Nokea
The nurse is answering questions from a client and his family regarding a recent diagnosis of Alzheimer's disease. The client asks how effective medication is in treating the disease. What is the nurse's best response?
- A. There is no cure or treatment for Alzheimer's disease.'
- B. Medications have shown little improvement in symptoms.'
- C. Medications for the disease have been found to improve thinking abilities, behavior, and daily functioning in some clients.'
- D. Alternative therapies, such as co-enzyme Q-10 and Ginkgo biloba, are more effective than any of the prescription medications used to treat the symptoms.'
Correct Answer: C
Rationale: The correct answer is C because medications for Alzheimer's disease, such as cholinesterase inhibitors and memantine, have been found to improve thinking abilities, behavior, and daily functioning in some clients. These medications can help manage symptoms and slow down the progression of the disease. Option A is incorrect because while there is no cure for Alzheimer's disease, there are treatments available. Option B is incorrect as medications have shown some efficacy in managing symptoms. Option D is incorrect as there is limited scientific evidence to support the effectiveness of alternative therapies compared to prescription medications for Alzheimer's disease.
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An elderly patient must be physically restrained. Who is responsible for the patient's safety?
- A. The nurse assigned to care for the patient
- B. Unlicensed assistive personnel who apply the restraint
- C. Family member who agrees to application of the restraint
- D. Health care provider who prescribed application of restraint
Correct Answer: A
Rationale: The correct answer is A: The nurse assigned to care for the patient. The nurse is responsible for the patient's safety because they are the primary caregiver and have the training and knowledge to ensure proper application of restraints, monitor the patient's condition, and respond to any potential complications. Unlicensed assistive personnel (choice B) may apply restraints under the nurse's supervision but do not have the same level of training or accountability. Family members (choice C) and healthcare providers (choice D) may be involved in the decision-making process, but ultimate responsibility for patient safety lies with the nurse who directly cares for the patient.
Family members of a patient newly diagnosed with paranoid schizophrenia state that they do not understand what caused the patient's illness. The nurse's response should be predicated on the:
- A. Neurobiological-genetic model.
- B. Stress model.
- C. Family theory model.
- D. Developmental model.
Correct Answer: A
Rationale: The correct answer is A, the Neurobiological-genetic model, because paranoid schizophrenia is known to have a strong genetic component. Research has shown that individuals with a family history of schizophrenia are at a higher risk of developing the disorder. The neurobiological aspect refers to the abnormalities in brain structure and function associated with schizophrenia, such as neurotransmitter imbalances. Therefore, the nurse should educate the family members about the genetic predisposition and neurobiological factors contributing to the patient's illness.
Choices B, C, and D are incorrect:
B: The Stress model focuses on the role of environmental stressors in triggering or exacerbating mental illness, which is not the primary cause of paranoid schizophrenia.
C: The Family theory model emphasizes family dynamics and interactions as contributing factors to mental illness, but it is not the primary cause of paranoid schizophrenia.
D: The Developmental model looks at how early childhood experiences and developmental stages may influence mental health outcomes, but it is not the primary etiology of paranoid
A client with a borderline personality disorder tells the nurse, 'My doctor tells me there's something wrong with the hard wiring of my brain, and that's why I'm so impulsive and get so many mood swings. He said he's going to prescribe some medication.' Being aware of current practice guidelines, the nurse will prepare a teaching plan for:
- A. Lithium
- B. Fluoxetine
- C. Lorazepam
- D. Haloperidol
Correct Answer: B
Rationale: The correct answer is B: Fluoxetine. Borderline personality disorder (BPD) is primarily treated with psychotherapy, but in some cases, medication is used to manage symptoms like impulsivity and mood swings. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is commonly used to address mood instability and impulsivity in BPD. SSRIs help regulate serotonin levels in the brain, which can improve mood stability and decrease impulsive behaviors. Lithium (choice A) is used for bipolar disorder, not BPD. Lorazepam (choice C) is a benzodiazepine used for anxiety and not typically recommended for BPD. Haloperidol (choice D) is an antipsychotic used for conditions like schizophrenia and not typically indicated for BPD.
Which of the following personality disorders describes a person who has an extremely unstable self image, is moody, and does not develop stable relationships?
- A. borderline
- B. histrionic
- C. narcissistic
- D. schizoid
Correct Answer: A
Rationale: Borderline personality disorder involves unstable self-image, mood swings, and relationship difficulties.
A 17-year-old client is admitted to the ED after being alternately hyperalert and difficult to arouse. His symptoms all started within the last few hours, during which time he became disoriented and confused. His behavior was agitated and restless, and his memory was impaired, especially for recent events. The client displayed some delusions and misinterpretations of his surroundings. The nurse knows she needs to assess the client further for:
- A. Dementia
- B. Depression
- C. Delirium
- D. Amnesia
Correct Answer: C
Rationale: The correct answer is C: Delirium. Delirium is characterized by acute and fluctuating changes in cognition, attention, and awareness. The client's sudden onset of symptoms, including disorientation, confusion, agitation, restlessness, impaired memory, delusions, and misinterpretations of surroundings, align with the hallmark features of delirium. The nurse needs to further assess the client for delirium to determine the underlying cause and provide appropriate interventions promptly.
Incorrect choices:
A: Dementia - Dementia is a chronic, progressive condition characterized by gradual cognitive decline. The client's acute onset of symptoms is not consistent with dementia.
B: Depression - Depression typically presents with persistent feelings of sadness, hopelessness, and loss of interest, which are different from the acute and fluctuating cognitive changes seen in delirium.
D: Amnesia - Amnesia refers to memory loss, which is only one aspect of the client's presentation. Delirium involves a broader range of cognitive