Nokea
The physician's admission note mentions that a patient has sundown syndrome. The nurse can expect that the patient will:
- A. exhibit chronic fatigue.
- B. evidence extreme lethargy at night.
- C. manifest confusion and agitation at night.
- D. be more alert between 6 PM and 11 PM.
Correct Answer: C
Rationale: The correct answer is C: manifest confusion and agitation at night. Sundown syndrome refers to a pattern of behavior where individuals with dementia experience increased confusion, agitation, or restlessness in the late afternoon or evening. This is due to disruptions in the person's internal body clock. It is important for the nurse to anticipate and manage these symptoms during the evening shift.
Choice A: Chronic fatigue is not a typical symptom of sundowning.
Choice B: Extreme lethargy at night is not a common feature of sundown syndrome.
Choice D: Being more alert between 6 PM and 11 PM is not characteristic of sundowning, as individuals with this syndrome typically experience worsening symptoms during these hours.
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In the UK, the Special Education Needs & Disability Act of 2001 extended the rights of individuals with intellectual disabilities to be educated in mainstream schools. Schools are now required to draw up which of the following in order to facilitate the inclusion of pupils with intellectual disabilities and to make reasonable adjustments so that they are not disadvantaged?
- A. Inclusion strategies
- B. Facilitation strategies
- C. Accessibility strategies
- D. Availability strategies
Correct Answer: C
Rationale: Accessibility Strategies: Programmes extending rights of individuals with intellectual disabilities to be educated according to their needs in mainstream schools.
A woman, abducted and raped at gunpoint by an unknown assailant, was found confused and disoriented. The nurse makes these observations about the patient: talking rapidly in disjointed phrases, unable to concentrate, indecisive when asked to make simple decisions. What is the patient's level of anxiety?
- A. Weak
- B. Mild
- C. Moderate
- D. Severe
Correct Answer: D
Rationale: The correct answer is D: Severe. The patient's symptoms of talking rapidly, inability to concentrate, and indecisiveness are indicative of severe anxiety. Rapid speech and disjointed phrases suggest heightened arousal, while the inability to concentrate and make decisions point to severe impairment in cognitive functioning. These symptoms align with the DSM-5 criteria for severe anxiety, which includes extreme levels of distress and impairment in daily functioning. Weak (A), mild (B), and moderate (C) levels of anxiety would not typically manifest in such severe cognitive and behavioral symptoms.
A patient is noted to be bending over backward in the group room. A peer asks what he is doing, and he replies, 'People say they are bending over backwards to help me, so I am bending over backwards to help myself.' This is an example of:
- A. abstract thinking.
- B. concrete thinking.
- C. impaired reality testing.
- D. boundary impairment.
Correct Answer: B
Rationale: The correct answer is B: concrete thinking. Concrete thinking refers to interpreting things in a literal or straightforward manner without grasping abstract concepts or metaphors. In this scenario, the patient is taking the expression "bending over backward" literally, demonstrating a lack of understanding of its figurative meaning.
A: Abstract thinking involves understanding complex concepts and interpreting information beyond the literal meaning. The patient's response does not demonstrate abstract thinking.
C: Impaired reality testing refers to an inability to distinguish between what is real and what is not. The patient's response does not suggest a detachment from reality.
D: Boundary impairment involves difficulty in recognizing and maintaining personal boundaries. The patient's response does not relate to boundary issues.
In summary, the patient's literal interpretation of the expression "bending over backward" reflects concrete thinking, making choice B the correct answer.
A 75-year-old patient comes to the clinic reporting frequent headaches. As the nurse begins the interaction, which action is most important?
- A. Complete a neurological assessment
- B. Determine whether the patient can hear as the nurse speaks
- C. Suggest that the patient lie down in a darkened room for a few minutes
- D. Administer medication to relieve the patient's pain before continuing the assessment
Correct Answer: B
Rationale: Before proceeding with any further assessment, the nurse should assess the patients ability to hear questions. Impaired hearing could lead to inaccurate answers.
What is a key consideration when treating a patient with anorexia nervosa?
- A. Addressing the patient's weight first and foremost.
- B. Focusing on nutrition and caloric intake without addressing underlying issues.
- C. Addressing the psychological and emotional factors that contribute to the disorder.
- D. Providing strict dietary restrictions to help the patient regain control over food.
Correct Answer: C
Rationale: The correct answer is C because addressing the psychological and emotional factors is crucial in treating anorexia nervosa. This disorder is not solely about weight or food intake; it often involves deeper psychological issues such as body image distortion, low self-esteem, and control issues. By focusing on the underlying psychological and emotional factors, therapists can help patients understand and cope with these issues, leading to more effective and sustainable recovery. Choices A, B, and D are incorrect because they overlook the complexity of anorexia nervosa and may even exacerbate the patient's condition by neglecting the root causes of the disorder.