Health Care Utilization by Age Group

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The nurse reports to the interdisciplinary team that an antisocial patient lies to other patients, verbally abuses a patient with Alzheimer's disease, flatters his primary nurse, and is detached and superficial during counseling sessions. Which behavior should be the priority focus of limit setting?

  • A. Lying to other patients
  • B. Flattering the nursing staff
  • C. Verbally abusing other patients
  • D. Superficiality during counseling
Correct Answer: C

Rationale: The priority focus of limit setting should be on verbally abusing other patients (Choice C) because it directly harms others and creates a hostile environment. This behavior is not only detrimental to the well-being of other patients but also disrupts the therapeutic milieu. Limiting this behavior is crucial to ensure the safety and emotional health of all patients in the care setting. Lying to other patients (Choice A), flattering the nursing staff (Choice B), and being superficial during counseling sessions (Choice D) are concerning behaviors as well, but they do not pose an immediate risk to the safety and well-being of others in the same way that verbal abuse does. It is important to address all inappropriate behaviors, but the priority should be given to the behavior that has the most significant negative impact on the therapeutic environment.

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A 19-year-old client is admitted for the second time in 9 months and is acutely psychotic with a diagnosis of undifferentiated schizophrenia. The client sits alone rubbing her arms and smiling. She tells the nurse her thoughts cause earthquakes and that the world is burning. The nurse assesses the primary deficit associated with the client's condition as:

  • A. Altered mood states
  • B. Disturbed thinking
  • C. Social isolation
  • D. Poor impulse control
Correct Answer: B

Rationale: The correct answer is B: Disturbed thinking. This is because the client's belief that her thoughts cause earthquakes and the world is burning indicates a break from reality, a hallmark of psychosis in schizophrenia. This demonstrates disorganized and illogical thinking, a key symptom of disturbed thinking. The other choices are incorrect because: A) Altered mood states typically refer to emotional disturbances, which are not the primary deficit in this scenario; C) Social isolation is a consequence of the client's symptoms but not the primary deficit; D) Poor impulse control is not the primary deficit in this case as the client's behavior is more indicative of disorganized thinking.

Parkinson's disease results from the death of neurons that produce

  • A. serotonin
  • B. acetylcholine
  • C. dopamine
  • D. norepinephrine
Correct Answer: C

Rationale: Parkinson's involves dopamine neuron loss, leading to motor and cognitive symptoms.

Select the best comment for a nurse to begin an interview with an elderly patient.

  • A. I am a nurse. Are you familiar with what nurses do?
  • B. Hello. I am going to ask you some questions to get to know you better.
  • C. You look comfortable and ready to participate in an admission interview. Shall we get started?
  • D. Hello. My name is_____ and I am a nurse. How you would like to be addressed by staff?
Correct Answer: D

Rationale: The correct answer is D because it establishes the nurse's identity and shows respect by asking the patient's preference for addressing them. This approach sets a positive tone and promotes patient-centered care. Option A is incorrect as it assumes the patient's familiarity with nurses. Option B lacks professionalism and fails to acknowledge the purpose of the interview. Option C assumes the patient's readiness without confirming it directly and may come off as presumptuous.

In the powerpoint activity for this lesson, you witnessed photographs of typical weekly food consumptions for families in various countries. Which country depicted a photograph of a family who consumed the LEAST amount of fruits and vegetables and the MOST amount of processed food?

  • A. Germany
  • B. Poland
  • C. Chad
  • D. United States
Correct Answer: D

Rationale: The United States is often depicted with diets high in processed foods and low in fruits and vegetables, reflecting modern consumption patterns.

A client admitted with delusions, hallucinations, and thought disorder has the admitting diagnosis schizophreniform disorder R/O organic pathology. Based on this information, the nurse can expect that the client will:

  • A. Undergo an MRI test
  • B. Have psychological testing
  • C. Have an immunologic assay performed
  • D. Participate in a dexamethasone suppression test
Correct Answer: A

Rationale: Step 1: The client is admitted with symptoms suggestive of a psychotic disorder, specifically schizophreniform disorder.
Step 2: The admitting diagnosis includes ruling out organic pathology, indicating a need to investigate potential physical causes.
Step 3: An MRI test is a non-invasive imaging procedure that can help identify any structural abnormalities in the brain.
Step 4: This test is appropriate in ruling out organic causes of the symptoms presented by the client.
Step 5: Psychological testing (Choice B) is more focused on assessing cognitive and emotional functioning, not ruling out organic pathology.
Step 6: Immunologic assay (Choice C) is used to detect antibodies or antigens in the blood, not typically relevant in this context.
Step 7: Dexamethasone suppression test (Choice D) is used to assess for abnormalities related to cortisol levels in conditions like depression, not specific to ruling out organic pathology in psychotic disorders.

Summary: Choice A is correct because an MRI test is the most relevant

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