Health Care Utilization by Age Group

Health Care Utilization by Age Group Related

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The highest priority for assessment by nurses caring for older adults who self-administer medications is

  • A. use of multiple drugs with anticholinergic effects.
  • B. overuse of medications for erectile dysfunction.
  • C. missed doses of medications for arthritis.
  • D. trading medications with acquaintances.
Correct Answer: A

Rationale: The correct answer is A: use of multiple drugs with anticholinergic effects. This is the highest priority because anticholinergic medications are commonly prescribed to older adults and can lead to serious adverse effects such as confusion, memory issues, and falls. Nurses must assess for these effects to prevent harm.

Choice B (overuse of medications for erectile dysfunction) is not as high a priority as anticholinergic effects, as it is not as common and typically has less immediate serious consequences for older adults.

Choice C (missed doses of medications for arthritis) is important but not as critical as assessing for anticholinergic effects, as missed doses can generally be managed through education and adherence support.

Choice D (trading medications with acquaintances) is a serious concern but is not as high a priority as assessing for anticholinergic effects, as the immediate risks associated with anticholinergic medications are more severe.

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Which of the following is related to recent attempts to find biochemical explanations for schizophrenia?

  • A. schizotaxin
  • B. psychotropin
  • C. dopamine
  • D. diazepam
Correct Answer: C

Rationale: Dopamine excess in the brain is a leading biochemical theory for schizophrenia, supported by antipsychotic efficacy.

What is a key consideration when treating a patient with anorexia nervosa?

  • A. Addressing the patient's weight first and foremost.
  • B. Focusing on nutrition and caloric intake without addressing underlying issues.
  • C. Addressing the psychological and emotional factors that contribute to the disorder.
  • D. Providing strict dietary restrictions to help the patient regain control over food.
Correct Answer: C

Rationale: The correct answer is C because addressing the psychological and emotional factors is crucial in treating anorexia nervosa. This disorder is not solely about weight or food intake; it often involves deeper psychological issues such as body image distortion, low self-esteem, and control issues. By focusing on the underlying psychological and emotional factors, therapists can help patients understand and cope with these issues, leading to more effective and sustainable recovery. Choices A, B, and D are incorrect because they overlook the complexity of anorexia nervosa and may even exacerbate the patient's condition by neglecting the root causes of the disorder.

To plan effective interventions, the nurse should understand that the underlying reason a patient with paranoid personality disorder is so critical of others probably lies in the patient's:

  • A. need to control all aspects of the world around him.
  • B. use of intellectualization to protect against anxiety.
  • C. inflexible view of the environment and the people in it.
  • D. projection of blame for his own shortcomings onto others.
Correct Answer: D

Rationale: The correct answer is D because paranoid personality disorder is characterized by distrust and suspicion of others, leading individuals to project their own negative traits onto others (projection). This defense mechanism helps them avoid accepting their own shortcomings. Option A is incorrect because the focus is on control, not blame. Option B is incorrect as intellectualization is a defense mechanism that involves avoiding emotions by focusing on rational aspects. Option C is incorrect as it refers to rigidity and not projection of blame. In summary, projection of blame onto others is the underlying reason for the critical behavior in paranoid personality disorder.

A client has been diagnosed with a dementia secondary to cerebral disease. The family members note the client 'has not been as sharp as he once was' and that he has developed urinary incontinence and a gait disturbance. They attributed the first symptom to normal aging but were alarmed by the latter two symptoms. Based on this history, which of the following should come to mind?

  • A. Normal pressure hydrocephalus
  • B. Vitamin B12 deficiency
  • C. Hepatic disease
  • D. Tuberculosis
Correct Answer: A

Rationale: Step 1: The client presents with urinary incontinence and a gait disturbance, suggestive of normal pressure hydrocephalus (NPH) due to cerebral disease.
Step 2: NPH is characterized by the triad of cognitive decline, gait disturbances, and urinary incontinence.
Step 3: Symptoms of NPH can mimic normal aging but are distinct from other conditions.
Step 4: Vitamin B12 deficiency (B) primarily presents with anemia and neurological symptoms, not the triad seen in NPH.
Step 5: Hepatic disease (C) typically presents with symptoms related to liver dysfunction, not the triad of NPH.
Step 6: Tuberculosis (D) manifests with respiratory symptoms and constitutional symptoms, not the cognitive decline and gait issues seen in NPH.

Delusional thinking is characteristic of

  • A. psychosis
  • B. obsessive-compulsive disorder
  • C. conversion disorder
  • D. fugue
Correct Answer: A

Rationale: Delusions are a hallmark of psychosis, indicating a break from reality.

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