Age Specific Populations

Age Specific Populations Related

Review Age Specific Populations related questions and content

An elderly client was well until 12 hours ago, when she reported to her family that during the evening she saw strange faces peering in her windows and in the middle of the night awakened to see a man standing at the foot of her bed. She admits to being very frightened. She is presently pacing and somewhat agitated in the examining room. The client's family reports that the client has recently been to the doctor, who made some medication changes, although they are unsure what the changes were. The nurse hearing this history will identify the history and symptoms as pointing to:

  • A. Delirium related to drug toxicity
  • B. Pick's disease
  • C. Parkinson's dementia
  • D. Amnestic disorder
Correct Answer: A

Rationale: The correct answer is A: Delirium related to drug toxicity. The client's sudden onset of visual hallucinations, fear, agitation, recent medication changes, and pacing behavior are indicative of delirium. Delirium is an acute change in mental status characterized by confusion, disorientation, and perceptual disturbances, often triggered by medication changes in the elderly. Pick's disease (B) is a type of frontotemporal dementia characterized by personality changes and language difficulties. Parkinson's dementia (C) is a type of dementia associated with Parkinson's disease, presenting with motor symptoms first. Amnestic disorder (D) is a memory impairment disorder, not consistent with the client's symptoms.

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A 45-year-old married woman who works full time in a factory has recently been absent for 3-day periods on several occasions. Each time, she returned to work wearing dark glasses. Facial and body bruises were apparent. Her supervisor became suspicious that she was a victim of battering and referred her to the occupational health nurse. Which initial inquiry would be most important for the nurse to make?

  • A. Tell me what has happened to you.'
  • B. Did your husband beat you?'
  • C. Why do you let this happen?'
  • D. What can you do to prevent this?'
Correct Answer: A

Rationale: The correct answer is A: "Tell me what has happened to you." This open-ended question allows the woman to share her experience without judgment or assumptions. It shows empathy and respect for her autonomy. It is crucial for the nurse to gather information directly from the patient to understand the situation fully and provide appropriate support.

Choice B is incorrect because it assumes the woman's husband is the perpetrator without giving her a chance to disclose the information herself. This can be intimidating and may not lead to a truthful response.

Choice C is incorrect because it implies blame on the victim for the abuse, which is not appropriate. It does not focus on providing support or understanding the situation.

Choice D is incorrect as it puts the responsibility on the victim to prevent the abuse, which is not a helpful approach. The focus should be on providing support and understanding the victim's situation.

A patient tells the nurse, "My doctor prescribed Paxil (paroxetine) for my depression. I assume I'll have side effects like I had when I was taking Tofranil (imipramine)." The nurse's reply should be based on the knowledge that paroxetine is a:

  • A. Selective norepinephrine reuptake inhibitor.
  • B. Tricyclic antidepressant.
  • C. MAO inhibitor.
  • D. SSRI
Correct Answer: D

Rationale: The correct answer is D: SSRI. Paroxetine belongs to the class of selective serotonin reuptake inhibitors (SSRIs), which work by primarily increasing the levels of serotonin in the brain. This mechanism differs from tricyclic antidepressants like Tofranil (imipramine) and MAO inhibitors. SSRIs are known for having fewer side effects compared to tricyclic antidepressants and MAO inhibitors. Therefore, the nurse should inform the patient that the side effects experienced with Tofranil are not necessarily indicative of what they will experience with Paxil due to the different drug classes.

Bob has never met Madonna but he is convinced that she is deeply in love with him. Bob is suffering from

  • A. grandiose delusions
  • B. jealous delusions
  • C. obsessive-compulsive disorder
  • D. erotomanic delusions
Correct Answer: A

Rationale: This should be D (erotomanic delusions), where a person believes someone, often a celebrity, is in love with them; the answer key may be incorrect as grandiose delusions involve exaggerated self-importance.

A 72-year-old female patient has the medical diagnosis of delirium secondary to anticholinergic medication toxicity. A nurse planning discharge care must consider the need to teach the family to be alert for maladaptive cognitive symptoms because:

  • A. delirium is a hypersensitivity reaction.
  • B. the elderly often deny changes in cognition.
  • C. elderly females are more prone to delirium than elderly males.
  • D. slower metabolism in the elderly predisposes to medication toxicity.
Correct Answer: D

Rationale: The correct answer is D because slower metabolism in the elderly can lead to medication toxicity, including anticholinergic toxicity causing delirium. As people age, their metabolism slows down, making them more susceptible to drug accumulation and toxicity. This can result in cognitive symptoms like delirium.

A: Delirium is not a hypersensitivity reaction; it is an acute state of confusion.
B: Denial of cognitive changes is not directly related to the risk of medication toxicity in the elderly.
C: Gender is not a significant factor in medication toxicity leading to delirium; it is more related to individual metabolism and drug interactions.

The characteristic in individuals with personality disorders that makes it most necessary for staff to schedule frequent meetings is:

  • A. flexibility and unconventional responses to stress.
  • B. a desire to achieve emotional intimacy with staff.
  • C. a tendency to evoke countertransference and conflict.
  • D. an impaired ability to develop trusting relationships.
Correct Answer: C

Rationale: The correct answer is C because individuals with personality disorders often evoke countertransference and conflict in staff due to their challenging behaviors and interpersonal dynamics. This can lead to potential misunderstandings and ineffective treatment if not addressed through frequent meetings. Option A is incorrect as flexibility and unconventional responses to stress are not typically the primary concern necessitating frequent meetings. Option B is incorrect as a desire for emotional intimacy is not necessarily a reason for staff to schedule frequent meetings. Option D is incorrect as an impaired ability to develop trusting relationships might be a symptom of a personality disorder, but it is not the characteristic that most necessitates frequent meetings.

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