Age Specific Care

Age Specific Care Related

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A patient with fluctuating levels of awareness, confusion, and disorientation shouts, 'The bugs, they are crawling on my legs! Get them off me!' The nurse's inspections show that no bugs are present. The nurse can best assess this presentation as:

  • A. Perseveration.
  • B. Hypermetamorphosis.
  • C. Tactile hallucinations.
  • D. None of the above.
Correct Answer: C

Rationale: The correct answer is C: Tactile hallucinations. Tactile hallucinations involve the perception of physical sensations such as bugs crawling on the skin when no external stimuli are present. In this scenario, the patient's complaint of bugs crawling on their legs despite the nurse's inspection confirming the absence of bugs indicates a sensory hallucination, specifically a tactile one. This is different from perseveration (repetition of a particular response or activity) and hypermetamorphosis (excessive attention to environmental details). Choosing "None of the above" would not address the specific symptom of tactile hallucinations described in the patient's presentation.

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A school-aged patient with attention-deficit hyperactivity disorder (ADHD) is displaying disruptive behaviors at home. The psychiatric-mental health nurse modifies the treatment plan for the social domain, by advising the patient's parents to:

  • A. establish eye contact before giving directions
  • B. initiate a point system, to reward the patient for appropriate behavior
  • C. instruct the patient to work on one homework assignment at a time
  • D. maintain a predictable environment in the home
Correct Answer: B

Rationale: A point system reinforces positive behavior, directly addressing social disruptiveness in ADHD.

Psychological dependence on mood- or behavior-altering drugs is known as

  • A. drug psychosis
  • B. a substance related disorder
  • C. an orthopsychosis
  • D. a psychotropic disorder
Correct Answer: B

Rationale: Substance-related disorders encompass psychological dependence on drugs altering mood or behavior.

A 75-year-old male client is brought to the clinic by his son. The son states, 'Ever since Mom died, Dad hasn't been the same. At first he just seemed sad, but now he seems to get mixed up about everything.' The nurse is aware that based on the client's history, the source of confusion is most likely:

  • A. Dementia
  • B. Depression from the loss of his wife
  • C. Hypoxia of the brain
  • D. Delirium from medications
Correct Answer: B

Rationale: Correct Answer: B - Depression from the loss of his wife

Rationale: Given the client's recent loss of his wife and subsequent changes in behavior, the most likely cause of his confusion is depression. Depression can manifest as cognitive impairment in older adults, leading to symptoms such as confusion and memory problems. Additionally, grief and loss can exacerbate depressive symptoms in elderly individuals, further contributing to cognitive difficulties.

Summary of other choices:
A: Dementia - Dementia typically presents with gradual cognitive decline over time, not a sudden onset following a specific event like the loss of a loved one.
C: Hypoxia of the brain - Hypoxia would likely present with more acute symptoms and physical signs, such as shortness of breath or cyanosis.
D: Delirium from medications - Delirium is characterized by acute onset and fluctuating course, often related to medication changes or other medical conditions, rather than an emotional trigger like grief.

What is the correct assessment for a patient with bulimia nervosa who frequently engages in purging behaviors?

  • A. Observe for parotid gland enlargement and dehydration.
  • B. Assess for fluid retention and leg swelling.
  • C. Perform regular weight checks to assess for weight loss.
  • D. Evaluate for signs of hyperactivity and poor sleep.
Correct Answer: A

Rationale: The correct assessment for a patient with bulimia nervosa who frequently engages in purging behaviors is to observe for parotid gland enlargement and dehydration. Parotid gland enlargement is a common physical manifestation due to repeated vomiting, and dehydration can result from purging behaviors. This assessment is crucial in monitoring the patient's physical health and identifying potential complications. Assessing for fluid retention and leg swelling (Choice B) is more typical in conditions like heart failure. Performing weight checks (Choice C) may not accurately reflect the patient's health status due to fluid shifts. Evaluating for signs of hyperactivity and poor sleep (Choice D) are not directly related to the immediate physical consequences of purging behaviors.

Children should undergo further evaluation when their weight is % above their height.

  • A. 10
  • B. 15
  • C. 20
  • D. 25
Correct Answer: C

Rationale: The correct answer is C (20%). This is because a weight that is 20% above a child's height can indicate potential health issues such as obesity. Excess weight can lead to various health problems in children. Choices A, B, and D are incorrect as they represent lower percentages, which may not be as concerning in terms of potential health risks. It is important to consider a higher percentage threshold for further evaluation to ensure early detection and intervention for any weight-related issues.

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