Age Specific Patient Care

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A patient who has been hospitalized for 2 days remains delusional and anxious and does not yet appear to be ready to give up the delusions. What intervention will best help the patient focus less on the delusion?

  • A. Schedule time for the patient to read and listen to music.
  • B. Plan activities that require physical skills and constructive use of time.
  • C. Begin planning for discharge by engaging the patient in psychoeducation.
  • D. Discuss personal goals related to improved socialization with the patient.
Correct Answer: B

Rationale: The correct answer is B because engaging in activities that require physical skills and constructive use of time can help the patient shift their focus away from the delusions. Physical activities can help reduce anxiety and provide a sense of accomplishment, which can help distract the patient from the delusions. It also promotes a sense of normalcy and routine, which can aid in grounding the patient in reality.

Choice A is incorrect because reading and listening to music may not actively engage the patient in a way that helps them shift their focus from the delusions. Choice C is incorrect because planning for discharge may be premature and may not address the immediate need to distract the patient from the delusions. Choice D is incorrect because discussing personal goals related to improved socialization may not be effective in helping the patient focus less on the delusions at this stage.

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An adolescent patient is diagnosed with dementia. The patient's age would cause a nurse to suspect which underlying condition sometimes associated with this diagnosis?

  • A. Head trauma
  • B. Neurosyphilis
  • C. Pick disease
  • D. Hypothyroidism
Correct Answer: A

Rationale: The correct answer is A: Head trauma. Adolescents are less likely to develop dementia due to age-related neurodegenerative diseases. Head trauma can lead to cognitive impairment and memory loss, mimicking symptoms of dementia. Neurosyphilis is a sexually transmitted infection affecting the brain, not common in adolescents. Pick disease is a rare neurodegenerative disorder more commonly seen in older adults. Hypothyroidism can cause cognitive symptoms but is not typically associated with dementia in adolescents.

The nurse who is caring for a 23-year-old client with bulimia knows that the most common method of purging to monitor this client for is:

  • A. Vomiting.
  • B. Starvation.
  • C. Excessive enema use.
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A: Vomiting. In bulimia, vomiting is the most common method of purging after binge eating to control weight. Monitoring for signs of vomiting, such as frequent trips to the bathroom after meals or presence of swollen salivary glands, is crucial. Starvation (B) is not a method of purging in bulimia but rather a consequence of restriction in anorexia nervosa. Excessive enema use (C) is not a common method of purging in bulimia and can be harmful. Therefore, the correct choice is A as it aligns with the typical behavior of individuals with bulimia.

Which data gathered from the assessment of a family with a schizophrenic member would be of greatest importance in discharge planning for the patient?

  • A. The patient is the middle sibling.
  • B. The patient's mother is a talented artist.
  • C. The patient's paternal grandfather was considered 'eccentric.'
  • D. The patient becomes anxious when family members are critical of one another.
Correct Answer: D

Rationale: The correct answer is D because understanding how the patient reacts to family dynamics is crucial for discharge planning. Anxiety triggered by family conflict can impact the patient's well-being post-discharge. Choices A, B, and C are less relevant as they do not directly address the patient's immediate needs or potential stressors. Middle sibling status, maternal artistic talent, and paternal grandfather's eccentricity are interesting but not as directly impactful on the patient's discharge planning compared to the patient's response to family conflicts.

Sudden temporary amnesia or instances of multiple personality are disorders

  • A. dissociative
  • B. anxiety
  • C. psychotic
  • D. schizophrenic
Correct Answer: A

Rationale: Dissociative disorders include amnesia and multiple personalities, linked to identity disruption.

Which of these nursing communications best reflects the nurse's use of an empowerment model with an individual who has been abused?

  • A. Let me share with you my knowledge of what happens psychologically to individuals who have been abused.'
  • B. I know you feel that your partner will change, but the current research does not validate your thinking.'
  • C. It's up to you to end the violence. You are the only one who can set limits on how your partner is allowed to treat you.'
  • D. Let's consider what you believe your options are in terms of your relationship with your partner in light of the behavior toward you.'
Correct Answer: D

Rationale: The correct answer, D, reflects the nurse's use of an empowerment model because it focuses on exploring the individual's beliefs and options, empowering them to make informed decisions. The nurse is not imposing their own knowledge or opinions but instead facilitating the individual's self-reflection and decision-making process. This approach respects the individual's autonomy and promotes empowerment by helping them identify and evaluate their own choices.

Choice A focuses on the nurse sharing knowledge, which may come across as patronizing and disempowering. Choice B dismisses the individual's feelings and relies on research rather than empowering the individual to make their own decisions. Choice C places the responsibility solely on the individual to end the violence, which may feel overwhelming and lacking in support or guidance.

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