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A patient is referred to the visiting nurse agency due to cognitive impairment. Which functional problems is this patient most likely to exhibit?
- A. Inability to bathe and dress independently.
- B. Wandering in and away from his home.
- C. Lability of moods, from sociable to irritable.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Inability to bathe and dress independently. Cognitive impairment can impact a person's ability to remember tasks and follow routines, resulting in difficulties with self-care activities like bathing and dressing. This is a common functional problem seen in patients with cognitive impairment.
Choice B (Wandering) is more indicative of behavioral symptoms like agitation and restlessness. Choice C (Mood lability) is related to emotional regulation and not directly related to functional problems caused by cognitive impairment. Choice D (None of the above) is incorrect as cognitive impairment often leads to difficulties with self-care tasks.
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Priority nursing interventions for a client with borderline personality disorder who has a history of self-mutilation and is currently angry, irritable, and impulsive would be:
- A. Establishing a contract for safety with the client
- B. Teaching the client ways to manage anger
- C. Helping the client tolerate feelings
- D. Implementing behavioral modification
Correct Answer: A
Rationale: The correct answer is A: Establishing a contract for safety with the client. This is the priority intervention as it focuses on ensuring the client's immediate safety. By setting up a contract for safety, the nurse can collaborate with the client on identifying warning signs and developing a plan to prevent self-harm.
Choice B (Teaching the client ways to manage anger) and Choice C (Helping the client tolerate feelings) are important interventions but may not be as urgent as ensuring the client's safety in this scenario.
Choice D (Implementing behavioral modification) is not the priority because the client's safety needs to be addressed first before focusing on behavioral changes.
Which of the following is an expected finding for a patient with anorexia nervosa?
- A. Increased appetite and food cravings.
- B. A body mass index (BMI) in the normal range.
- C. Bradycardia and hypotension.
- D. Elevated blood pressure and rapid pulse.
Correct Answer: C
Rationale: The correct answer is C. Patients with anorexia nervosa often have bradycardia and hypotension due to the physiological effects of severe malnutrition. Explanation: Severe restriction of food intake leads to decreased energy stores, causing the body to slow down its metabolic processes, including heart rate and blood pressure. Bradycardia and hypotension are common findings in individuals with anorexia nervosa.
Summary:
A: Increased appetite and food cravings are not expected findings in anorexia nervosa as patients typically have a decreased appetite.
B: A body mass index (BMI) in the normal range is not expected in anorexia nervosa, as patients often have a low BMI due to significant weight loss.
D: Elevated blood pressure and rapid pulse are not typical findings in anorexia nervosa; rather, patients may present with low blood pressure and bradycardia.
What is not the primary evidence-based approach to managing oppositional behaviour in children?
- A. Cognitive-behavioural intervention
- B. Psychosocial intervention
- C. Pharmacological intervention
- D. Family therapy
Correct Answer: C
Rationale: Pharmacological intervention is not a primary approach for oppositional behavior; psychosocial interventions like parent training are first-line.
The most widely used system of psychological classification today is
- A. the Freudian Psychoanalytic System (FPS)
- B. found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
- C. the system designed by Emil Kraepelin and Eugen Bleuler
- D. to be found in the Federal Uniform Code of Psychopathology (UCP)
Correct Answer: B
Rationale: The DSM-IV (now DSM-5) is the standard diagnostic system globally used in psychology.
A patient diagnosed with dementia associated with excessive alcohol use tells a nurse, "Last week I had to take my baby to the hospital for major surgery. That's why I've been so nervous and needed to come here."Â The nurse is aware that the patient has never parented any children. The symptom described can be assessed as:
- A. akathisia.
- B. confabulation.
- C. intellectualization.
- D. magical thinking.
Correct Answer: B
Rationale: The correct answer is B: confabulation. Confabulation is the production of fabricated or distorted memories without the conscious intention to deceive. In this case, the patient is creating a false memory about having a baby and needing to take it to the hospital, which is not based on reality. Akathisia (A) is a movement disorder associated with restlessness, not memory distortion. Intellectualization (C) is a defense mechanism involving excessive focus on facts to avoid uncomfortable emotions, not memory fabrication. Magical thinking (D) involves believing that one's thoughts can influence events, not creating false memories.