Nokea
An adolescent patient is diagnosed with dementia. The patient's age would cause a nurse to suspect which underlying condition sometimes associated with this diagnosis?
- A. Head trauma
- B. Neurosyphilis
- C. Pick disease
- D. Hypothyroidism
Correct Answer: A
Rationale: The correct answer is A: Head trauma. Adolescents are less likely to develop dementia due to age-related neurodegenerative diseases. Head trauma can lead to cognitive impairment and memory loss, mimicking symptoms of dementia. Neurosyphilis is a sexually transmitted infection affecting the brain, not common in adolescents. Pick disease is a rare neurodegenerative disorder more commonly seen in older adults. Hypothyroidism can cause cognitive symptoms but is not typically associated with dementia in adolescents.
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A newly admitted patient diagnosed with paranoid schizophrenia is hypervigilant and constantly scans the environment. He states that he saw two doctors talking in the hall and knows they were plotting to kill him. When charting, how should the nurse identify this behavior?
- A. Idea of reference
- B. Delusion of infidelity
- C. Auditory hallucination
- D. Echolalia
Correct Answer: A
Rationale: The correct identification for the behavior described is "A: Idea of reference." This term refers to the belief that neutral events are directed at oneself. In this case, the patient's belief that the doctors were plotting to kill him is an example of a false idea of reference. Delusion of infidelity (choice B) involves false beliefs about a partner's unfaithfulness, not relevant here. Auditory hallucination (choice C) pertains to false perceptions of hearing sounds, not applicable. Echolalia (choice D) is the repetition of words spoken by others, not seen in this scenario. Identifying the behavior as an idea of reference helps the nurse understand the patient's distorted perception of reality.
Which beliefs by a nurse facilitate provision of safe, effective care for older adult patients? Select one tha does not apply.
- A. Sexual interest declines with aging.
- B. Older adults are able to learn new tasks.
- C. Aging results in a decline in restorative sleep.
- D. Older adults are prone to become crime victims.
Correct Answer: A
Rationale: Older adults can learn new tasks (B), experience a decline in restorative sleep (C), and are prone to crime (D), aiding effective care. Sexual interest doesn't universally decline (A), and isolation isn't typical (E); these are myths.
A parent who is very concerned about a 3-year-old son says, 'He likes to play with girls' toys. Do you think he is homosexual or mentally ill?' Which response by the nurse most professionally describes the current understanding of gender identity?
- A. A child's interest in the activities of the opposite gender is not unusual or related to sexuality. Most children do not carry cross-gender interests into adulthood.
- B. It's difficult to say for sure because the research is incomplete so far, but chances are that he will grow up to be a normal adult.
- C. The research is incomplete, but many boys play with girls' toys and turn out normal as adults.
- D. I am sure that whatever happens, he will be a loving son, and you will be a proud parent.
Correct Answer: A
Rationale: The correct answer is A because it accurately reflects the current understanding of gender identity. Children's interests in activities typically associated with the opposite gender are not unusual and are not indicative of sexual orientation or mental illness. Most children who exhibit cross-gender interests do not carry these into adulthood. This response emphasizes the normalcy of such behavior and provides reassurance to the parent.
Choice B is incorrect because it implies uncertainty based on incomplete research, which goes against the established understanding that cross-gender interests in childhood are common and not predictive of future outcomes.
Choice C is incorrect because it focuses on incomplete research and uses the term "normal as adults," which can perpetuate stigmas surrounding gender expression.
Choice D is incorrect because it does not address the parent's concerns about the child's behavior and does not provide accurate information about gender identity development.
For those family members who desire to care at home for loved ones who have been given a diagnosis of Alzheimer's disease, it is important for the nurse to ensure that the family is aware of which caregiver skills and responsibilities will be necessary. What is one of the responsibilities of the caregiver during the middle stage of the disease?
- A. Helping the loved one with memory and communication problems
- B. Providing a stable, routine environment
- C. Providing complete assistance with physical care
- D. Adapting to the changing personality and behavior of the loved one
Correct Answer: D
Rationale: The correct answer is D: Adapting to the changing personality and behavior of the loved one. During the middle stage of Alzheimer's disease, individuals may experience significant changes in personality and behavior. Caregivers need to adapt to these changes by being patient, understanding, and flexible. This responsibility is crucial for maintaining a positive and supportive relationship with the loved one.
A: Helping the loved one with memory and communication problems is important, but it is more relevant in the early stages of the disease when these issues are more prominent.
B: Providing a stable, routine environment is essential throughout all stages of Alzheimer's disease, not just the middle stage.
C: Providing complete assistance with physical care may become necessary in the later stages of the disease when the individual's physical abilities decline significantly.
An emergency department nurse prepares to assist with evidence collection for a sexual assault victim. Prior to photographs and pelvic examination, what documentation is important?
- A. The patient's vital signs
- B. Consent signed by the patient
- C. Supervision and credentials of the examiner
- D. Storage location of the patient's personal effects
Correct Answer: B
Rationale: The correct answer is B: Consent signed by the patient. This is crucial as it ensures the patient's autonomy and willingness to undergo evidence collection. Without proper consent, the procedure would be unethical and potentially illegal. Vital signs (A) may be important for overall assessment but are not directly related to evidence collection. Supervision and credentials of the examiner (C) are necessary but not the most important documentation. The storage location of personal effects (D) is relevant for patient safety but not essential for evidence collection.