Age Specific Care Competency

Age Specific Care Competency Related

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A patient remanded by the court after his wife had him jailed for battery told the judge how sorry he was and suggested he needed psychiatric help. His history reveals acting-out behaviors as an adolescent and several adult arrests. The nurse interviews him about his relationship with his wife. Which statement by the patient is most consistent with a diagnosis of antisocial personality disorder?

  • A. I've done some stupid things in my life, but I've learned a lesson.'
  • B. I'm feeling terrible about the way my behavior has hurt my family.'
  • C. I have a quick temper, but I can usually keep it under control.'
  • D. I hit her because she nags at me. She deserves it when I beat her up.'
Correct Answer: D

Rationale: The correct answer is D because it demonstrates a lack of remorse, empathy, and justification for violent behavior, which are key characteristics of antisocial personality disorder. The statement indicates a pattern of blaming others for his actions and a sense of entitlement to use violence as a means of control.

Choice A is incorrect because it shows acknowledgment of past mistakes and a willingness to learn from them, which is not typical of individuals with antisocial personality disorder. Choice B is incorrect as it reflects genuine regret and concern for the impact of his actions, which is inconsistent with the disorder. Choice C is incorrect because it implies an ability to control his temper, whereas individuals with antisocial personality disorder often struggle with impulsivity and aggression.

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Which of the following is not a common type of water pollutant?

  • A. Protists
  • B. Bacteria
  • C. Particulates
  • D. Carbon Monoxide
Correct Answer: D

Rationale: Carbon Monoxide is an air pollutant, not a common water pollutant, unlike protists, bacteria, and particulates.

Which remarks by a 72-year-old patient should prompt the nurse to assess for depression? Select one tha does not apply.

  • A. Lately I have had a lot of aches and pains and just havent felt very well.
  • B. People are in and out of my room all day and all night taking my things.
  • C. Dont ask me to eat. I cant because my stomach is upset all the time.
  • D. Im eating more than usual, and I am sleeping about 6 hours a night.
Correct Answer: D

Rationale: Somatic symptoms (A), delusions of persecution (B), and nihilistic delusions (C) are common in late-onset depression, warranting assessment. Increased appetite and contentment (D, E) do not suggest depression.

A newly admitted patient diagnosed with paranoid schizophrenia is hypervigilant and constantly scans the environment. He states that he saw two doctors talking in the hall and knows they were plotting to kill him. When charting, how should the nurse identify this behavior?

  • A. Idea of reference
  • B. Delusion of infidelity
  • C. Auditory hallucination
  • D. Echolalia
Correct Answer: A

Rationale: The correct answer is A: Idea of reference. This term refers to the belief that neutral events are directed at oneself. In this case, the patient's interpretation of doctors talking as a plot against him signifies a misinterpretation of reality. Delusion of infidelity (B) involves belief in a partner's unfaithfulness, which is not applicable here. Auditory hallucination (C) involves hearing voices, not relevant to this scenario. Echolalia (D) is the repetition of words spoken by others, not demonstrated in the patient's behavior. Thus, A is the most appropriate identification for this behavior.

A common nursing diagnosis for a patient with antisocial personality disorder is:

  • A. chronic low self-esteem, related to poor self-image and excessive fear of failure
  • B. disturbed thought processes, related to sensory-perceptual alterations
  • C. impaired social interaction, related to manipulative behaviors
  • D. social isolation, related to anxiety in social situations
Correct Answer: C

Rationale: Impaired social interaction due to manipulation reflects the interpersonal challenges of antisocial personality disorder.

A victim of spousal abuse comes to the emergency department for treatment of a broken arm. She appears hypervigilant and anxious and admits to sleep disturbance when the nurse questions the dark circles under her eyes. She reluctantly tells the nurse the abuse usually occurs when the husband has been drinking, although she concedes he is always jealous and controlling. She is a stay-at-home mother of two preschool children. The family has lived in this town for 1 month. The patient states she has fleetingly considered suicide but must stay alive to care for her children and work her way out of the abusive relationship. She denies any further suicidal thoughts. The nurse should document in the medical record that: (Select all that apply.)

  • A. Signs of high anxiety and chronic stress are present.
  • B. The patient relies on the perpetrator for basic needs.
  • C. The patient has a history of suicidal ideation.
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A: Signs of high anxiety and chronic stress are present.
Rationale:
1. The patient displaying hypervigilance, anxiety, sleep disturbances, and dark circles under her eyes are indicators of high anxiety and chronic stress, common in victims of abuse.
2. Mentioning abuse occurring when the husband drinks, his jealousy, and control further support the presence of chronic stress and anxiety.
3. The patient's fleeting suicidal thoughts are a response to the abusive situation, not indicative of a history of suicidal ideation.

Summary:
B: The patient relying on the perpetrator for basic needs is not supported by the information provided.
C: There is no indication of a history of suicidal ideation, as the patient's thoughts are tied to her children and escaping the abusive relationship.

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