Age Specific Care

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The mother of a client newly diagnosed with schizophrenia is a nurse. She unhappily tells the nurse on the unit, 'I've tried to be a good mother, but my daughter still developed schizophrenia. When I was in school, we were taught that it was the mother's fault if a child became schizophrenic. I wish I knew what I did wrong.' The response that would help the mother evaluate models explaining schizophrenia would be:

  • A. I can see how you would be upset over this turn of events.'
  • B. New findings suggest this disorder is biologic in nature.'
  • C. Don't be so hard on yourself; your daughter needs you to be strong.'
  • D. It's difficult to see that double-bind communication produces stress for the child at the time it's occurring.'
Correct Answer: B

Rationale: Correct Answer: B

Rationale:
1. Choice B is the correct answer because it provides the mother with new information that schizophrenia is biologic in nature, shifting the blame away from her.
2. This response helps the mother understand that her daughter's condition is not her fault, based on current scientific understanding.
3. By offering this information, the nurse helps the mother reevaluate her beliefs and perceptions about the causes of schizophrenia.
4. Choices A, C, and D do not address the mother's concerns directly or provide her with the necessary information to understand the biological basis of schizophrenia.

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The nurse knows that stimulant medication for ADHD should be administered:

  • A. At bedtime, to coincide with rising cortisol levels
  • B. Only on school days to improve performance
  • C. On an empty stomach
  • D. With breakfast and lunch
Correct Answer: D

Rationale: Because these medications can contribute to insomnia, it is best to administer them earlier in the day with food. These are generally taken daily unless the doctor orders a drug holiday.

A worker is characterized by her co-workers as 'painfully shy' and lacking in self-confidence. Her co-workers say she stays in her cubicle all day, never coming out for breaks or lunch. One day after falling on the ice in the parking lot, she goes to the nurse's office, where she apologizes for falling and mentions that she hopes the company will not fire her for being so clumsy. With which diagnosis is this presentation most consistent?

  • A. Avoidant
  • B. Dependent
  • C. Histrionic
  • D. Paranoid
Correct Answer: A

Rationale: The correct answer is A: Avoidant. This diagnosis is consistent because the worker exhibits characteristics of extreme shyness, lack of self-confidence, social avoidance, and fear of rejection or criticism. By apologizing excessively for a simple accident and expressing worry about being fired for it, the worker's behavior aligns with the avoidance of social situations and excessive concern about negative evaluation typical of Avoidant Personality Disorder.

Choice B: Dependent, does not fit as the worker is not displaying excessive need for others to take responsibility for major areas of her life.
Choice C: Histrionic, is not a match as this disorder is characterized by attention-seeking behavior, which is not evident in the worker's presentation.
Choice D: Paranoid, is not the correct diagnosis as the worker does not display distrust or suspiciousness towards others.

An advance directive gives legally binding direction for health care interventions when a patient:

  • A. has a new diagnosis of cancer
  • B. is diagnosed with Parkinsons disease
  • C. is unable to make decisions for self because of illness
  • D. diagnosed with amyotrophic lateral sclerosis is unable to speak
Correct Answer: C

Rationale: Advance directives are invoked when patients are unable to make their own health care decisions. The correct response is the most global answer. A diagnosis of cancer or Parkinsons disease does not mean the patient is unable to make a decision. For a patient with amyotrophic lateral sclerosis, there are other ways to communicate beyond speaking.

In activity 5, all of the following people got sick from the concession stand except

  • A. Jose
  • B. Lisa
  • C. Mia
  • D. Ken
Correct Answer: D

Rationale: Assuming Ken did not get sick (context-specific), he is the exception among those listed.

The nurse is explaining to the family of a patient diagnosed with schizophrenia that the disorder is considered to have neurobiological origins. When the patient's mother asks, 'What part of the brain is dysfunctional?' the nurse should reply, 'Research has implicated the:

  • A. medulla and cortex.
  • B. cerebellum and cerebrum.
  • C. hypothalamus and medulla.
  • D. prefrontal and limbic cortices.'
Correct Answer: D

Rationale: The correct answer is D: prefrontal and limbic cortices. The prefrontal cortex is involved in decision-making, planning, and social behavior, functions commonly impaired in schizophrenia. The limbic cortex regulates emotions and memory, areas affected in schizophrenia. Medulla (A, C) controls basic functions like breathing, not implicated in schizophrenia. Cerebellum (B) coordinates movement, unrelated to schizophrenia. Hypothalamus (C) regulates hormones, not directly linked to schizophrenia. In summary, D is correct as prefrontal and limbic cortices are key brain regions affected in schizophrenia, while the other choices are not directly involved in the disorder.

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