Age Specific Nursing Care

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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: The correct answer is A: "This disorder responds well to treatment and, with follow-up, may not recur."

Rationale:
1. Paranoid schizophrenia typically responds well to treatment, especially with early intervention.
2. With proper medication and therapy, individuals with paranoid schizophrenia can experience significant improvement and lead fulfilling lives.
3. Follow-up care and support are crucial in maintaining stability and preventing relapses.

Summary of why other choices are incorrect:
B: All types of schizophrenia are chronic relapsing disorders - This is not accurate as outcomes can vary depending on the subtype of schizophrenia.
C: Outcomes are poor related to client prehospital disorganization - This statement is too general and does not specifically address the prognosis of paranoid schizophrenia.
D: The usual outcome is that only partial remission is achieved - This is not always the case, as many individuals with paranoid schizophrenia can achieve full remission with appropriate treatment.

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A nurse and social worker co-lead a reminiscence group for eight elite-old adults. Which activity is appropriate to include in the group?

  • A. Mild aerobic exercise
  • B. Singing a song from World War II
  • C. Discussing national leadership during the Vietnam War
  • D. Identifying the most troubling story in todays newspaper
Correct Answer: B

Rationale: Elite-old adults (100+ years) were young during World War II. Singing a song from that era (B) aligns with reminiscence therapy by sharing relevant past memories. Other options (A, C, D) are less tied to their life experiences.

A client displays disorganized thinking, difficult-to-follow speech, and silly, inappropriate affect. The client isolates himself from other clients and staff, ignores unit activities, and often seems to be listening and responding to unseen stimuli. This client's behavior most closely conforms to the characteristic behavior of:

  • A. Residual schizophrenia
  • B. Schizoaffective disorder
  • C. Paranoid schizophrenia
  • D. Disorganized schizophrenia
Correct Answer: D

Rationale: The correct answer is D: Disorganized schizophrenia. The client's symptoms of disorganized thinking, difficult-to-follow speech, inappropriate affect, social withdrawal, and hallucinations (responding to unseen stimuli) align with the diagnostic criteria for Disorganized Schizophrenia. This subtype is characterized by disorganized behavior, speech, and affect, as well as social withdrawal and hallucinations.

A: Residual schizophrenia does not involve active psychotic symptoms like hallucinations or delusions, which are present in the client's behavior described.
B: Schizoaffective disorder combines symptoms of schizophrenia and mood disorders, and the client's symptoms do not strongly suggest a mood disorder component.
C: Paranoid schizophrenia typically involves prominent delusions and auditory hallucinations, which are not emphasized in the client's behavior described.

A homeless patient diagnosed with a serious mental illness became suspicious and delusional. Depot antipsychotic medication began, and housing was obtained in a local shelter. One month later, which statement by the patient indicates significant improvement?

  • A. They will not let me drink. They have many rules in the shelter.'
  • B. I feel comfortable here. Nobody bothers me.'
  • C. Those shots make my arm very sore.'
  • D. Those people watch me a lot.'
Correct Answer: B

Rationale: Evaluation of a patients progress is made based on patient satisfaction with the new health status and the health care teams estimation of improvement. For a formerly delusional patient to admit to feeling comfortable and free of being bothered by others denotes improvement in the patients condition. The other options suggest that the patient is in danger of relapse.

A young patient diagnosed with schizophrenia is standing naked after showering and appears to be both dazed and indecisive. The nursing intervention that will be most helpful to promote dressing would be:

  • A. saying, 'These are your clothes. Please get dressed.'
  • B. saying, 'These are your underpants. I'll help you put them on.'
  • C. asking, 'Which of these two outfits would you like to wear now?'
  • D. asking, 'Is something the matter with your clothes that makes you not want to dress?'
Correct Answer: B

Rationale: The correct answer is B. By saying, "These are your underpants. I'll help you put them on," the nurse provides clear guidance and offers assistance, which can help the patient feel more comfortable and supported in the dressing process. This approach acknowledges the patient's need for help while respecting their autonomy.

Choice A is too directive and may make the patient feel pressured or overwhelmed. Choice C involves too many options, which can be confusing for a patient experiencing indecisiveness. Choice D assumes a problem with the clothes rather than focusing on the patient's needs and feelings. Overall, choice B is the most appropriate and supportive intervention in this situation.

Which statement by a parent of a teen with anorexia nervosa suggests a need for further education?

  • A. I will make sure my teen eats three meals a day.
  • B. It is important to monitor my teen's weight regularly.
  • C. I should encourage my teen to keep a food journal.
  • D. I should allow my teen to skip meals if she feels full.
Correct Answer: D

Rationale: The correct answer is D because allowing the teen to skip meals if she feels full can reinforce unhealthy eating behaviors associated with anorexia nervosa. This statement contradicts the essential goal of promoting regular and adequate meal intake to support recovery. Encouraging the teen to eat when not hungry may be necessary to restore normal eating patterns. Choices A, B, and C align with supporting the teen's nutritional needs and recovery process.

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