Age Specific Patient Care

Age Specific Patient Care Related

Review Age Specific Patient Care related questions and content

The client tells the nurse, 'I thought my psychiatrist was the best doctor in the world. I thought he understood me completely. Now, I hate him! He doesn't understand me at all. He's just dumping me to go on a 2-week vacation.' The nurse assesses the client's description of feelings about the physician as evidence of the use of:

  • A. Splitting
  • B. Projective identification
  • C. Isolation of affect
  • D. Dissociation
Correct Answer: A

Rationale: The correct answer is A: Splitting. Splitting is a defense mechanism where a person sees things in extremes of either all good or all bad. In this scenario, the client initially idealizes the psychiatrist as the best doctor, then suddenly devalues and hates him for taking a vacation, indicating a shift from all good to all bad. This extreme change in perception is characteristic of splitting.

B: Projective identification involves projecting one's own feelings onto another person and then identifying with those projected feelings. This choice does not fit the scenario as the client is not projecting their feelings onto the psychiatrist.

C: Isolation of affect refers to the separation of feelings from ideas and events. The client's strong emotions towards the psychiatrist do not demonstrate a lack of emotional expression or detachment from feelings.

D: Dissociation is a defense mechanism where thoughts, feelings, and experiences are separated from conscious awareness. The client's reaction does not suggest a disconnection from reality or consciousness.

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The nurse is aware, when developing a care plan, that the three major goals of care for the client in whom Alzheimer's disease has been diagnosed include providing for the client's safety and well-being, therapeutically managing the client's behaviors, and:

  • A. Supporting the client during curative care.
  • B. Providing support for family, relatives, and caregivers.
  • C. Arranging for nursing home placement.
  • D. None of the above.
Correct Answer: B

Rationale: The correct answer is B. Providing support for family, relatives, and caregivers is crucial in the care of a client with Alzheimer's disease as it helps to ensure a holistic approach to care. Family members and caregivers often experience significant stress and burden in caring for someone with Alzheimer's, so providing support to them can improve the overall quality of care for the client. Additionally, involving family and caregivers in the care plan can help in maintaining continuity and consistency in the client's care.

Other choices are incorrect because:
A: Supporting the client during curative care is not applicable in Alzheimer's disease as there is currently no cure for the condition.
C: Arranging for nursing home placement may be necessary in some cases, but it is not one of the three major goals of care for a client with Alzheimer's disease.
D: None of the above is incorrect as providing support for family, relatives, and caregivers is a critical aspect of care for clients with Alzheimer's disease.

A person who was raped comes to the hospital for treatment. The person abruptly decides to decline treatment and leave the facility. Before this person leaves, the nurse should:

  • A. Say, "You may not leave until you're given prophylactic treatment for sexually transmitted diseases."
  • B. Provide written information about physical and emotional reactions the person may experience.
  • C. Explain the need and importance of HIV and pregnancy tests.
  • D. Give verbal information about legal resources.
Correct Answer: B

Rationale: The correct answer is B because providing written information about physical and emotional reactions respects the individual's autonomy and empowers them to make informed decisions. It also ensures they have resources to understand and cope with potential consequences. Choice A violates the individual's right to refuse treatment. Choice C focuses on specific tests without addressing the person's immediate concerns. Choice D, while important, is not as immediate or relevant as providing information on potential reactions.

The nurse is told that a patient with disorganized schizophrenia is being admitted to the unit. The nurse should expect the patient to demonstrate:

  • A. highly suspicious, delusional behavior.
  • B. extremes of motor activity and excitement to stupor.
  • C. social withdrawal and ineffective communication.
  • D. severe anxiety and ritualistic behavior.
Correct Answer: C

Rationale: The correct answer is C because disorganized schizophrenia is characterized by social withdrawal and ineffective communication. This subtype of schizophrenia involves disorganized speech and behavior, flat or inappropriate affect, and disorganized thinking. Patients with this type may display bizarre or nonsensical behavior and have difficulty with daily activities. Choice A is incorrect as suspiciousness and delusions are more commonly associated with paranoid schizophrenia. Choice B is incorrect as extremes of motor activity and excitement to stupor are characteristic of catatonic schizophrenia. Choice D is incorrect as severe anxiety and ritualistic behavior are not typical features of disorganized schizophrenia.

Which information would be of greatest assistance to a nurse assessing a patient's motivation to change behavior associated with maladaptive eating regulation responses?

  • A. The number, on a scale of 1 to 10, that reflects the patient's desire for treatment.
  • B. The name of a person the patient feels he or she can rely on for emotional support.
  • C. The advantages the patient identifies as motivation for controlling the maladaptive behavior.
  • D. The reasons the patient identifies as the factors that originally caused the maladaptive behavior.
Correct Answer: A

Rationale: The correct answer is A because assessing the patient's desire for treatment provides insight into their readiness and motivation to change behavior. This information indicates their willingness to engage in the treatment process and is a key factor in predicting behavior change.

Option B is incorrect because relying on emotional support may not necessarily reflect the patient's motivation to change their behavior. Option C is incorrect as identifying advantages for controlling maladaptive behavior does not directly address the patient's motivation level. Option D is incorrect because understanding the factors that caused the behavior does not necessarily indicate the patient's current motivation to change.

The caregiver for a client with moderate to severe dementia tells the nurse, 'I'm exhausted. He wanders at night instead of sleeping, so I get no rest. I'm afraid to leave him during the day, so I have to take him to the grocery store and to the laundromat. When I'm busy there, he often wanders off. Still, I have to do it all.' The nurse recognizes the need to provide teaching for this caregiver. An appropriate outcome is that the caregiver will:

  • A. Feel justified in putting the client in a nursing home
  • B. Verbalize realistic self-expectations
  • C. Cease abusive interactions with the client
  • D. Feel comfortable leaving the client alone one morning a week
Correct Answer: B

Rationale: The correct answer is B: Verbalize realistic self-expectations. This is the most appropriate outcome to address the caregiver's situation. By verbalizing realistic self-expectations, the caregiver can understand the importance of self-care and setting boundaries. This outcome promotes the caregiver's well-being while still providing care for the client.

Choice A is incorrect because putting the client in a nursing home may not be the best solution without exploring other options first. Choice C is incorrect as there is no mention of abusive interactions in the scenario. Choice D is incorrect because feeling comfortable leaving the client alone without addressing the caregiver's exhaustion and concerns may not be the most appropriate approach.

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