Age Specific Care Competency

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What is an important aspect of managing refeeding syndrome in patients with anorexia nervosa?

  • A. Refeeding the patient with high-calorie foods immediately.
  • B. Monitoring electrolytes closely during the refeeding process.
  • C. Allowing the patient to eat whatever they want without restrictions.
  • D. Restricting fluid intake to avoid water retention.
Correct Answer: B

Rationale: The correct answer is B because monitoring electrolytes closely during refeeding is crucial to prevent life-threatening complications such as electrolyte imbalances. Refeeding syndrome can lead to shifts in electrolytes, particularly phosphorus, potassium, and magnesium, which may result in cardiac arrhythmias, respiratory failure, or even death. Close monitoring allows for timely interventions to maintain electrolyte balance.

Choice A is incorrect because refeeding a patient with high-calorie foods immediately can actually exacerbate refeeding syndrome by overwhelming the body's metabolic and electrolyte regulation processes. Choice C is incorrect because allowing the patient to eat whatever they want without restrictions can lead to rapid and uncontrolled weight gain, which may worsen medical complications. Choice D is incorrect because restricting fluid intake can also contribute to electrolyte imbalances and dehydration during refeeding.

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Which remarks by a 72-year-old patient should prompt the nurse to assess for depression? Select one tha does not apply.

  • A. Lately I have had a lot of aches and pains and just havent felt very well.
  • B. People are in and out of my room all day and all night taking my things.
  • C. Dont ask me to eat. I cant because my stomach is upset all the time.
  • D. Im eating more than usual, and I am sleeping about 6 hours a night.
Correct Answer: D

Rationale: Somatic symptoms (A), delusions of persecution (B), and nihilistic delusions (C) are common in late-onset depression, warranting assessment. Increased appetite and contentment (D, E) do not suggest depression.

A newly admitted patient diagnosed with paranoid schizophrenia is hypervigilant and constantly scans the environment. He states that he saw two doctors talking in the hall and knows they were plotting to kill him. When charting, how should the nurse identify this behavior?

  • A. Idea of reference
  • B. Delusion of infidelity
  • C. Auditory hallucination
  • D. Echolalia
Correct Answer: A

Rationale: The correct answer is A: Idea of reference. This patient's belief that the doctors were plotting to kill him is an example of an idea of reference, a symptom of paranoia common in paranoid schizophrenia. This term refers to the belief that neutral actions or events are directed at oneself. Delusion of infidelity (B) involves false beliefs about a partner's infidelity, not relevant here. Auditory hallucination (C) is false perception of sound, not applicable. Echolalia (D) is the repetition of words or phrases, not seen in this scenario. Identifying the behavior as an idea of reference helps the nurse understand the patient's distorted perception and tailor interventions effectively.

A novice nurse tells the assigned mentor, 'I admitted a patient today who has several bizarre delusions. I wanted to tell the patient that the ideas and conclusions simply are not logical. What do you think will happen if I do?' Which reply by the mentor is best?

  • A. I think you'll give the patient something to think about.'
  • B. The patient will probably incorporate you into the delusions as a persecutor.'
  • C. Develop trust using empathy and calmness before pointing out discrepancies.'
  • D. Initially, it would be better to go along with the patient's thinking to gain cooperation.'
Correct Answer: C

Rationale: The correct answer is C because it emphasizes the importance of developing trust and rapport with the patient before addressing their delusions. By using empathy and calmness, the nurse can create a safe environment for the patient to feel understood and supported. This approach can help the patient be more receptive to feedback about the discrepancies in their thinking.

Choice A is incorrect because simply giving the patient something to think about may not address the underlying issues causing the delusions.

Choice B is incorrect as it assumes the patient will view the nurse negatively, which may not always be the case.

Choice D is incorrect as it suggests going along with the patient's delusions, which can potentially reinforce and perpetuate their false beliefs.

A delusion is defined as seeing something that is not real

  • A. TRUE
  • B. FALSE
Correct Answer: B

Rationale: A delusion is a fixed false belief, not a perception (hallucination involves seeing/hearing something not real).

The average time that a person with Alzheimer's disease lives after diagnosis is:

  • A. 2 years
  • B. 8 years
  • C. 10 years
  • D. 20 years
Correct Answer: B

Rationale: The correct answer is B: 8 years. Alzheimer's disease typically progresses slowly, with individuals living an average of 8 years after diagnosis. This is due to the degenerative nature of the disease, leading to gradual decline in cognitive function. Choice A (2 years) is too short for Alzheimer's progression. Choice C (10 years) is close but slightly overestimates the average. Choice D (20 years) is too long, as Alzheimer's typically does not allow for such a long survival time post-diagnosis. Therefore, B is the most accurate option based on the typical progression and outcomes of Alzheimer's disease.

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