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Discharge planning begins for an elderly patient hospitalized for 2 weeks diagnosed with major depression. The patient needs ongoing assessment and socialization opportunities as well as education about medication and relapse prevention. The patient lives with a daughter, who works during the week. Select the best referral for this patient.
- A. Behavioral health home care
- B. A skilled nursing facility
- C. Partial hospitalization
- D. A halfway house
Correct Answer: C
Rationale: Partial hospitalization will provide services the patient needs as well as give supervision and meals to the patient while the daughter is at work. Home care would not provide socialization. The patient does not need the intensity of a skilled nursing facility. A halfway house provides 24-hour care and usually expects involvement in off-campus programs.
You may also like to solve these questions
Which personality characteristic is most likely in a patient with anorexia nervosa?
- A. Open displays of emotion
- B. Perfectionism
- C. Optimism
- D. Flexibility
Correct Answer: B
Rationale: Perfectionism is the most likely personality characteristic in a patient with anorexia nervosa because individuals with this disorder often exhibit an intense desire for control, rigid thinking patterns, and a relentless pursuit of thinness. This perfectionistic trait can manifest as strict adherence to self-imposed rules around food intake and excessive exercise. Open displays of emotion (choice A) are less common due to emotional suppression related to the disorder. Optimism (choice C) is unlikely as anorexia nervosa is associated with negative self-perceptions and low self-esteem. Flexibility (choice D) is also unlikely due to the rigid and inflexible behaviors typical of individuals with anorexia nervosa.
A client tells the nurse he has just finished an important business meeting, when in fact he has been napping. Upon what rationale should the nurse's response be based?
- A. Ignoring memory deficit avoids catastrophic reactions.
- B. Delusions should be confronted to clarify thinking.
- C. Reality should be reinforced to maximize functioning.
- D. Changing the topic provides diversion.
Correct Answer: C
Rationale: The correct answer is C because reinforcing reality helps the client maintain maximum functioning. By gently guiding the client back to reality, the nurse can support their cognitive abilities and prevent further confusion or disorientation. Choice A is incorrect because ignoring memory deficits does not address the issue at hand. Choice B is incorrect as confronting delusions may lead to increased distress. Choice D is incorrect as it does not address the situation effectively and may not help the client maintain cognitive functioning.
You are a nurse meeting for the first time with a stage 3 Alzheimer's patient who is newly referred to your home health agency. Which assessment data about the patient and caregiver(s) would be most important to acquire during your first visit to the family's home?
- A. Is the house design such that patient access to exits and stairways can be restricted?
- B. Does the family understand that the disease is likely to prove fatal within 3 to 5 years?
- C. What resources is the patient's family able to access in their particular community?
- D. What activities or memories are most comforting and calming for the patient?
Correct Answer: A
Rationale: Step 1: Ensuring patient safety is the top priority in caring for a stage 3 Alzheimer's patient in a home setting.
Step 2: Restricting access to exits and stairways is crucial to prevent the patient from wandering or falling.
Step 3: This assessment data is essential for implementing safety measures and preventing potential harm to the patient.
Step 4: Choices B, C, and D, while important, do not directly address the immediate safety concerns of the patient.
An elderly client who lives with her daughter and son-in-law and their three children reveals that her daughter sometimes slaps her when she does not move fast enough or spills things. The daughter is a mid-level business executive who is under considerable stress at work. The children are often left in the care of the elderly client. The husband is often out of town on business trips. The daughter states, 'I have so much to do that I become frustrated when my mother can't move fast enough or causes me extra work.' The nurse caring for the mother could appropriately suggest:
- A. Family therapy.
- B. Individual counseling for the daughter.
- C. Respite care for the elderly client.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Family therapy. Family therapy is the most appropriate suggestion because it addresses the dysfunctional dynamics within the family and provides an opportunity for all family members to work through their issues. In this scenario, the daughter's stress at work and lack of coping skills are contributing to the abuse of the elderly client. Family therapy can help the family communicate effectively, set boundaries, and address underlying issues causing the abuse.
Choice B (Individual counseling for the daughter) may help the daughter address her stress and coping mechanisms, but it does not address the family dynamics that are contributing to the abuse. Choice C (Respite care for the elderly client) provides temporary relief but does not address the root cause of the issue. Choice D (None of the above) is incorrect as family therapy is the most appropriate intervention in this case.
When are the recommended ages for developmental screening to be done according to AAP guidelines?
- A. 6 months, 12 months, and 18 months
- B. 6 months, 18 months, and 36 months
- C. 18 months, 24 months, and 36 months
- D. 9 months, 18 months, and 30 months
Correct Answer: D
Rationale: The American Academy of Pediatrics (AAP) recommends developmental screening at 9, 18, and 30 months during well-child visits to identify developmental delays early.