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Which assessment data suggests a person who appears to have dementia instead has depression and pseudodementia?
- A. Demonstrates impaired judgment.
- B. Demonstrates impaired concentration.
- C. Has a history of significant losses or crises.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B because impaired concentration is a key indicator of depression and pseudodementia rather than dementia. In depression, individuals may experience difficulties focusing and maintaining attention, leading to impaired concentration. Pseudodementia, which mimics dementia but is caused by depression, also presents with similar cognitive symptoms like impaired concentration. Choices A and C are incorrect because impaired judgment and significant losses or crises can be present in both dementia and depression, making them less specific to differentiating between the two conditions. Choice D is incorrect as choice B clearly distinguishes the cognitive symptomatology between dementia and depression/pseudodementia.
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A family discusses the impact of a seriously mental ill member. Insurance partially covered treatment expenses, but the family spent much of their savings for care. The patients sibling says, 'My parents have no time for me.' The parents are concerned that when they are older, there will be no one to care for the patient. Which response by the nurse would be most helpful?
- A. Acknowledge their concerns and consult with the treatment team about ways to bring the patients symptoms under better control
- B. Give them names of financial advisors that could help them save or borrow sufficient funds to leave a trust fund to care for their loved one
- C. Refer them to crisis intervention services to learn ways to manage caregiver stress and provide titles of some helpful books for families
- D. Discuss benefits of participating in National Alliance on Mental Illness (NAMI) programs and ways to help the patient become more independent
Correct Answer: D
Rationale: The family has raised a number of concerns, but the major issues appear to be the effects caregiving has had on the family and their concerns about the patients future. The National Alliance on Mental Illness (NAMI) offers support, education, resources, and access to other families who have experience with the issues now facing this family. NAMI can help address caregiver burden and planning for the future needs of SMI persons. Improving the patients symptom control and general functioning can help reduce caregiver burden but would likely be a slow process, whereas NAMI involvement could benefit them on a number of fronts, possibly in a shorter time period. The family will need more than financial planning; their issues go beyond financial. The family is distressed but not in crisis. Crisis intervention is not an appropriate resource for the longer-term issues and needs affecting this family.
An elderly patient brings a bag of medications to the clinic. The nurse finds bottles of medications as well as assorted pills in no containers in the bag. What is the nurse's priority action?
- A. Dispose of all medications that are not in properly labeled bottles.
- B. Confer with a family member about the patient's management of medication.
- C. Engage the patient in education about safe storage and labeling of medication.
- D. Ask the patient to name the purpose and date of expiration of each medication not in a bottle.
Correct Answer: C
Rationale: The correct answer is C because engaging the patient in education about safe storage and labeling of medication is the priority action. This approach promotes patient understanding and empowerment in managing their medications safely. It addresses the immediate concern of the medications being improperly stored and unlabeled. Option A focuses solely on disposal without addressing the root cause. Option B involves a third party and may not address the patient's immediate needs. Option D is important but not as urgent as ensuring safe storage and labeling. Ultimately, educating the patient promotes long-term safety and adherence to medication management.
What is a common consequence of long-term purging in patients with bulimia nervosa?
- A. Improved digestive health and better nutrient absorption.
- B. Increased risk of dehydration and electrolyte imbalances.
- C. Improved self-esteem and body image.
- D. Decreased risk of cardiovascular problems and hypertension.
Correct Answer: B
Rationale: The correct answer is B because long-term purging in patients with bulimia nervosa can lead to increased risk of dehydration and electrolyte imbalances. Purging behaviors such as vomiting or laxative abuse can disrupt the body's fluid and electrolyte balance, potentially causing dehydration and electrolyte imbalances. These imbalances can have serious health consequences, including cardiac arrhythmias, muscle weakness, and kidney damage.
Incorrect choices:
A: Improved digestive health and better nutrient absorption - Purging does not improve digestive health or nutrient absorption; rather, it can lead to nutrient deficiencies.
C: Improved self-esteem and body image - Purging behaviors are harmful and do not lead to improved self-esteem or body image.
D: Decreased risk of cardiovascular problems and hypertension - Purging behaviors can actually increase the risk of cardiovascular problems due to electrolyte imbalances and dehydration.
A 16-year-old female patient who is Chinese American is admitted to the unit with reports of sadness and suicidal ideation. The patient is accompanied by many family members, including her mother and father. The patient and her family emigrated from mainland China five years ago. Regarding the family, the psychiatric-mental health nurse:
- A. encourages the patient to communicate her need for privacy to her family
- B. gently asks the family members to leave the room
- C. privately asks the mother for her assistance in clearing the room
- D. provides care for the patient while the family members are present
Correct Answer: C
Rationale: Involving the mother respects cultural family dynamics while facilitating a private assessment, balancing sensitivity and need.
Which symptom of Alzheimer's disease is associated with disorientation to time and place?
- A. Forgetting in what order to put clothes on
- B. Forgetting simple words
- C. Forgetting where he or she lives
- D. Becoming suspicious of others
Correct Answer: C
Rationale: The correct answer is C: Forgetting where he or she lives. In Alzheimer's disease, disorientation to time and place is a common symptom due to memory loss and cognitive decline. Forgetting where one lives directly relates to disorientation, as the individual may not recognize their home or surroundings. Choice A is related to sequencing and executive function, not specific to time and place. Choice B is more associated with language and communication difficulties. Choice D relates to paranoia or mistrust, not specifically related to disorientation to time and place. In summary, the correct answer directly reflects the symptom of disorientation in Alzheimer's disease, while the other choices are related to different cognitive functions.