (Select one tha does not apply)
- A. anhedonia.
- B. increased appetite.
- C. sleep pattern changes.
- D. increased concerns with bodily functions.
Correct Answer: B
Rationale: The correct responses (A, C, E) relate to symptoms often noted in elderly patients with depression: anhedonia (loss of pleasure), sleep changes, and somatic concerns. Increased appetite (B) is less typical than anorexia, and grandiosity (D) relates to bipolar disorder, not depression.
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A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. He occasionally curses or calls another client a 'jerk' without provocation. The nurse asks the client how he is feeling, and he responds, 'Everybody picks on me. They frobitz me.' The nurse would assess 'frobitz' as:
- A. Circumstantial speech
- B. Loose associations
- C. Evidence of delusional thinking
- D. A neologism
Correct Answer: D
Rationale: The correct answer is D: A neologism. A neologism is a newly created word or phrase that is unique to the individual and not understandable to others. In this scenario, the client's use of the word 'frobitz' is an example of a neologism. This demonstrates disorganized thinking and language typical of schizophrenia.
A: Circumstantial speech involves providing unnecessary details before reaching the main point, which is not evident in the client's response.
B: Loose associations involve a lack of logical connection between thoughts, which is not demonstrated by the client's use of 'frobitz.'
C: Delusional thinking involves fixed false beliefs, which are not explicitly present in the client's response.
In summary, the client's use of 'frobitz' indicates a neologism, reflecting disorganized thinking in schizophrenia, making it the correct assessment.
A client with antisocial personality disorder yells, 'Shut up about that, or I'll punch you in the nose!' and shakes his fist at another client in a group meeting after the client speaks negatively of illicit drug use. The nurse quickly determines that the client is at risk to act violently against others as evidenced by his aggressive behavior, verbal threats, and a history of impulsivity. Which is the best approach for the nurse to use?
- A. Seclude the client to protect the other clients and staff.
- B. Put the client in restraints to protect the milieu.
- C. Explore alternate ways to handle frustrating topics in the group.
- D. Tell the client to leave the group until he can behave appropriately.
Correct Answer: C
Rationale: The correct answer is C: Explore alternate ways to handle frustrating topics in the group. This approach focuses on addressing the underlying issue of the client's aggressive behavior by finding healthier ways to manage emotions and conflicts. It promotes therapeutic communication and helps the client develop coping strategies.
Secluding the client (choice A) may escalate the situation and reinforce negative behavior. Putting the client in restraints (choice B) is a physical intervention that should only be used as a last resort for safety reasons. Telling the client to leave the group (choice D) may not address the root cause of the behavior and could lead to further isolation and resentment. Ultimately, exploring alternate ways to handle frustrating topics is the most therapeutic and effective approach in this scenario.
The nurse is explaining to the family of a patient diagnosed with schizophrenia that the disorder is considered to have neurobiological origins. When the patient's mother asks, 'What part of the brain is dysfunctional?' the nurse should reply, 'Research has implicated the:
- A. medulla and cortex.'
- B. cerebellum and cerebrum.'
- C. hypothalamus and medulla.'
- D. prefrontal and limbic cortices.'
Correct Answer: D
Rationale: The correct answer is D: prefrontal and limbic cortices. The prefrontal cortex is involved in decision-making, problem-solving, and social behavior, functions that are often impaired in schizophrenia. The limbic cortex is responsible for emotions and memory, both of which are affected in schizophrenia. Research has shown abnormalities in these brain regions in individuals with schizophrenia, supporting the neurobiological origins of the disorder. Choices A, B, and C are incorrect as they do not specifically address the brain regions known to be involved in schizophrenia.
The mother of a teen with an eating disorder tells the nurse, "Our family is pretty well adjusted. It's hard for me to imagine what we could have done to have this happen."Â The nurse can promote more complete understanding of the etiology of eating disorders by mentioning that young women are also influenced by:
- A. the abundance of nutritious foods available.
- B. the fashion industry's idealization of thinness.
- C. competition in the work place.
- D. the biologic tendency to be underweight.
Correct Answer: B
Rationale: The correct answer is B: the fashion industry's idealization of thinness. This is because the fashion industry often promotes thinness as the ideal body type, leading to societal pressure on young women to conform to this standard. This can contribute to the development of eating disorders as individuals may engage in unhealthy behaviors to achieve or maintain a thin body shape.
A: the abundance of nutritious foods available - While access to nutritious foods is important for overall health, it does not directly influence the development of eating disorders.
C: competition in the work place - While workplace competition may contribute to stress, it is not a primary factor in the development of eating disorders.
D: the biologic tendency to be underweight - While genetic factors can play a role in susceptibility to eating disorders, it is not the primary influence in the development of these disorders in young women.
An elderly woman is brought to the clinic by her daughter. The client states that she has had a cold for several days. Her daughter states that her mother has been confused about when her routine medications are to be taken and that her mother has never experienced confusion about her medications before. Based on this information, it is important that the nurse ask the client whether:
- A. There is a history of mental illness in the family
- B. She has been given a diagnosis of a mental health disorder in the past
- C. She can recall her last visit to a physician
- D. She has taken any over-the-counter medications for her cold
Correct Answer: D
Rationale: The correct answer is D: She has taken any over-the-counter medications for her cold. It is important for the nurse to ask this question because over-the-counter medications can sometimes interact with prescription medications, leading to confusion or other cognitive issues in elderly patients. By identifying any OTC medications the client has taken, the nurse can assess potential drug interactions that may be contributing to the confusion.
Choices A, B, and C are incorrect. History of mental illness in the family or a previous diagnosis of mental health disorder may not directly address the current issue of confusion related to medication management. Asking about the last visit to a physician is also less relevant compared to inquiring about current medication use for a potential cause of confusion.