Age Specific Patient Care

Age Specific Patient Care Related

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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. This response acknowledges the mother's distress but shifts the focus to new findings suggesting schizophrenia is biologic in nature.
2. It provides the mother with updated information that contradicts the outdated belief that mothers are to blame for schizophrenia.
3. By highlighting the biological basis of the disorder, it helps the mother understand that it is not her fault.
4. This response encourages the mother to consider scientific evidence rather than blaming herself, promoting a more accurate understanding of the condition.

Summary:
- Choice A validates the mother's feelings but doesn't offer factual information to challenge her belief.
- Choice C aims to provide emotional support but doesn't address the mother's need for accurate information.
- Choice D introduces the concept of double-bind communication, which is not directly relevant to helping the mother understand the biological nature of schizophrenia.

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A patient with borderline personality disorder has cut her wrists. The physician orders daily dressing changes for the lacerations. The nurse performing this care should:

  • A. encourage the patient to vent anger and aggression.
  • B. provide care in a matter-of-fact manner
  • C. be kindly, sympathetic, and concerned.
  • D. offer to listen to the patient's feelings about cutting.
Correct Answer: B

Rationale: The correct answer is B: provide care in a matter-of-fact manner. This approach is important in treating patients with borderline personality disorder as it helps maintain boundaries and consistency, which are crucial for managing their condition. By being matter-of-fact, the nurse can prevent potential manipulation or reinforcement of maladaptive behaviors. Encouraging the patient to vent anger (choice A) may escalate the situation. Being overly sympathetic (choice C) can blur professional boundaries. Offering to listen to feelings (choice D) may reinforce the behavior and not address the underlying issues effectively.

Which measure is advisable to take, considering that individuals with dramatic erratic personality disorders often have the ability to evade limits and manipulate others?

  • A. Plan frequent client-centered staff meetings.
  • B. Practice take-down and restraint procedures.
  • C. Institute written or taped change-of-shift reports.
  • D. Rotate staff assignments so no one is responsible for the client for a prolonged period of days.
Correct Answer: A

Rationale: The correct answer is A: Plan frequent client-centered staff meetings. This measure is advisable as it promotes open communication, collaboration, and consistency in care. By holding regular meetings, staff can discuss concerns, share observations, and develop strategies to effectively manage individuals with erratic personality disorders. This approach helps in setting clear boundaries, identifying manipulative behaviors, and ensuring a unified team response.

Summary:
- Choice B: Practice take-down and restraint procedures is incorrect as it focuses on physical control rather than preventive strategies.
- Choice C: Institute written or taped change-of-shift reports is incorrect as it lacks real-time communication and immediate response to potential issues.
- Choice D: Rotate staff assignments so no one is responsible for the client for a prolonged period of days is incorrect as it may disrupt continuity of care and hinder the establishment of trust and rapport.

What is the main issue for adolescents with anorexia?

  • A. Anxiety.
  • B. Control.
  • C. Body image.
  • D. Appropriate behavior.
Correct Answer: B

Rationale: The correct answer is B: Control. Adolescents with anorexia often have a strong desire for control over their lives, including their body and food intake. This need for control can manifest in restrictive eating behaviors. Anxiety (choice A) may be a symptom but is not the main issue. Body image (choice C) is a contributing factor, but not the primary issue. Appropriate behavior (choice D) is too broad and not specific to the core issue of control seen in anorexia.

The nurse is assisting a victim of spousal abuse to create a plan for escape if it becomes necessary. What components should the plan include? Select all that apply.

  • A. A code word to signal children that it is time to leave.
  • B. Phone numbers for the nearest shelter and crisis hotline.
  • C. Telling the spouse that she has a plan and will leave.
  • D. Collecting birth certificates and other essential documents.
Correct Answer: A

Rationale: The correct answer is A: A code word to signal children that it is time to leave. This is crucial for ensuring the safety of the victim and their children without alerting the abuser. Other choices like B, providing phone numbers for shelters, are important but may not always be feasible in an emergency. Choice C, informing the spouse about the plan, can escalate the situation. Choice D, collecting essential documents, is important but may not always be the immediate priority in a dangerous situation. Having a code word ensures a discreet and quick escape if needed.

An emergency department nurse prepares to assist with evidence collection for a sexual assault victim. Prior to photographs and pelvic examination, what documentation is important?

  • A. The patient's vital signs
  • B. Consent signed by the patient
  • C. Supervision and credentials of the examiner
  • D. Storage location of the patient's personal effects
Correct Answer: B

Rationale: The correct answer is B: Consent signed by the patient. This is crucial as it ensures the patient's autonomy and willingness to undergo evidence collection. Without proper consent, the procedure would be unethical and potentially illegal. Vital signs (A) may be important for overall assessment but are not directly related to evidence collection. Supervision and credentials of the examiner (C) are necessary but not the most important documentation. The storage location of personal effects (D) is relevant for patient safety but not essential for evidence collection.

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