Population Specific Care

Population Specific Care Related

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The wife of a client newly diagnosed with paranoid schizophrenia asks the nurse, 'My husband was well adjusted until a month ago, and then, after a lot of work stress, he got sick. What can I expect? Will he be this sick for the rest of his life?' What information can the nurse provide about prognosis?

  • A. This disorder responds well to treatment and, with follow-up, may not recur.'
  • B. All types of schizophrenia are chronic relapsing disorders.'
  • C. Outcomes are poor related to client prehospital disorganization.'
  • D. The usual outcome is that only partial remission is achieved.'
Correct Answer: A

Rationale: Step 1: Paranoid schizophrenia is a subtype that tends to have a better prognosis compared to other types.
Step 2: The statement that the disorder responds well to treatment and may not recur aligns with the typical course of paranoid schizophrenia.
Step 3: With proper medication and therapy, individuals with paranoid schizophrenia can experience significant improvement and have periods of stability.
Step 4: Recurrence of symptoms is less likely compared to other types of schizophrenia.
Step 5: Therefore, choice A is correct as it provides accurate information about the prognosis of paranoid schizophrenia.
Summary: Choice B is incorrect because not all types of schizophrenia are chronic relapsing disorders. Choice C is incorrect as outcomes are not solely determined by prehospital disorganization. Choice D is incorrect as partial remission is not the usual outcome for paranoid schizophrenia.

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A new nurse asks, 'My elderly patient has Lewy body disease. What should I do about assessing for pain?' Select the best response from the nurse manager.

  • A. Ask the patients family if they think the patient is experiencing pain.'
  • B. Use a visual analog scale to help the patient determine the presence and severity of pain.'
  • C. There are special scales for assessing patients with dementia. Lets review how to use them.'
  • D. The perception of pain is diminished by this type of dementia. Focus your assessment on the patients mental status.'
Correct Answer: C

Rationale: Lewy body disease is a form of dementia. There are special scales to assess the presence and severity of pain in patients with dementia. The Pain Assessment in Advanced Dementia Scale evaluates breathing, negative vocalizations, body language, and consolability. A patient with dementia would be unable to use a visual analog scale. The family may be able to help the nurse gain perspective about the pain, but this strategy alone is inadequate. The other distracters are myths.

What is an appropriate goal for a nurse when working with a patient who has anorexia nervosa?

  • A. The patient will achieve rapid weight gain and improve self-esteem.
  • B. The patient will restore nutritional balance through safe weight gain.
  • C. The patient will accept their body image without therapeutic intervention.
  • D. The patient will maintain a healthy weight without any professional assistance.
Correct Answer: B

Rationale: The correct answer is B because restoring nutritional balance through safe weight gain is a realistic and appropriate goal for a nurse working with a patient with anorexia nervosa. This goal focuses on the patient's physical health and addresses the underlying issue of malnutrition. Rapid weight gain (A) may be dangerous and unsustainable. Accepting body image without intervention (C) ignores the severity of the disorder. Maintaining a healthy weight without professional assistance (D) is unlikely for someone with anorexia nervosa who requires specialized care.

Irrational and very specific fears that persist even when there is no real danger to a person are called

  • A. anxieties
  • B. dissociation's
  • C. phobias
  • D. obsessions
Correct Answer: C

Rationale: Phobias are specific, irrational fears persisting despite no real threat, distinct from general anxiety.

Stuttering is a disturbance in the normal fluency and time patterning of speech that is inappropriate for the individual's age. It involves which of the following?

  • A. Frequent repetitions or prolongations of sounds
  • B. Pauses within words
  • C. Filled or unfilled pauses in speech
  • D. All of the above
Correct Answer: D

Rationale: Stuttering: A disturbance in the normal fluency and time patterning of speech that includes frequent repetitions, prolongations, and pauses.

An appropriate short-term goal for a withdrawn, isolated patient diagnosed with schizophrenia is:

  • A. The patient will participate in all therapeutic activities.'
  • B. The patient will define major barriers to communication.'
  • C. The patient will talk about feelings of withdrawal in group.'
  • D. The patient will consistently interact with an assigned nurse.'
Correct Answer: D

Rationale: Step 1: Interacting with an assigned nurse helps build a therapeutic relationship, essential for engaging withdrawn patients.
Step 2: Consistent interaction promotes trust and communication, aiding in the patient's socialization.
Step 3: This goal is specific, measurable, achievable, relevant, and time-bound, aligning with the SMART criteria.
Summary:
A: Participation in all activities may overwhelm the patient.
B: Defining barriers to communication is too advanced for someone withdrawn.
C: Talking about feelings in a group setting may be too challenging for a withdrawn patient.

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