Age Specific Care

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A physically frail elderly patient with mild cognitive impairments needs services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this patient during the evening and night. Which type of facility should the nurse suggest to meet this patient's needs?

  • A. Adult day care program
  • B. Skilled nursing facility
  • C. Partial hospitalization
  • D. Group home
Correct Answer: A

Rationale: The correct answer is A: Adult day care program. This option is suitable as it provides supervision, safety, recreation, and social interaction during the day while allowing the family to care for the patient in the evening and night. Adult day care programs offer a structured environment with trained staff to ensure the patient's safety and provide social engagement.

- Option B, Skilled nursing facility, is not the best choice as it usually provides round-the-clock care, which may not be necessary in this case.
- Option C, Partial hospitalization, is more focused on intensive psychiatric treatment and therapy, which may not align with the patient's needs.
- Option D, Group home, is designed for individuals who need 24-hour care and supervision, which exceeds the patient's current requirements.

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A nurse is working with a patient diagnosed with bulimia nervosa. Which of the following would indicate the need for further education?

  • A. I know that purging is harmful to my health, but I continue to do it.
  • B. I feel better after purging, but I realize it is not a long-term solution.
  • C. I can control my eating and purging behaviors without help from others.
  • D. I am working with my healthcare team to improve my eating habits and emotional health.
Correct Answer: C

Rationale: The correct answer is C because it indicates a lack of awareness about the severity of the disorder. Choice A acknowledges the harm of purging but struggles to stop, showing insight. Choice B recognizes the temporary relief of purging but understands the need for a better solution. Choice D demonstrates active engagement with healthcare professionals for support. In contrast, choice C suggests overconfidence in managing the disorder independently, which can hinder recovery progress. It is crucial for individuals with bulimia nervosa to acknowledge the need for professional help and support.

A patient with the diagnosis of schizophrenia, disorganized type, approaches the nurse and says, 'It's beat, it's eat. No room for doom.' The nurse can correctly assess this verbalization as:

  • A. neologisms.
  • B. clanging.
  • C. ideas of reference.
  • D. associative looseness.
Correct Answer: B

Rationale: The correct answer is B: clanging. Clanging refers to the pattern of speech characterized by the association of words based on sound rather than meaning. In this case, the patient's verbalization, "It's beat, it's eat. No room for doom," demonstrates a connection based on rhyming sounds rather than coherent meaning. This is a classic example of clanging commonly seen in individuals with disorganized schizophrenia. Neologisms (choice A) refer to new words created by the individual, ideas of reference (choice C) involve believing that external events have special significance for oneself, and associative looseness (choice D) pertains to a lack of logical connection between thoughts. These choices are incorrect as they do not accurately describe the patient's speech pattern in this scenario.

The nursing diagnosis Rape-trauma syndrome is established for a rape victim in the emergency department. Select the most important outcome to achieve before discharging the patient!

  • A. The patient will describe feelings of safety and relaxation.
  • B. The memory of the rape will be less vivid and less frightening.
  • C. Physical symptoms of pain and discomfort are no longer present.
  • D. The patient will agree to keep a follow-up appointment with a rape victim advocate.
Correct Answer: D

Rationale: The correct answer is D. Establishing a follow-up appointment with a rape victim advocate is crucial for ongoing support and recovery. It ensures the patient has access to necessary resources and assistance in coping with the trauma. Choice A focuses on emotional well-being but doesn't address long-term support. Choice B addresses memory but doesn't ensure ongoing care. Choice C only addresses physical symptoms, neglecting the emotional and psychological impact of the trauma. Thus, choice D is the most important outcome to achieve before discharging the patient to promote comprehensive care and support.

A patient reports an intense, overwhelming fear of driving a car. The fear has disrupted all elements of the patient's life. The patient does not go to the grocery store unless driven by someone else, has relinquished their job, and has few social contacts. The patient's treatment plan includes:

  • A. assertiveness training
  • B. biofeedback
  • C. stress management assistance
  • D. systematic desensitization
Correct Answer: D

Rationale: Systematic desensitization gradually exposes the patient to driving-related stimuli, reducing phobia through controlled steps.

In activity 5, all of the following people got sick from the concession stand except

  • A. Jose
  • B. Lisa
  • C. Mia
  • D. Ken
Correct Answer: D

Rationale: Assuming Ken did not get sick (context-specific), he is the exception among those listed.

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