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The nurse is assessing mental health in children. Which of the following statements is true?
- A. All aspects of mental health in children are interrelated.
- B. Children are highly labile and unstable until the age of 2 years.
- C. Until the age of 7 years, children's mental health is largely a function of their parents' mental health.
- D. Children's mental health is impossible to assess until they develop the ability to concentrate.
Correct Answer: A
Rationale: The correct answer is A because all aspects of mental health in children are indeed interrelated. Mental health encompasses various components such as emotional, social, and psychological well-being, which are interconnected and influence each other. Understanding and assessing mental health in children require considering the holistic picture.
Choice B is incorrect because children are not inherently labile and unstable until the age of 2 years. Choice C is incorrect as children's mental health is influenced by various factors beyond just their parents' mental health. Choice D is incorrect because mental health assessment in children can be done using age-appropriate methods even before they develop the ability to concentrate.
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The nurse is performing a review of systems on a 76-year-old patient. Which of the following statements is correct for this situation?
- A. The questions asked are identical for all ages.
- B. The interviewer will start incorporating different questions for patients 70 years of age and older.
- C. Additional questions are reflective of the normal effects of aging.
- D. At this age, a review of systems is not necessary; just focus on current problems.
Correct Answer: C
Rationale: Rationale: Choice C is correct as additional questions in a review of systems for a 76-year-old patient should address age-related changes. This allows for better assessment of potential health issues specific to older adults. Choice A is incorrect as questions may vary based on age. Choice B is incorrect as age alone does not dictate question changes. Choice D is incorrect as a review of systems is important at all ages for comprehensive patient assessment.
Which of the following is the best choice for an opening statement with a patient who is in distress?
- A. "Nancy, my name is Mrs. C."
- B. "Hello, Mrs. H., my name is Mrs. C. It sure is cold today!"
- C. "Mrs. H., my name is Mrs. C. I'll need to ask you a few questions about what happened."
- D. "Mrs. H., my name is Mrs. C. I'll need to ask you a few questions about what happened."
Correct Answer: D
Rationale: The correct answer is D because it directly acknowledges the patient's distress and sets the stage for gathering essential information. By stating the need to ask questions about what happened, it shows empathy and readiness to provide help. Choice A is too formal and lacks empathy. Choice B shifts the focus away from the patient's distress. Choice C is similar to D but lacks the crucial element of acknowledging the patient's emotional state. Thus, D is the best choice for an opening statement in this scenario.
Which of the following statements best describes the Montreal Cognitive Assessment (MoCA) examination?
- A. Scores below 30 indicate cognitive impairment.
- B. It is a good tool to evaluate mood and thought processes.
- C. It is a good tool to detect delirium and dementia and to differentiate these from psychiatric mental illness.
- D. It is useful for an initial evaluation of mental health. Additional tools are needed to evaluate changes in cognition over time.
Correct Answer: C
Rationale: The correct answer is C because the Montreal Cognitive Assessment (MoCA) is specifically designed to detect delirium and dementia and differentiate these conditions from psychiatric mental illness. It assesses various cognitive domains such as memory, attention, language, and visuospatial abilities. Scores below the normal range on the MoCA can indicate cognitive impairment related to delirium or dementia.
Choice A is incorrect because a score below 30 on the MoCA does not necessarily indicate cognitive impairment; it depends on the individual's baseline and education level.
Choice B is incorrect because the MoCA primarily focuses on cognitive function rather than mood and thought processes.
Choice D is incorrect because while the MoCA can be used for initial evaluation of cognitive function, it is not sufficient for evaluating changes over time. Additional tools and assessments are needed for longitudinal monitoring of cognitive changes.
An example of objective information obtained during the physical assessment includes the patient's:
- A. history of allergies.
- B. use of medications at home.
- C. last menstrual period.
- D. 2 cm x 5 cm scar present on the right forearm.
Correct Answer: D
Rationale: The correct answer is D because the presence of a physical characteristic like a scar is an objective finding that can be directly observed and measured during a physical assessment. This information is not subject to interpretation or bias. In contrast, choices A, B, and C involve subjective information that relies on the patient's report or memory, making them less reliable and objective. History of allergies (A) and use of medications (B) are subjective and based on the patient's self-report, while last menstrual period (C) is also subjective and may not always be accurate. Therefore, choice D is the only objective piece of information among the options provided.
When examining an infant, which area should the nurse examine first?
- A. Ear
- B. Nose
- C. Throat
- D. Abdomen
Correct Answer: A
Rationale: The correct answer is A: Ear. Examining the ear first is crucial in infants as it allows the nurse to assess for any signs of infection or abnormalities that could impact the infant's overall health. Ear infections are common in infants and can lead to serious complications if not detected early. By examining the ear first, the nurse can promptly address any issues and provide appropriate treatment.
Summary of why other choices are incorrect:
- B: Nose - While examining the nose is important, it is not the priority in infants as ear issues are more common and can have immediate implications on health.
- C: Throat - Throat examination is important but typically follows ear examination in infants, as ear infections are more prevalent.
- D: Abdomen - Abdominal examination is important for overall health assessment but is not the initial area to examine in infants as ear issues take precedence due to their frequency and potential impact.