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For patients diagnosed with serious mental illness, what is the major advantage of case management?
- A. The case manager can modify traditional psychotherapy
- B. With one coordinator of services, resources can be more efficiently used
- C. The case manager can focus on social skills training and esteem building
- D. Case managers bring groups of patients together to discuss common problems
Correct Answer: B
Rationale: The case manager coordinates the care and multiple referrals that so often confuse the seriously mentally ill patient and the patients family. Case management promotes efficient use of services. The other options are lesser advantages or are irrelevant.
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A newly admitted elderly client seems to become confused and agitated every evening after dinner. This client most likely is suffering from:
- A. Alzheimer's disease
- B. Acute dementia
- C. Sundown syndrome
- D. Delirium
Correct Answer: C
Rationale: The correct answer is C: Sundown syndrome. This is a condition where elderly individuals experience confusion and agitation in the evening. The symptoms are typically more pronounced during this time of day. It is not Alzheimer's disease (A) as that is a progressive neurodegenerative disorder. Acute dementia (B) is not a recognized medical term and does not accurately describe the symptoms. Delirium (D) is an acute state of confusion that can occur at any time of day, not just in the evening like sundown syndrome.
Behavioral problems in which the person exhibits symptoms suggesting physical disease or injury, but for which there is no identifiable cause, are called
- A. mood disorders
- B. schizophrenia
- C. organic brain pathologies
- D. somatoform disorders
Correct Answer: D
Rationale: Somatoform disorders feature physical complaints without medical explanation.
Select the best comment for a nurse to begin an interview with an elderly patient.
- A. I am a nurse. Are you familiar with what nurses do?'
- B. Hello. I am going to ask you some questions to get to know you better.'
- C. You look comfortable and ready to participate in an admission interview. Shall we get started?'
- D. Hello. My name is and I am a nurse. How you would like to be addressed by staff?'
Correct Answer: D
Rationale: The correct opening identifies the nurses role and politely seeks direction for addressing the patient in a way that will make him or her comfortable. This is particularly important when a considerable age difference exists between the nurse and the patient. The nurse should address patients by name and not assume patients want to be called by a first name. The nurse should always introduce self.
A patient, aged 77 years, has Alzheimer's disease and lives with her daughter. While checking her blood pressure at the clinic, the nurse noticed fresh bruises on the patient's palms and buttocks. The patient could not explain these bruises. The nurse discussed her observations with the daughter, who became defensive and said that her mother was very difficult to manage. She stated, "My mother is getting worse every week. She is not my mother anymore. She can't recognize me, and she wanders all night. We take turns because she has to be watched constantly. Last night I fell asleep, and she fell down the stairs while wandering."Â Which statement is most accurate?
- A. Reporting the injuries in this case is not indicated by available data.
- B. The nurse should report the injuries as suggestive of elder abuse.
- C. The nurse is only required to report the injury if the patient is incompetent.
- D. The nurse is legally required to report the injuries as possible abuse.
Correct Answer: A
Rationale: Step 1: The nurse observed bruises on the patient's palms and buttocks.
Step 2: The patient could not explain these bruises.
Step 3: The daughter mentioned the patient's worsening condition and the incident of falling down the stairs.
Step 4: The daughter's statement indicates the patient's deteriorating cognitive and physical abilities.
Step 5: The daughter's challenges in managing the patient are due to the progression of Alzheimer's disease.
Step 6: There is no explicit evidence or indication of elder abuse based on the provided information.
Step 7: Reporting the injuries without clear signs of abuse may harm the patient's relationship with the daughter.
Step 8: Therefore, the most appropriate action is not to report the injuries based on the available data to avoid potential harm.
Summary:
- Choice A is correct as reporting the injuries is not indicated by the available data.
- Choices B, C, and D are incorrect as there is no clear evidence of elder abuse in the scenario
A rape victim tells the emergency room nurse, "I feel so dirty. Help me take a shower before the doctor examines me."Â The nurse should:
- A. Arrange for the patient to shower.
- B. Explain that bathing would destroy evidence.
- C. Give the patient a basin of water and towels.
- D. Explain that bathing facilities are not available in the emergency department.
Correct Answer: B
Rationale: The correct answer is B: Explain that bathing would destroy evidence. This is the correct choice because bathing can potentially wash away crucial forensic evidence that can be collected during a sexual assault examination. Preserving evidence is essential for legal proceedings and ensuring justice for the victim.
Choice A is incorrect because arranging for the patient to shower would destroy evidence. Choice C is incorrect as giving the patient a basin of water and towels would still risk destroying evidence. Choice D is also incorrect as it does not address the importance of preserving evidence in cases of sexual assault.