Age Specific Patient Care Quizlet

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In clinical supervision, the nurse caring for the patient with a paranoid personality disorder tells the advanced practice nurse, 'I tried being caring and empathetic, but the patient just kept telling me to stay away.' Which response by the advanced practice nurse would be best?

  • A. Acting somewhat cynical and aloof, like they do, will make it easier for paranoid persons to bond with you over time. That, plus humor.'
  • B. You may be trying too hard too soon. Back off, give him some time to get used to you, then try your caring and empathetic approach again.'
  • C. Mistrustful people do not bond as others do, so first it's important to be realistic. Second, a neutral yet courteous approach will work better.'
  • D. You are on the right track, but give it more time. Actively conveying empathy and care will work, but paranoid persons respond more slowly.'
Correct Answer: C

Rationale: The correct answer is C because it acknowledges the unique challenges of working with individuals with paranoid personality disorder. The response emphasizes the importance of being realistic about the patient's mistrust and suggests a neutral yet courteous approach. This approach recognizes the need to build trust gradually and not rush into being overly caring or empathetic, which could further trigger the patient's paranoia.

Choice A is incorrect because adopting a cynical and aloof attitude is not conducive to building rapport with individuals with paranoid personality disorder. Humor may also be perceived as mocking or dismissive.

Choice B is incorrect because it suggests backing off completely before trying a caring and empathetic approach again. This approach may not effectively address the patient's needs for support and may reinforce their feelings of isolation.

Choice D is incorrect because it suggests continuing with the caring and empathetic approach without acknowledging the need for a more cautious and neutral approach with individuals who are mistrustful. This approach may not effectively address the patient's specific needs and could potentially worsen the

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The parent of a seriously mentally ill adult asks the nurse, 'Why are you making a referral to a vocational rehabilitation program? My child wont ever be able to hold a job.' Which is the nurses best reply?

  • A. We make this referral to continue eligibility for federal funding.'
  • B. Are you concerned that were trying to make your child too independent?'
  • C. If you think the program would be detrimental, we can postpone it for a time.'
  • D. Most patients are capable of employment at some level, competitive or supported.'
Correct Answer: D

Rationale: Studies have shown that most patients who complete vocational rehabilitation programs are capable of some level of employment. They also demonstrate significant improvement in assertiveness and work behaviors as well as decreased depression.

Which situation is consensual sex rather than rape?

  • A. A husband forces vaginal sex when he comes home intoxicated from a party. The wife objects.
  • B. A woman's lover pleads with her to have oral sex. She gives in but then regrets the decision.
  • C. A person is beaten, robbed, and forcibly subjected to anal penetration by an assailant.
  • D. A dentist gives anesthesia for a procedure and then has intercourse with the unconscious patient.
Correct Answer: B

Rationale: The correct answer is B because, although the woman initially gave in to her lover's plea for oral sex, she later regretted the decision. Consent must be freely given without coercion or manipulation. In this scenario, the woman's regret indicates that her initial agreement was not genuine consent. Choice A involves force and lack of consent. Choice C depicts a violent and non-consensual act. Choice D involves taking advantage of a vulnerable and unconscious individual, which is also non-consensual.

Which assessment data suggests a person who appears to have dementia instead has depression and pseudodementia?

  • A. Demonstrates impaired judgment.
  • B. Demonstrates impaired concentration.
  • C. Has a history of significant losses or crises.
  • D. None of the above.
Correct Answer: B

Rationale: The correct answer is B because impaired concentration is a key indicator of depression and pseudodementia rather than dementia. In depression, individuals may experience difficulties focusing and maintaining attention, leading to impaired concentration. Pseudodementia, which mimics dementia but is caused by depression, also presents with similar cognitive symptoms like impaired concentration. Choices A and C are incorrect because impaired judgment and significant losses or crises can be present in both dementia and depression, making them less specific to differentiating between the two conditions. Choice D is incorrect as choice B clearly distinguishes the cognitive symptomatology between dementia and depression/pseudodementia.

When people successfully adapt to their environment by using logical thought and socially appropriate ways, they are said to be functioning at the adaptive end of the _____ continuum.

  • A. Emotional
  • B. Self-protective
  • C. Neurobiological
  • D. Psychobiological
Correct Answer: C

Rationale: The correct answer is C: Neurobiological. This is because neurobiological factors refer to the brain's functioning and how it affects behavior and cognition. When individuals adapt to their environment using logical thought and socially appropriate ways, it indicates a high level of cognitive and behavioral functioning, which is closely tied to neurobiological processes.

A: Emotional is incorrect because emotional factors focus on feelings and affective responses, not necessarily on logical thought and social appropriateness.
B: Self-protective is incorrect as it pertains to behaviors aimed at ensuring one's safety and security, which may not necessarily involve logical thought and social appropriateness.
D: Psychobiological is incorrect as it encompasses the interaction between psychological and biological processes, which may not specifically relate to adaptive functioning in the given context.

A client who received chlorpromazine (Thorazine) for 15 years to treat schizophrenia developed tardive dyskinesia as evidenced by tongue thrusting and chewing motions. The physician discontinued the chlorpromazine and prescribed Seroquel (quetiapine). As a result of this change, the nurse should carefully monitor for:

  • A. Development of pseudoparkinsonism
  • B. Development of dystonic reactions
  • C. Improvement in tardive dyskinesia
  • D. Worsening of anticholinergic symptoms
Correct Answer: C

Rationale: The correct answer is C: Improvement in tardive dyskinesia. Tardive dyskinesia is a side effect of long-term antipsychotic use, like chlorpromazine. Quetiapine (Seroquel) is an atypical antipsychotic with a lower risk of causing tardive dyskinesia. By discontinuing chlorpromazine and switching to quetiapine, there is a higher likelihood of improvement or resolution of tardive dyskinesia symptoms. Options A and B are incorrect as they are related to other movement disorders caused by antipsychotics. Option D is incorrect as anticholinergic symptoms are not directly related to tardive dyskinesia improvement with the medication switch.

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