Nokea
Most individuals with Alzheimer's disease are cared for in:
- A. Nursing homes
- B. Their homes
- C. Mental health facilities
- D. Long-term care facilities specifically set up for clients with Alzheimer's
Correct Answer: B
Rationale: The correct answer is B: Their homes. Most individuals with Alzheimer's disease are cared for in their homes because it allows for familiar surroundings and routines, which can help reduce confusion and anxiety. Home care also promotes independence and maintains a sense of normalcy. Nursing homes (choice A) may be necessary for individuals with advanced Alzheimer's who require round-the-clock care. Mental health facilities (choice C) are not typically designed to provide specialized care for Alzheimer's. Long-term care facilities specifically for Alzheimer's clients (choice D) are a subset of nursing homes and may not be the most common setting for care.
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Because there is considerable overlap among the types of schizophrenia, and because patterns of behavior shift over time, many patients are simply classified as suffering from schizophrenia
- A. borderline
- B. atypical
- C. mixed
- D. undifferentiated
Correct Answer: D
Rationale: Undifferentiated schizophrenia is diagnosed when symptoms don't clearly fit other subtypes, reflecting overlap and shifting patterns.
A man, aged 84 years, was stopped for going through a red light in a small town where he lives. He told the officer, 'It wasn't there yesterday.' He was unable to tell the officer his address and demonstrated labile mood, seeming pleasant one minute and angry the next. The officer took the man home to discuss his condition with the family and found that he has been wandering around the neighborhood, sometimes taking tools from people's garages, saying they belong to him. The family reluctantly agreed that he should go to the emergency department. What cardinal sign of Alzheimer's disease does this patient demonstrate?
- A. Agnosia.
- B. Apraxia.
- C. Aphasia.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Agnosia. Agnosia is the inability to recognize or interpret sensory information, such as objects, people, sounds, or shapes. In this case, the patient's inability to recognize the red light, his own address, and the ownership of tools indicates a problem with perception and recognition. This aligns with the symptoms of agnosia commonly seen in Alzheimer's disease.
Choices B and C are incorrect. Apraxia is the inability to perform purposeful movements, and aphasia is the loss of ability to understand or express speech. These symptoms are not the primary cardinal sign demonstrated by the patient in the scenario. Choice D, "None of the above," is also incorrect as the patient's symptoms align with the characteristics of agnosia.
Disorders which are characterised by serious abnormalities in the developmental process, fall under the heading of pervasive developmental disorders (PDD) and are usually associated with impairment in several areas of development. From early infancy, some children will exhibit a spectrum of developmental impairments and delays that include which of the following?
- A. Social and emotional disturbances
- B. Intellectual disabilities
- C. Language and communication deficits
- D. All of the above
Correct Answer: D
Rationale: Pervasive Developmental Disorders (PDDs): Characterized by serious developmental abnormalities affecting social, intellectual, and communication skills.
The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating. He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. This information most likely suggests:
- A. medication nonadherence.
- B. a need for psychoeducation.
- C. the chronic nature of his illness.
- D. relapse of his schizophrenia.
Correct Answer: D
Rationale: The correct answer is D: relapse of his schizophrenia. The patient is displaying symptoms such as feeling tense, difficulty concentrating, disturbed sleep, and delusional thoughts about creatures hiding in his workplace. These symptoms indicate a return of psychotic features characteristic of schizophrenia, suggesting a relapse. This is supported by the patient's history of schizophrenia and the sudden onset of symptoms after a period of stability. Medication nonadherence (choice A) could be a possible cause, but the patient's symptoms are more indicative of a relapse. While psychoeducation (choice B) is important, the patient's current symptoms require immediate attention for relapse management. The chronic nature of his illness (choice C) is a general characteristic of schizophrenia and does not explain the current symptoms.
The wife of a client newly diagnosed with paranoid schizophrenia asks the nurse, 'My husband was well adjusted until a month ago, and then, after a lot of work stress, he got sick. What can I expect? Will he be this sick for the rest of his life?' What information can the nurse provide about prognosis?
- A. This disorder responds well to treatment and, with follow-up, may not recur.'
- B. All types of schizophrenia are chronic relapsing disorders.'
- C. Outcomes are poor related to client prehospital disorganization.'
- D. The usual outcome is that only partial remission is achieved.'
Correct Answer: A
Rationale: The correct answer is A: "This disorder responds well to treatment and, with follow-up, may not recur."
Rationale:
1. Paranoid schizophrenia typically responds well to treatment, especially with early intervention.
2. With proper medication and therapy, individuals with paranoid schizophrenia can experience significant improvement and lead fulfilling lives.
3. Follow-up care and support are crucial in maintaining stability and preventing relapses.
Summary of why other choices are incorrect:
B: All types of schizophrenia are chronic relapsing disorders - This is not accurate as outcomes can vary depending on the subtype of schizophrenia.
C: Outcomes are poor related to client prehospital disorganization - This statement is too general and does not specifically address the prognosis of paranoid schizophrenia.
D: The usual outcome is that only partial remission is achieved - This is not always the case, as many individuals with paranoid schizophrenia can achieve full remission with appropriate treatment.