Nokea
A woman with Alzheimer's disease has significant apraxia and poor hygiene. Which intervention would be most appropriate for ensuring that the patient completes a shower?
- A. Remind her of the need for a shower and where the shower is, and repeat this every 30 minutes until the shower is completed.
- B. Discuss with her the importance of showers as part of daily self-care, and elicit and resolve any obstacles to the patient's showering.
- C. Walk her to the shower, and provide occasional reminders of what she should do next if she seems to be unsure or begins to repeat previous actions.
- D. Walk her to the shower, assist her to undress, start the water, supply the soap and washcloth, and instruct her to rub her face with the washcloth.
Correct Answer: D
Rationale: The correct answer is D because it provides the most direct and hands-on assistance to ensure completion of the shower. By walking her to the shower, assisting with undressing, starting the water, and providing necessary supplies and instructions, the patient is guided through each step of the showering process. This approach is essential for someone with significant apraxia and poor hygiene due to Alzheimer's disease.
Choice A is incorrect because simply reminding the patient every 30 minutes may not address the physical assistance needed for shower completion. Choice B is also incorrect as discussing the importance of showers may not be enough to overcome the challenges of apraxia and poor hygiene. Choice C is not as effective as choice D as occasional reminders may not provide the comprehensive assistance required for the patient to successfully complete the shower.
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Multiple personality or dissociative identity disorder often begins
- A. as a result of combat exhaustion
- B. in adulthood as a response to unremitting phobias
- C. as a consequence of post-traumatic stress disorders
- D. in childhood as a result of unbearable experiences
Correct Answer: D
Rationale: Dissociative identity disorder typically originates in childhood from severe trauma, such as abuse, leading to identity fragmentation.
Health Services for disabilities in children and youth:
- A. Are provided by HPB and the Child Development Programmes only
- B. Are inclusive and equitable
- C. Are well-integrated with social services
- D. Ought to include caregiver support and be familycentred
Correct Answer: D
Rationale: Health services should be family-centered and include caregiver support, reflecting best practices in disability care.
Which of the following will lead one to need to consider autism spectrum disorder as a likely diagnosis?
- A. A girl spoke her first words at 14 months, enjoyed playing with Peppa Pig characters at age 2 daily. She tended to sit away from her classmates at recess at age 7 but when asked, would say she had 30 friends. She was very good at the piano and had strong knowledge of all the great composers at age 8. She entered the Gifted Education Programme at 10. At 13, she did poorly at group work, often talked about death and the afterlife, and became progressively silent
- B. A boy walked at 18 months, spoke his first words at 2 , and enjoyed playing Minecraft at 4 together with his friends. He participated at birthday parties. He struggled with composition writing, both for ideas and also for the efforts in writing in school, but managed an AL score of 18 and was promoted to secondary school
- C. A boy walked at 13 months and was a happy child in preschool. He started speaking at 18 months but did not recognise letters and numbers consistently until 4.5 years of age. He did not read until 7 . He was sometimes forgetful with instructions but did not cause disruption in school, though he was often the clown in class. He tended to not finish his work unless his parents sat with him. Nonetheless, he completed primary school with some extra time for exams and went on to secondary school
- D. A girl walked at 16 months and was often clumsy though she did not fall. She would bump into things and might drop items in her hands. She disliked writing and was slow to write. She could never complete her work in class. She would shade the wrong answers on the optical answer sheet although she knew the right answers. She had trouble with mathematics thoughout school but she enjoyed reading
Correct Answer: A
Rationale: Option A shows social withdrawal, poor group interaction, and restricted interests (music, death themes), aligning with ASD criteria in DSM-5, unlike the others with more typical development or specific learning/motor issues.
The client is describing her trip to town. She tells the nurse, 'I cold town yellow water girl outside below ground.' This speech disturbance is called:
- A. Neologism
- B. Word salad
- C. Flight of ideas
- D. Verbigeration
Correct Answer: B
Rationale: The correct answer is B: Word salad. This speech disturbance is characterized by a jumble of words that lack coherent meaning or connection. In this case, the client's words are disorganized and nonsensical. Neologism (A) is the creation of new words, not a jumble of existing words. Flight of ideas (C) involves rapid shifts in thoughts without a clear connection, not a jumble of words. Verbigeration (D) is the constant repetition of words or phrases, not a jumble of unrelated words.
A respected school coach was arrested after a student reported the coach attempted to have sexual contact. Which nursing action has priority in the period immediately following the coach's arrest?
- A. Determine the nature and extent of the coach's sexual disorder.
- B. Assess the coach's potential for suicide or other self-harm.
- C. Assess the coach's self-perception of problem and needs.
- D. Determine whether other children were harmed.
Correct Answer: B
Rationale: The correct answer is B: Assess the coach's potential for suicide or other self-harm. This is the priority nursing action because the coach may be experiencing intense emotional distress and may be at risk for harming themselves. By assessing for suicidal ideation or self-harm, the nurse can ensure the coach's safety and provide appropriate interventions if needed.
Choice A is incorrect because determining the nature and extent of the coach's sexual disorder is not the priority at this moment. Choice C is also incorrect as assessing the coach's self-perception of the problem and needs can be addressed after ensuring their immediate safety. Choice D is incorrect as determining whether other children were harmed is important but not the priority immediately following the coach's arrest.