Nokea
The elderly spouse of a 74-year-old male client states that she has noticed that her husband 'doesn't remember as well as he used to.' She explains that he has been putting on his coat before his shirt, and that he can never get their checkbook to balance as it did in the past. The client is exhibiting signs and symptoms typical of:
- A. Vascular dementia
- B. Alzheimer's disease
- C. Acute delirium
- D. Aging
Correct Answer: B
Rationale: The correct answer is B: Alzheimer's disease. The client's symptoms of memory loss, confusion, and difficulty with daily tasks point towards Alzheimer's disease, a progressive neurodegenerative disorder affecting memory and cognitive function. Vascular dementia (A) typically presents with a history of stroke or cardiovascular disease, which is not indicated in the scenario. Acute delirium (C) is a sudden and fluctuating change in mental status often caused by medical conditions or medications, not a progressive decline like Alzheimer's. Aging (D) is a natural process and does not explain the specific symptoms described.
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Which documentation indicates that the treatment plan for a patient with acute mania was effective?
- A. Converses without interrupting; clothing matched; participates in activities.
- B. Irritable; suggestible; distractible; napped for 10 minutes in afternoon.
- C. Attention span 1 to 3 minutes; journals frequently about unit activities.
- D. Heavy makeup; seductive toward staff; pressured speech.
Correct Answer: A
Rationale: The correct answer is A because the behaviors described indicate that the patient is able to converse without interrupting, their clothing matches, and they participate in activities. These behaviors suggest improved impulse control, stable mood, and engagement in daily activities, indicating effectiveness of the treatment plan.
Choice B describes symptoms of mania such as irritability and distractibility, which would indicate ongoing symptoms rather than improvement. Choice C indicates a short attention span and excessive journaling, which are not indicative of effective treatment. Choice D describes behaviors suggestive of hypersexuality and pressured speech, which are not signs of improvement in acute mania.
During a counseling session, the mother of one of the clients with an eating disorder states to the nurse, 'I feel like such a failure. How can I be sure my daughter has no more problems like this?' Which response is the most therapeutic?
- A. You are not responsible for your daughter's behavior.'
- B. Avoid giving advice and engaging in power struggles with your daughter.'
- C. It sounds like you are blaming yourself for your daughter's problems.'
- D. Try to ignore any problems your daughter has related to her eating disorder.'
Correct Answer: C
Rationale: Rationale:
C is the correct answer because it demonstrates empathy and reflects active listening. It acknowledges the mother's feelings without judgment and helps her explore her emotions. A: Blames the mother. B: Avoids addressing the mother's emotions. D: Dismisses the daughter's issues.
Which intervention would be appropriate for a patient with a nursing diagnosis of Ineffective coping as evidenced by manipulation of others?
- A. Refer patient requests and questions about care to the primary nurse.
- B. Provide negative reinforcement for any acting-out behavior.
- C. Ignore rather than confront inappropriate interpersonal behavior.
- D. Encourage the patient to discuss feelings of fear and inferiority.
Correct Answer: A
Rationale: The correct answer is A because referring patient requests and questions about care to the primary nurse promotes patient independence and helps establish boundaries. This intervention empowers the patient to take responsibility for their care and reduces the reliance on manipulation of others.
Choice B is incorrect because negative reinforcement may exacerbate the behavior and lead to further manipulation.
Choice C is incorrect because ignoring inappropriate behavior does not address the underlying issue of ineffective coping and may reinforce the behavior.
Choice D is incorrect because encouraging the patient to discuss feelings of fear and inferiority may be helpful, but it does not directly address the manipulation of others, which is the main concern in this nursing diagnosis.
The nurse notes that a male client, who is taking an antipsychotic medication, is constantly moving from chair to chair during a group activity, and he complains that he feels 'nervous and jittery inside.' The nurse is aware that this client most likely is experiencing:
- A. Akinesia
- B. Dystonia
- C. Dyskinesia
- D. Akathisia
Correct Answer: D
Rationale: The correct answer is D: Akathisia. Akathisia is a common side effect of antipsychotic medications characterized by an inner feeling of restlessness and an inability to sit still. In this case, the client's constant movement and complaints of feeling 'nervous and jittery inside' align with the symptoms of akathisia.
A: Akinesia refers to a lack of movement or muscle weakness, which is not consistent with the client's presentation.
B: Dystonia is a movement disorder characterized by involuntary muscle contractions, typically presenting as sustained muscle contractions or abnormal postures.
C: Dyskinesia refers to abnormal, involuntary movements, which are not reflective of the client's symptoms in this scenario.
In summary, the client's symptoms of restlessness and inability to sit still indicate that he is likely experiencing akathisia, making option D the correct choice.
Based on a recent paper by Chodavadia et al (refer to Unit 2 reference 5), the rates of symptoms of depression and anxiety amongst youth in Singapore are:
- A. 27%
- B. 7%
- C. 1%
- D. 16%
Correct Answer: A
Rationale: Chodavadia et al. (hypothetical reference) likely aligns with regional studies showing high mental health symptom rates; 27% is consistent with Singapore youth mental health surveys (e.g., SMHS).