Age Specific Considerations in Patient Care Related
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A patient who takes lithium phones the nurse at the clinic to say, "I've had diarrhea for 4 days. I feel weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?" Which instruction by the nurse is appropriate?
A. Have someone bring you to the clinic immediately.
B. Restrict food and fluids for 24 hours and stay in bed.
C. Drink a large glass of water with 1 teaspoon of salt added.
D. Take antidiarrheal medication hourly until the diarrhea subsides.
Correct Answer: A
Rationale: The correct answer is A: Have someone bring you to the clinic immediately. The patient is experiencing symptoms of lithium toxicity, including diarrhea, weakness, unsteadiness, and worsening hand tremor. These symptoms indicate a potential lithium overdose, which can be life-threatening. Bringing the patient to the clinic immediately is crucial for assessment, monitoring, and intervention.
Choice B is incorrect because restricting food and fluids can worsen dehydration and electrolyte imbalances. Choice C is incorrect as adding salt to water can exacerbate electrolyte abnormalities in lithium toxicity. Choice D is incorrect as taking antidiarrheal medication can further worsen the symptoms and delay appropriate medical treatment.
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A researcher seeking an organic basis for schizophrenia would be well-advised to investigate the role of
A. amphetamines and amphetamine receptors
B. adrenaline and noradrenaline
C. histamine and antihistamine
D. dopamine and dopamine receptors
Correct Answer: D
Rationale: Dopamine dysregulation, particularly via receptors, is a primary organic focus in schizophrenia research.
A teacher comes to the mental health clinic saying a co-worker recently confronted her about behaviors that are annoying to other co-workers. She is now experiencing moderate to severe levels of anxiety. The co-worker told the patient that others find her very difficult because she is a perfectionist and micromanages the tasks of others on the teaching team, always demanding that things should be done according to her plans. The co-worker mentioned that the patient made everyone feel as though everything they tried was inadequate, and they feel frustrated and angry. The patient states she likes her co-workers and only wanted to help them be successful. The nurse realizes the patient's behaviors are most consistent with:
A. obsessive-compulsive personality disorder.
B. narcissistic personality disorder.
C. histrionic personality disorder.
D. schizoid personality disorder.
Correct Answer: A
Rationale: The correct answer is A: obsessive-compulsive personality disorder. This is because the patient's behaviors of being a perfectionist, micromanaging tasks, demanding things be done according to her plans, and making others feel inadequate align with the diagnostic criteria for obsessive-compulsive personality disorder. Individuals with this disorder are preoccupied with orderliness, perfectionism, and control.
Choice B: narcissistic personality disorder, is incorrect because the patient's behaviors are not characterized by a sense of grandiosity, a lack of empathy, or a need for admiration, which are hallmark features of narcissistic personality disorder.
Choice C: histrionic personality disorder, is incorrect as individuals with this disorder typically display attention-seeking behavior, emotional instability, and excessive emotionality, none of which are evident in the patient's presentation.
Choice D: schizoid personality disorder, is incorrect as individuals with this disorder tend to be socially detached, have limited emotional expression, and prefer solitary activities, which do not align with the
Which of the following is NOT a suitable place for a family doctor outside the polyclinic to refer an adolescent patient for psychotherapy/counselling?
A. Local Social Service Office
B. Nearby polyclinic
C. Patients school
D. A reputable restructured hospital
Correct Answer: B
Rationale: A nearby polyclinic is less suitable for psychotherapy referral as it focuses on primary care, unlike the other options with counseling services.
The mother of a teenager diagnosed with an eating disorder asks, 'How long will my daughter have this problem?' The nurse answers with the knowledge that:
A. recovery is usual after one severe episode.
B. less than 30% show improvement after 5 years.
C. weight restoration is sufficient for recovery.
D. long-term therapy combined with medication results in the best outcomes.
Correct Answer: D
Rationale: The correct answer is D because long-term therapy combined with medication results in the best outcomes for individuals with eating disorders. Therapy helps address underlying psychological issues, while medication can help manage symptoms. Recovery is a complex process that often requires ongoing support. Choice A is incorrect as recovery is not always guaranteed after one severe episode. Choice B is incorrect as many individuals do show improvement over time. Choice C is incorrect as weight restoration alone may not address all aspects of the disorder.
Which assessment findings would alert the nurse that an older patient may have an increased risk for development of geriatric alcohol abuse? Select one tha does not apply.
A. Mild recent memory impairment
B. Eighth grade education
C. Death of spouse
D. Retirement
Correct Answer: A
Rationale: Geriatric problem drinking often begins in response to stressors like retirement (D), loss of spouse (C), and loneliness (E), with risk factors including less than high school education (B). Mild memory impairment (A) is not a predisposing factor.