Age Specific Care Quiz

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An individual is brought by ambulance to the emergency room. The patient's roommate reports that the patient was weak and confused on awakening and began "rambling and talking crazy" about 3 hours ago. A nurse notes that the patient's skin is flushed and dry. When transferred to a bed, the patient strikes out at the staff and shouts, "You're not going to kill me!" The most likely analysis of this behavior is:

  • A. disturbed self-esteem related to catastrophic reaction.
  • B. disturbed sensory perception related to altered brain function.
  • C. other-directed violence related to fear associated with hospitalization.
  • D. impaired environmental interpretational syndrome related to metabolic disturbance.
Correct Answer: B

Rationale: The correct answer is B: disturbed sensory perception related to altered brain function. The patient's presenting symptoms of confusion, rambling speech, physical aggression, and paranoia suggest an altered mental state. The flushed and dry skin may indicate dehydration, which can affect brain function. The behavior is likely a result of the patient's distorted sensory perceptions due to an underlying physiological or neurological issue.

Incorrect choices:
A: disturbed self-esteem related to catastrophic reaction - This choice does not address the patient's specific symptoms and is not supported by the scenario.
C: other-directed violence related to fear associated with hospitalization - While fear of hospitalization may contribute to violence, it does not explain the patient's overall presentation of altered mental status.
D: impaired environmental interpretational syndrome related to metabolic disturbance - This choice does not directly address the patient's symptoms and does not explain the confusion and paranoia displayed.

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What is the most effective intervention to address the disturbed body image in patients with anorexia nervosa?

  • A. Help the patient engage in self-care routines.
  • B. Provide psychotherapy to address the patient's perceptions.
  • C. Encourage participation in group activities that require social interaction.
  • D. Support the patient in selecting appropriate meals.
Correct Answer: B

Rationale: The correct answer is B because psychotherapy helps address the underlying psychological factors contributing to the disturbed body image in anorexia nervosa. Specifically, cognitive-behavioral therapy can challenge distorted thoughts about body image. Self-care routines (A) may not directly address the root cause. Group activities (C) may not target individual concerns effectively. Supporting meal selection (D) does not address the psychological aspect of body image distortion. In summary, psychotherapy is crucial in addressing the complex psychological issues associated with body image in anorexia nervosa.

Suicidal tendency is most commonly seen with

  • A. Schizophrenia
  • B. Obsessive Disorders
  • C. Mania
  • D. Depression
Correct Answer: D

Rationale: Depression is the most common mental disorder associated with suicidal tendencies due to persistent feelings of hopelessness and despair.

A nurse is caring for a patient with bulimia nervosa. What is a priority assessment for this patient?

  • A. Electrolyte imbalances and cardiac function.
  • B. Body image issues and mental health status.
  • C. Nutritional status and hydration levels.
  • D. Weight changes and exercise patterns.
Correct Answer: A

Rationale: The correct answer is A: Electrolyte imbalances and cardiac function. This is because patients with bulimia nervosa often engage in purging behaviors which can lead to electrolyte imbalances and cardiac complications. Assessing electrolyte levels and cardiac function is crucial to prevent life-threatening complications.

Choice B is incorrect because while body image and mental health are important considerations, they are not the priority assessment in this case. Choice C is also incorrect as nutritional status and hydration levels can be affected, but not as immediately life-threatening as electrolyte imbalances and cardiac issues. Choice D is incorrect as weight changes and exercise patterns may be important, but they are not the priority assessment for a patient with bulimia nervosa.

A 79-year-old white male tells a nurse, 'I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing.' The nurse should analyze this comment as

  • A. normal pessimism of the elderly.
  • B. evidence of risks for suicide.
  • C. a call for sympathy.
  • D. normal grieving.
Correct Answer: B

Rationale: The correct answer is B: evidence of risks for suicide. The elderly man's statement indicates feelings of hopelessness, loneliness, and lack of purpose, which are common risk factors for suicide in older adults. The nurse should assess further for suicidal ideation and intervene accordingly.

Choice A is incorrect because the statement goes beyond normal pessimism by expressing thoughts of not having much to live for. Choice C is incorrect as the statement is more indicative of distress rather than a mere call for sympathy. Choice D is incorrect as normal grieving typically involves processing emotions related to a specific loss, whereas the man's statement reflects a broader sense of despair.

A patient with the diagnosis of schizophrenia, disorganized type, approaches the nurse and says, "It's beat, it's eat. No room for doom." The nurse can correctly assess this verbalization as:

  • A. Neologisms
  • B. Clanging
  • C. Ideas of reference.
  • D. Associative looseness.
Correct Answer: B

Rationale: The correct answer is B: Clanging. Clanging refers to the association of words based on sound rather than meaning. In this case, the patient's verbalization "It's beat, it's eat. No room for doom" demonstrates a pattern of words that rhyme or have similar sounds but lack coherent meaning. This is characteristic of clanging seen in disorganized schizophrenia. Neologisms (A) are newly created words with unique meanings, which is not evident here. Ideas of reference (C) involve misinterpreting unrelated events as being personally significant, which is not demonstrated in the patient's statement. Associative looseness (D) is a thought disorder where ideas are loosely associated, but the patient's statement does not show this specific feature.

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