Nokea
The nurse determines that a patient is showing a decline in explicit memory. Which characterizes such a deficiency?
- A. Inability to remember how to operate a common kitchen appliance
- B. Difficulty remembering the name of a place visited 20 years ago
- C. Being unsuccessful at retaining new information
- D. Forgetting the ingredients of a favorite recipe
Correct Answer: B
Rationale: The correct answer is B because difficulty remembering the name of a place visited 20 years ago is a specific example of explicit memory decline. Explicit memory refers to the ability to consciously recall past events, facts, or experiences. This choice directly relates to a long-term memory retrieval issue, which is a hallmark of explicit memory decline. Choices A, C, and D do not specifically address explicit memory decline but rather touch on different memory processes such as procedural memory (A), short-term memory (C), and semantic memory (D).
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An adult patient shares that, When my mother died when we were children, I never saw my
father show any emotion. What do you think will happen with those unexpressed feelings?
Which response is most appropriate?
- A. Pent-up emotions may lead to depression or other disorders.
- B. Your father probably has worked through his grief by this time.
- C. Maybe you can teach him how to best express his own feelings.
- D. If feelings are not effectively expressed, the person can become suicidal.
Correct Answer: A
Rationale: Step 1: Pent-up emotions are emotions that are suppressed or not expressed.
Step 2: Unexpressed feelings, especially from past traumatic events, can lead to emotional distress.
Step 3: Long-term suppression can manifest as depression or other mental health disorders.
Step 4: Therefore, choice A is the most appropriate response as it highlights the potential negative consequences of unexpressed emotions.
Summary:
- Choice B assumes the father has processed his grief, which may not be the case.
- Choice C oversimplifies the complexity of emotional expression and may not address the root issue.
- Choice D jumps to an extreme outcome without considering the range of possible consequences.
Immediately after electroconvulsive therapy (ECT), nursing care of the patient is most similar to care of a patient:
- A. With delirium tremens
- B. Recovering from conscious sedation
- C. With acute alcohol withdrawal
- D. Undergoing a routine diagnostic procedure
Correct Answer: B
Rationale: The correct answer is B: Recovering from conscious sedation. After ECT, patients are closely monitored as they recover from anesthesia and sedation. Nursing care involves assessing vital signs, mental status, and ensuring the patient's safety. This is similar to caring for a patient recovering from conscious sedation, where monitoring and observation are essential.
A: Delirium tremens involves severe alcohol withdrawal symptoms, which require specialized care including managing agitation and hallucinations.
C: Acute alcohol withdrawal requires specific interventions such as monitoring for seizures and providing medications to prevent complications.
D: Routine diagnostic procedures do not typically involve sedation or anesthesia, so the level of monitoring and care needed is different from post-ECT care.
Which remark by one of the grief support group members would the nurse interpret as indicating unresolved feelings of guilt?
- A. The Christmas season is always a sad time for me.
- B. I know that my husband had a good life.
- C. It seems I miss my son more as time goes on.
- D. I am still wishing I had gotten help to him sooner.
Correct Answer: D
Rationale: The correct answer is D because expressing a wish for getting help sooner implies a sense of responsibility and guilt for not doing so. This indicates unresolved feelings of guilt. Choice A refers to sadness during a specific time of the year, not guilt. Choice B reflects acceptance and closure. Choice C indicates a natural progression of grief, not necessarily guilt.
The spouse of a patient recently diagnosed with early-stage Alzheimer's disease asks, "Is there anything I can do to help delay the progression of this disease?" Which strategy has the greatest potential for preserving the protective abilities of immune cells related to the disease?
- A. Minimize contact with the public during cold and flu season.
- B. Enroll the patient in an exercise program that meets regularly.
- C. Provide supplements to enhance the patient’s immune system.
- D. Identify creative ways to keep the patient mentally challenged.
Correct Answer: B
Rationale: The correct answer is B: Enroll the patient in an exercise program that meets regularly. Regular exercise has been shown to have numerous benefits for brain health, including improving cognitive function and reducing the risk of cognitive decline. Exercise also helps in maintaining a healthy immune system by promoting the circulation of immune cells throughout the body. This can help support the protective abilities of immune cells related to Alzheimer's disease.
Minimizing contact with the public during cold and flu season (Choice A) may reduce the risk of infections but does not directly address immune cell function. Providing supplements to enhance the patient's immune system (Choice C) may not be supported by scientific evidence and can potentially have adverse effects. Identifying creative ways to keep the patient mentally challenged (Choice D) is beneficial for cognitive health but does not directly target immune cell function as effectively as regular exercise.
A health care provider writes these new prescriptions for a resident in a skilled nursing facility: 2 G sodium diet, Restraint as needed, Limit fluids to 1800 mL daily, Continue antihypertensive medication, Milk of magnesia 30 mL PO once if no bowel movement for 3 days. The nurse should:
- A. Question the fluid restriction.
- B. Question the order for restraint.
- C. Transcribe the prescriptions as written.
- D. Assess the resident’s bowel elimination
Correct Answer: A
Rationale: Step 1: Fluid restriction of 1800 mL may not be appropriate for all residents in a skilled nursing facility. Step 2: Excessive fluid restriction can lead to dehydration, especially in elderly residents. Step 3: It is crucial for the nurse to question the fluid restriction to ensure it is safe for the resident. Therefore, the correct answer is A.
Summary:
- Option A is correct as questioning the fluid restriction is essential for the resident's safety.
- Option B is incorrect as restraining a resident should only be used as a last resort and should be questioned if not necessary.
- Option C is incorrect as blindly transcribing without assessing appropriateness can be harmful.
- Option D is incorrect as assessing bowel elimination is important but addressing the fluid restriction is more urgent in this scenario.