Age Specific Care

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A psychiatric technician mentions to the nurse, 'All these clients with Axis II problems! It makes me wonder how so many mothers could have been such poor parents and messed up their kids so badly!' The response by the nurse that helps put the development of personality disorders into perspective is:

  • A. Parenting is the responsibility of fathers, too, so don't blame only mothers.'
  • B. Personality disorder is often related to sexual abuse that occurs without parental knowledge.'
  • C. There is some evidence to suggest a biologic component to personality disorders.'
  • D. Peer interactions may be more important in child development than parental involvement.'
Correct Answer: C

Rationale: Step-by-step rationale for why choice C is correct:
1. Personality disorders are complex conditions influenced by a combination of genetic, environmental, and biological factors.
2. Research has shown evidence suggesting a biological component in the development of personality disorders.
3. Understanding the biological component helps to destigmatize and provide a more comprehensive view of personality disorders.
4. This response helps the psychiatric technician understand that blaming parents solely is not accurate and that multiple factors contribute to the development of personality disorders.

Summary:
Choice C is correct because it highlights the importance of considering biological factors in the development of personality disorders, providing a more holistic perspective. Choices A, B, and D are incorrect as they do not address the multifactorial nature of personality disorders.

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The elderly spouse of a female Alzheimer's client states that his wife seems to wander aimlessly from room to room looking for things in incorrect places, such as kitchen utensils in the bedroom and laundry detergent in the kitchen. He asks the nurse for suggestions of what he can do to help her. What is the nurse's best response?

  • A. Keep rooms well lit.'
  • B. Keep the home environment simple and user-friendly for her.'
  • C. Have clocks and calendars with large letters in several rooms of the house.'
  • D. Place large signs on doors or entryways that identify the room.'
Correct Answer: D

Rationale: The correct answer is D: Place large signs on doors or entryways that identify the room. This is the best response because it directly addresses the issue of the client's confusion and disorientation by providing clear visual cues to help her navigate the home environment effectively. By labeling the rooms with large signs, the client can easily recognize where she is and find what she needs. This strategy helps reduce her anxiety and frustration, promoting a sense of independence and safety.

Choices A, B, and C are incorrect because they do not specifically target the client's cognitive challenges related to Alzheimer's disease. Keeping rooms well lit, having a simple environment, and using clocks with large letters are helpful suggestions but do not address the primary issue of the client's spatial disorientation and confusion. Placing large signs on doors directly addresses the client's specific needs and is the most effective strategy in this situation.

Which of the following is the first-line treatment for Anorexia Nervosa?

  • A. Family-Based Therapy
  • B. Cognitive Behavioural Therapy
  • C. Psychodynamic therapy
  • D. Humanistic therapy
Correct Answer: A

Rationale: Family-Based Therapy (FBT) is the evidence-based first-line treatment for Anorexia Nervosa in adolescents, per NICE and APA guidelines.

Police bring a patient to the mental health unit. The patient was directing traffic and shouting rhymes on a busy city street. The patient's spouse reports that the patient has not slept or eaten for 3 days. Which assessment findings have priority concern for this patient's plan of care?

  • A. Pressured speech and grandiosity
  • B. Hyperactivity; not eating and sleeping
  • C. Poor concentration and decision making
  • D. Insulting
Correct Answer: B

Rationale: The correct answer is B. Hyperactivity, not eating, and not sleeping are priority concerns as they indicate potential mania or hypomania, which can be dangerous and require immediate intervention. Not eating and sleeping for days can lead to physical and mental health complications. Pressured speech and grandiosity (Choice A) are symptoms of mania but not as urgent as lack of eating and sleeping. Poor concentration and decision making (Choice C) are also symptoms of mania, but not as immediately concerning as the lack of eating and sleeping. Insulting behavior (Choice D) is not a priority concern for immediate intervention in this scenario.

A nurse plans a staff education program for employees of a senior living community. Which topic has priority?

  • A. Late-onset schizophrenia
  • B. Depression and suicide
  • C. Dementia
  • D. Delirium
Correct Answer: B

Rationale: Older Americans frequently experience undiagnosed depression and are disproportionately more likely to commit suicide (B). Educating staff about signs and symptoms of high-risk patients and early intervention strategies will decrease morbidity and mortality. The other conditions (A, C, D) have a lower prevalence.

A client with obsessive-compulsive personality disorder is described by other staff as being perfectionistic, inflexible, and a 'master at procrastination.' The nurse learns that the client is nearly immobilized during times that call for the client to make a decision. The nurse realizes that the most likely hypothesis is this behavior is related to:

  • A. A need to make others uncomfortable
  • B. Needing to be the center of attention
  • C. Wanting someone else to be responsible
  • D. Fear of making a mistake
Correct Answer: D

Rationale: The correct answer is D: Fear of making a mistake. This is the most likely hypothesis because individuals with obsessive-compulsive personality disorder often have an intense fear of making errors or mistakes. This fear can lead to excessive preoccupation with details, perfectionism, and procrastination. The client's immobilization during decision-making moments is likely due to the overwhelming anxiety and fear of making the wrong choice, which is a common trait in individuals with this disorder.

Choice A (A need to make others uncomfortable) is incorrect because there is no indication that the client's behavior is driven by a desire to cause discomfort to others. Choice B (Needing to be the center of attention) is incorrect as individuals with obsessive-compulsive personality disorder typically focus more on their own perfectionism rather than seeking attention. Choice C (Wanting someone else to be responsible) is incorrect as this behavior is more about the individual's fear of making mistakes rather than avoiding responsibility.

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