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A nurse plans an educational program for staff of a home health agency specializing in care of the elderly. Which topic is the highest priority to include?
- A. Pain assessment techniques for older adults
- B. Psychosocial stimulation for those who live alone
- C. Preparation of psychiatric advance directives in the elderly
- D. Ways to manage disinhibition in elderly persons with dementia
Correct Answer: A
Rationale: The correct answer is A: Pain assessment techniques for older adults. This is the highest priority as pain management is crucial in the care of the elderly to ensure their comfort and well-being. By assessing pain accurately, appropriate interventions can be implemented.
- Choice B (Psychosocial stimulation): While important, it is not as critical as addressing pain, which directly impacts the individual's physical comfort.
- Choice C (Psychiatric advance directives): Important for mental health planning but not as immediately essential as pain assessment in day-to-day care.
- Choice D (Managing disinhibition in dementia): Important but secondary to addressing pain, which has a more immediate impact on the individual's quality of life.
Prioritizing pain assessment ensures holistic care for elderly patients.
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A short-term goal for a patient with anorexia nervosa is 'Patient will select and eat a balanced diet.' The nurse writes which of the following nursing interventions into the care plan that will foster attainment of this goal?
- A. Allow patient to weigh self every time a meal is completely eaten.
- B. Assist the patient to fill out the dietary menus to ensure a balanced diet.
- C. Encourage the patient to engage in only appropriate compensatory exercise.
- D. Implement contracted consequences 50% of the time if a meal is not completed.
Correct Answer: B
Rationale: The correct answer is B: Assist the patient to fill out the dietary menus to ensure a balanced diet. This intervention is appropriate because it directly supports the goal of the patient selecting and eating a balanced diet. By assisting the patient in filling out dietary menus, the nurse can help the patient make informed choices about their food intake, ensuring they are consuming a variety of nutrients necessary for a balanced diet. This intervention promotes patient autonomy and education, empowering the patient to make healthier choices.
Choice A is incorrect because allowing the patient to weigh themselves every time a meal is eaten does not directly address the goal of selecting and eating a balanced diet.
Choice C is incorrect because encouraging compensatory exercise may lead to unhealthy behaviors and does not focus on achieving a balanced diet.
Choice D is incorrect because implementing contracted consequences for incomplete meals may create a negative environment and does not promote a positive approach to achieving a balanced diet.
What is the most appropriate initial treatment goal for a patient with anorexia nervosa?
- A. Achieve rapid weight gain to restore nutritional status.
- B. Restore the patient's nutritional balance through gradual weight gain.
- C. Focus on addressing body image issues before weight gain.
- D. Encourage the patient to participate in group therapy for support.
Correct Answer: B
Rationale: The correct initial treatment goal for a patient with anorexia nervosa is to restore the patient's nutritional balance through gradual weight gain. This approach is crucial as rapid weight gain can lead to refeeding syndrome, a potentially life-threatening complication. Gradual weight gain allows the body to adjust to increased caloric intake safely. Addressing body image issues is important but can be more effectively tackled after nutritional balance is restored. Group therapy can be beneficial but should not be the primary focus initially. Thus, choice B is the most appropriate initial treatment goal.
A patient with schizophrenia has received typical (first-generation) antipsychotics for a year. His hallucinations are less intrusive, but he remains apathetic, has poverty of thought, cannot work, and is socially isolated. To address these symptoms, the nurse might consult the prescribing health care provider to suggest a change to:
- A. haloperidol (Haldol).
- B. olanzapine (Zyprexa).
- C. diphenhydramine (Benadryl).
- D. chlorpromazine (Thorazine).
Correct Answer: B
Rationale: The correct answer is B: olanzapine (Zyprexa). Olanzapine is an atypical (second-generation) antipsychotic that addresses both positive and negative symptoms of schizophrenia. In this case, the patient still experiences negative symptoms like apathy, poverty of thought, and social withdrawal. Olanzapine has been shown to be effective in improving negative symptoms and overall functioning in patients with schizophrenia.
A: haloperidol is a typical (first-generation) antipsychotic that primarily targets positive symptoms like hallucinations, not negative symptoms.
C: diphenhydramine is an antihistamine with no known efficacy for treating schizophrenia symptoms.
D: chlorpromazine is a typical antipsychotic like haloperidol and is not typically used for addressing negative symptoms.
When people successfully adapt to their environment by using logical thought and socially appropriate ways, they are said to be functioning at the adaptive end of the _____ continuum.
- A. Emotional
- B. Self-protective
- C. Neurobiological
- D. Psychobiological
Correct Answer: C
Rationale: The correct answer is C: Neurobiological. This is because neurobiological factors refer to the brain's functioning and how it affects behavior and cognition. When individuals adapt to their environment using logical thought and socially appropriate ways, it indicates a high level of cognitive and behavioral functioning, which is closely tied to neurobiological processes.
A: Emotional is incorrect because emotional factors focus on feelings and affective responses, not necessarily on logical thought and social appropriateness.
B: Self-protective is incorrect as it pertains to behaviors aimed at ensuring one's safety and security, which may not necessarily involve logical thought and social appropriateness.
D: Psychobiological is incorrect as it encompasses the interaction between psychological and biological processes, which may not specifically relate to adaptive functioning in the given context.
Which information is most important to obtain during assessment of an older adult diagnosed with a mental disorder?
- A. Functional ability and emotional status
- B. Chronological age and sexual function
- C. Economic status and sources of income
- D. Developmental history, interests, and activities
Correct Answer: A
Rationale: Information related to functional ability and emotional status provides an overview of patient problems and abilities. It guides selection of interventions and services to meet identified needs. The distracters reflect information of relevance, but are not of highest priority.