Nokea
An appropriate intervention for a patient with situational low self-esteem would be:
- A. Providing large muscle activities to relieve stress
- B. Attempting to determine triggers to hallucinations
- C. Engaging patient in activities designed to permit success
- D.
Encouraging verbalization of feelings in a safe environment
Correct Answer: C
Rationale: The correct answer is C because engaging the patient in activities designed to permit success helps boost self-esteem by providing opportunities for achievement. This intervention focuses on building the patient's confidence and self-worth through positive experiences. Choice A is incorrect as it addresses stress relief rather than self-esteem. Choice B is irrelevant as it pertains to hallucinations, not self-esteem. Choice D is also incorrect because while verbalizing feelings is important, it may not directly target the underlying issue of low self-esteem.
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What is the priority nursing diagnosis for a catatonic patient?
- A. Ineffective coping
- B. Impaired physical mobility
- C. Risk for deficient fluid volume
- D. Impaired social interaction
Correct Answer: C
Rationale: The priority nursing diagnosis for a catatonic patient is Risk for deficient fluid volume (C) because catatonic patients are at risk for dehydration due to decreased fluid intake or inability to meet fluid needs. This diagnosis takes precedence over others as dehydration can lead to serious complications. Ineffective coping (A) may be secondary to the catatonic state but addressing fluid volume is more urgent. Impaired physical mobility (B) and Impaired social interaction (D) are important but not as critical as addressing the risk of dehydration in a catatonic patient.
Which physical disturbance is commonly assessed in patients experiencing acute grief?
- A. Tightness in the chest
- B. Hypersomnia
- C. Increased appetite
- D. Cardiovascular problems
Correct Answer: A
Rationale: The correct answer is A: Tightness in the chest. This physical disturbance is commonly associated with acute grief due to the emotional pain experienced. It is a manifestation of the intense feelings of sadness and loss that accompany grief. Tightness in the chest can be a result of the stress response triggered by grief, leading to physical symptoms such as chest pain and difficulty breathing.
Summary:
B: Hypersomnia and C: Increased appetite are more commonly associated with conditions like depression, while D: Cardiovascular problems may be a long-term consequence of chronic stress but are not typically assessed as a primary physical disturbance in acute grief.
A new nurse asks, “My elderly patient has Lewy body disease. What should I do about assessing for pain?” Select the best response from the nurse manager.
- A. Ask the patient’s family if they think the patient is experiencing pain.
- B. Use a visual analog scale to help the patient determine the presence and severity of pain.
- C. There are special scales for assessing patients with dementia. Let’s review how to use them.
- D. The perception of pain is diminished by this type of dementia. Focus your assessment on the patient’s mental status.
Correct Answer: C
Rationale: The correct answer is C because Lewy body disease can affect a patient's ability to communicate pain, making specialized pain assessment tools crucial. Special scales designed for patients with dementia can help in accurately assessing pain levels. These tools consider non-verbal cues and behavioral changes that may indicate pain. Asking the patient's family (A) may not always provide an accurate assessment of pain perception. Using a visual analog scale (B) may be challenging for a patient with cognitive impairment. Focusing solely on mental status (D) may overlook important indicators of pain in patients with Lewy body disease.
A nurse assesses four patients between the ages of 70 and 80. Which patient has the highest risk for alcohol abuse? The patient who:
- A. Consumes 1 glass of wine nightly with dinner.
- B. Drank socially throughout adult life and continues this pattern, saying, “I’ve earned the right to do as I please.”
- C. Began drinking alcohol daily after retirement and says, “A few drinks keep my mind off my arthritis.”
- D. Abused alcohol between the ages of 25 and 40 but now abstains and occasionally attends Alcoholics Anonymous (AA).
Correct Answer: C
Rationale: The correct answer is C because the patient who started drinking daily after retirement as a coping mechanism for arthritis has the highest risk for alcohol abuse. This behavior indicates a potential dependence on alcohol to manage physical and emotional discomfort, leading to increased consumption and potential addiction.
Choice A is not the correct answer because consuming 1 glass of wine nightly with dinner is generally considered moderate drinking and does not necessarily indicate alcohol abuse.
Choice B is also not the correct answer as social drinking throughout adult life, even if justified as a reward, does not inherently suggest alcohol abuse without further evidence of problematic drinking patterns.
Choice D is incorrect as the patient has a history of alcohol abuse but currently abstains and seeks support through AA, indicating active efforts to maintain sobriety and reduce the risk of alcohol abuse.
A nurse is working with a group of older adults attending a seminar on the physical and emotional effects of aging. Which patient statements are good predictors of positive well-being and perceived mortality? (Select all that apply.)
“Not having to deal with the stress of any major chronic illnesses.”
- A. “Being satisfied with growing older.”
- B. “Feeling younger than my birthdays say I should.”
- C. “Retirement gives me time to do the things I’ve put off doing.”
- D. “At least I don’t have to worry about having enough money to retire.
Correct Answer: A, C
Rationale: The correct answers are A and C. Statement A indicates a positive attitude towards aging, which is a good predictor of positive well-being. Feeling satisfied with growing older can lead to better emotional health and higher perceived mortality. Statement C suggests that retirement provides opportunities for personal fulfillment, which can contribute to positive well-being. Statements B and D do not directly address attitudes towards aging or well-being, making them less reliable predictors.