Age Specific Patient Care

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For those family members who desire to care at home for loved ones who have been given a diagnosis of Alzheimer's disease, it is important for the nurse to ensure that the family is aware of which caregiver skills and responsibilities will be necessary. What is one of the responsibilities of the caregiver during the middle stage of the disease?

  • A. Helping the loved one with memory and communication problems
  • B. Providing a stable, routine environment
  • C. Providing complete assistance with physical care
  • D. Adapting to the changing personality and behavior of the loved one
Correct Answer: D

Rationale: The correct answer is D: Adapting to the changing personality and behavior of the loved one. During the middle stage of Alzheimer's disease, individuals may experience significant changes in personality and behavior. Caregivers need to adapt to these changes by being patient, understanding, and flexible. This responsibility is crucial for maintaining a positive and supportive relationship with the loved one.

A: Helping the loved one with memory and communication problems is important, but it is more relevant in the early stages of the disease when these issues are more prominent.
B: Providing a stable, routine environment is essential throughout all stages of Alzheimer's disease, not just the middle stage.
C: Providing complete assistance with physical care may become necessary in the later stages of the disease when the individual's physical abilities decline significantly.

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Statistical approaches to abnormality define as 'abnormal' those who

  • A. show evidence of loss of contact with reality
  • B. are unhappy, withdrawn, and depressed
  • C. deviate from typical or average patterns of behavior
  • D. are disabled by anxiety
Correct Answer: C

Rationale: Statistical definitions label behavior abnormal if it deviates significantly from the norm, regardless of specific symptoms.

What is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors?

  • A. Monitor for signs of electrolyte imbalances and dehydration.
  • B. Assess for any weight gain and increase exercise habits.
  • C. Encourage the patient to express feelings about food and body image.
  • D. Monitor for compulsive eating behaviors and binge episodes.
Correct Answer: A

Rationale: The correct answer is A: Monitor for signs of electrolyte imbalances and dehydration. This is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors because purging can lead to electrolyte imbalances and dehydration, which can result in serious health complications such as cardiac arrhythmias and renal issues. Monitoring electrolyte levels and hydration status is crucial for the patient's safety and well-being.

Summary:
- Choice B is incorrect because focusing on weight gain and exercise habits is not the priority when dealing with the immediate health risks of electrolyte imbalances and dehydration.
- Choice C is incorrect as expressing feelings about food and body image is important for therapy but not the priority in this acute situation.
- Choice D is incorrect as monitoring for compulsive eating behaviors and binge episodes is more relevant for patients with binge eating disorder rather than bulimia nervosa with frequent purging behaviors.

The single most common symptom of autism is:

  • A. Inability to grasp reality
  • B. Impaired social interaction
  • C. Acting out behaviors
  • D. Diminished affect
Correct Answer: B

Rationale: Though all of these behaviors may occur at some time in autism, impaired social interaction is the overriding symptom that occurs in this disorder.

A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self. Select the best outcome related to this diagnosis. Within 2 weeks, the patient will:

  • A. Appropriately express angry feelings.
  • B. Verbalize two positive things about self.
  • C. Verbalize the importance of eating a balanced diet.
  • D. None of the above.
Correct Answer: D

Rationale: Rationale:
1. Patient's diagnosis indicates coping issues, not anger expression or self-esteem.
2. Patient's coping mechanism involves overeating and vomiting, not diet.
3. Outcome should focus on coping skills improvement, not unrelated goals.
4. None of the choices address the root issue of coping with loneliness and isolation.
5. Thus, the correct answer is D, as none of the options directly address the patient's ineffective coping mechanism.

The patient on the mental health unit who should be assessed as being at highest risk for directing violent behavior toward others is the patient who has:

  • A. Obsessive-compulsive disorder and performs many rituals.
  • B. Paranoid delusions of being followed by the Mafia.
  • C. Severe depression with feelings of worthlessness and self-loathing.
  • D. Completed alcohol withdrawal and is now in a rehabilitation program.
Correct Answer: B

Rationale: The correct answer is B because paranoid delusions of being followed by the Mafia indicate a high level of suspiciousness and potential for harm to others. This patient may act out violently in self-defense or as a reaction to perceived threats. Choice A is incorrect as OCD rituals are typically not associated with violent behavior. Choice C is incorrect as severe depression is more likely to result in self-harm rather than harm towards others. Choice D is incorrect as completed alcohol withdrawal and entering a rehabilitation program do not inherently indicate an increased risk of violent behavior towards others.

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