Health Care Utilization by Age Group

Health Care Utilization by Age Group Related

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A patient tells a nurse, 'The others won't give me my pain meds early, but you are more understanding, you know what it's like to be in pain, and you don't want to see your patients suffer. Could you find a way to get me my pill now? I won't tell anyone.' Which response by the nurse would be most therapeutic?

  • A. I'm not comfortable doing that,' then ignore subsequent requests for early meds.
  • B. I'll have to check with your doctor about that; I will get back to you after I do.'
  • C. It would be unsafe to give the medicine early; none of us will do that.'
  • D. I understand that you have pain, but giving medicine too soon would not be safe.'
Correct Answer: D

Rationale: Rationale:
- Choice D is the correct response because it acknowledges the patient's pain, shows empathy, and educates on the importance of safe medication administration.
- Step 1: Acknowledge the patient's pain to validate their feelings.
- Step 2: Express understanding but emphasize safety concerns to educate the patient on responsible medication use.
- Step 3: Maintain boundaries by emphasizing the importance of safe medication practices.
- Other Choices:
- A: Ignoring the patient's request can create distrust and may not address the underlying issue of pain management.
- B: Delaying the response by involving the doctor may increase the patient's anxiety and does not address the safety concern.
- C: Simply stating that it is unsafe without providing further explanation or addressing the patient's concerns lacks empathy and education.

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A 10-year-old boy presents with a history of central abdominal pain of a few hours' duration. On examination he has minimal tenderness in the right iliac fossa and no abnormal findings on rectal examination. Which of the following alternatives should be carried out?

  • A. Arrange a barium meal follow through.
  • B. Arrange to see the patient later on in the day for review.
  • C. Send the patient away with instructions to return if the pain becomes worse.
  • D. Tell the patient to come back in a week.
Correct Answer: B

Rationale: Early appendicitis can present subtly. Minimal right iliac fossa tenderness warrants observation, so reviewing later (B) is appropriate. Imaging (A), dismissal (C, D), or immediate surgery (E) without further assessment are not justified yet.

Which of the following is related to recent attempts to find biochemical explanations for schizophrenia?

  • A. schizotaxin
  • B. psychotropin
  • C. dopamine
  • D. diazepam
Correct Answer: C

Rationale: Dopamine excess in the brain is a leading biochemical theory for schizophrenia, supported by antipsychotic efficacy.

Reading Disorder is a developmental disorder and is characterised by reading achievement (e.g. accuracy, speed and comprehension) being significantly below standards expected for which of the following

  • A. Chronological age
  • B. IQ
  • C. Schooling experience.
  • D. All of the above
Correct Answer: D

Rationale: Reading Disorder: A specific learning disability characterised by the accuracy, speed and comprehension of reading being significantly below standards expected for chronological age and IQ.

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.

A child, aged 11 years, stays home from school to care for his siblings while his mother works, because the family cannot afford a babysitter. The home is cluttered and dirty when the community mental health nurse visits to investigate the child's school absences. The nurse's legal responsibility if child abuse or neglect is suspected is to:

  • A. consult with the child's teacher, principal, and school psychologist.
  • B. document the observations and impressions in the family health record.
  • C. report her suspicions of abuse or neglect according to state regulations.
  • D. wait until she has proof of abuse or neglect, then report it to authorities.
Correct Answer: C

Rationale: Correct Answer: C

Rationale:
1. **Legal Obligation**: The nurse has a legal duty to report suspicions of child abuse or neglect.
2. **Protecting the Child**: Reporting ensures the child's safety and well-being.
3. **State Regulations**: State laws mandate reporting suspected abuse or neglect.
4. **Immediate Action**: Waiting for proof delays intervention and puts the child at risk.

Summary:
- Choice A: Consulting with school staff doesn't fulfill the legal obligation to report.
- Choice B: Documenting is important but not sufficient; reporting is crucial.
- Choice D: Waiting for proof is dangerous; immediate reporting is necessary to protect the child.

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