Nokea
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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What is the primary source of mental stimulation in early childhood?
- A. Television
- B. Parental interaction
- C. Toys
- D. School lessons
Correct Answer: B
Rationale: Parental interaction (B) provides responsive, tailored stimulation critical for early mental development. TV (A) and toys (C) are less interactive, and school lessons (D) come later.
Which outcome is realistic for a client with stage 1 Alzheimer's disease?
- A. Appropriate long-term placement will be arranged to maintain caregiver's health and well-being.
- B. The client will maintain the highest possible functional level within his or her capacity.
- C. All day-to-day decisions will be made by the caregiver to relieve client of stress.
- D. The client will remain fully functional physically, since Alzheimer's affects only the brain.
Correct Answer: B
Rationale: The correct answer is B because in stage 1 Alzheimer's, individuals can still maintain a relatively high level of functionality. This is because in the early stages, the cognitive decline is mild and individuals can still perform daily tasks independently. It is important to focus on maximizing the client's functional abilities through cognitive exercises and support services.
Choice A is incorrect because long-term placement may not be necessary in stage 1 and should only be considered if the caregiver's health is at risk. Choice C is incorrect because individuals with Alzheimer's should be encouraged to make decisions to maintain their sense of autonomy. Choice D is incorrect because Alzheimer's is a progressive disease that affects both cognitive and physical functions over time.
In DSM-IV-TR intellectual disabilities are divided into a number of degrees of severity, depending primarily on the range of IQ score provided by the sufferer. One of these is Mild Mental Retardation, corresponding to an IQ score between:
- A. 60-65 to 80
- B. 40-55 to 60
- C. 50-55 to 70
- D. 70-75 to 90
Correct Answer: C
Rationale: Mild Mental Retardation: Defined by DSM-IV-TR as an IQ score between 50-55 to 70.
A woman became severely depressed when the last of her six children moved out of the home 4 months ago. Since then she has neglected to care for herself, sleeps poorly, lost weight, and repeatedly states, "No one cares about me anymore. I'm worthless." After hospitalization, the nursing diagnosis of situational low self-esteem related to feelings of abandonment was identified. The nurse wishes to reinforce the patient's self-esteem by acknowledging the improvement in her personal appearance. She's wearing a new dress and has combed her hair. The most appropriate remark would be:
- A. You look very nice this morning, Mrs. J.
- B. I like the dress you're wearing, it's very pretty.
- C. What brought about this glamorous transformation?
- D. You've combed your hair and are wearing a new dress.
Correct Answer: A
Rationale: The correct answer is A because it directly compliments Mrs. J's personal appearance, reinforcing her self-esteem. By stating "You look very nice this morning, Mrs. J," the nurse acknowledges and validates Mrs. J's efforts to improve her appearance, which can help boost her self-esteem.
Choice B focuses solely on the dress, not directly addressing Mrs. J's overall appearance. Choice C may come across as insincere or too focused on the transformation rather than Mrs. J herself. Choice D, while acknowledging the hair and dress, lacks the personal and direct compliment needed to reinforce self-esteem effectively.
In summary, choice A is the best option as it provides a genuine and direct compliment that can positively impact Mrs. J's self-esteem.
Older adults have reached Erikson's developmental stage of ego integrity when they:
- A. acknowledge that one cannot get everything one wants in life
- B. assess their lives and identify actions that had value and purpose
- C. express a wish that life could be relived differently
- D. feel that they are being punished for things they did not do
Correct Answer: B
Rationale: Ego integrity involves reflecting on life with acceptance and finding meaning, per Erikson's theory.