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Which beliefs by a nurse facilitate provision of safe, effective care for older adult patients? Select one tha does not apply.
- A. Sexual interest declines with aging.
- B. Older adults are able to learn new tasks.
- C. Aging results in a decline in restorative sleep.
- D. Older adults are prone to become crime victims.
Correct Answer: A
Rationale: Older adults can learn new tasks (B), experience a decline in restorative sleep (C), and are prone to crime (D), aiding effective care. Sexual interest doesn't universally decline (A), and isolation isn't typical (E); these are myths.
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Which of the following is a priority intervention for a patient with bulimia nervosa who is experiencing electrolyte imbalances?
- A. Encourage the patient to drink fluids and increase food intake.
- B. Monitor the patient's heart rate and electrolyte levels closely.
- C. Provide high-protein foods to help restore energy.
- D. Instruct the patient to avoid any form of physical exercise.
Correct Answer: B
Rationale: The correct answer is B. Monitoring the patient's heart rate and electrolyte levels closely is crucial in managing electrolyte imbalances in patients with bulimia nervosa. Electrolyte imbalances, often caused by purging behaviors, can lead to serious complications like cardiac arrhythmias. Close monitoring allows for timely interventions such as electrolyte replacement therapy to prevent cardiac issues.
A: Encouraging the patient to drink fluids and increase food intake is not the priority when dealing with electrolyte imbalances as it may worsen the imbalance.
C: Providing high-protein foods may be beneficial for overall nutrition but does not address the immediate need to correct electrolyte imbalances.
D: Instructing the patient to avoid physical exercise is not directly related to managing electrolyte imbalances and may not address the underlying issue effectively.
For those family members who desire to care at home for loved ones who have been given a diagnosis of Alzheimer's disease, it is important for the nurse to ensure that the family is aware of which caregiver skills and responsibilities will be necessary. What is one of the responsibilities of the caregiver during the middle stage of the disease?
- A. Helping the loved one with memory and communication problems
- B. Providing a stable, routine environment
- C. Providing complete assistance with physical care
- D. Adapting to the changing personality and behavior of the loved one
Correct Answer: D
Rationale: The correct answer is D: Adapting to the changing personality and behavior of the loved one. During the middle stage of Alzheimer's disease, individuals may experience significant changes in personality and behavior. Caregivers need to adapt to these changes by being patient, understanding, and flexible. This responsibility is crucial for maintaining a positive and supportive relationship with the loved one.
A: Helping the loved one with memory and communication problems is important, but it is more relevant in the early stages of the disease when these issues are more prominent.
B: Providing a stable, routine environment is essential throughout all stages of Alzheimer's disease, not just the middle stage.
C: Providing complete assistance with physical care may become necessary in the later stages of the disease when the individual's physical abilities decline significantly.
A patient with schizophrenia refuses to take his medication because he believes he is not ill. What phenomenon most likely underlies this presentation?
- A. The patient is unable to face having an illness and is in denial.
- B. Stigma causes the patient to refuse to admit his mental illness.
- C. The illness itself is preventing the patient from realizing he is ill.
- D. Command hallucinations are instructing him to deny the illness.
Correct Answer: C
Rationale: The correct answer is C because anosognosia, a symptom of schizophrenia, can prevent patients from recognizing they are ill due to the illness itself affecting their insight and awareness. Anosognosia is a neurocognitive deficit common in schizophrenia, where the brain's ability to recognize one's own illness is impaired. This leads the patient to genuinely believe they are not ill, even when presented with evidence to the contrary.
Choice A: Denial is a psychological defense mechanism, not a symptom of schizophrenia.
Choice B: Stigma might influence perceptions of mental illness, but it does not directly cause anosognosia in schizophrenia.
Choice D: Command hallucinations can influence behavior, but they typically involve auditory commands unrelated to recognizing one's illness.
A parent who is very concerned about a 3-year-old son says, 'He likes to play with girls' toys. Do you think he is homosexual or mentally ill?' Which response by the nurse most professionally describes the current understanding of gender identity?
- A. A child's interest in the activities of the opposite gender is not unusual or related to sexuality. Most children do not carry cross-gender interests into adulthood.
- B. It's difficult to say for sure because the research is incomplete so far, but chances are that he will grow up to be a normal adult.
- C. The research is incomplete, but many boys play with girls' toys and turn out normal as adults.
- D. I am sure that whatever happens, he will be a loving son, and you will be a proud parent.
Correct Answer: A
Rationale: The correct answer is A because it accurately reflects the current understanding of gender identity. Children's interests in activities typically associated with the opposite gender are not unusual and are not indicative of sexual orientation or mental illness. Most children who exhibit cross-gender interests do not carry these into adulthood. This response emphasizes the normalcy of such behavior and provides reassurance to the parent.
Choice B is incorrect because it implies uncertainty based on incomplete research, which goes against the established understanding that cross-gender interests in childhood are common and not predictive of future outcomes.
Choice C is incorrect because it focuses on incomplete research and uses the term "normal as adults," which can perpetuate stigmas surrounding gender expression.
Choice D is incorrect because it does not address the parent's concerns about the child's behavior and does not provide accurate information about gender identity development.
The nurse who is caring for a 23-year-old client with bulimia knows that the most common method of purging to monitor this client for is:
- A. Vomiting.
- B. Starvation.
- C. Excessive enema use.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Vomiting. In bulimia, vomiting is the most common method of purging after binge eating to control weight. Monitoring for signs of vomiting, such as frequent trips to the bathroom after meals or presence of swollen salivary glands, is crucial. Starvation (B) is not a method of purging in bulimia but rather a consequence of restriction in anorexia nervosa. Excessive enema use (C) is not a common method of purging in bulimia and can be harmful. Therefore, the correct choice is A as it aligns with the typical behavior of individuals with bulimia.