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Which information is most important to obtain during assessment of an older adult diagnosed with a mental disorder?
- A. Functional ability and emotional status
- B. Chronological age and sexual function
- C. Economic status and sources of income
- D. Developmental history, interests, and activities
Correct Answer: A
Rationale: Information related to functional ability and emotional status provides an overview of patient problems and abilities. It guides selection of interventions and services to meet identified needs. The distracters reflect information of relevance, but are not of highest priority.
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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 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.
The therapeutic approach in the care of an autistic child include the following EXCEPT:
- A. Engage in diversionary activities when acting out
- B. Provide an atmosphere of acceptance
- C. Provide safety measures
- D. Rearrange the environment to activate the child
Correct Answer: D
Rationale: Rearranging the environment to activate the child may overstimulate an autistic child, who typically benefits from consistency and calm settings.
A widowed patient tells a nurse that the door should be left unlocked because her husband will be coming home soon. Which response by the nurse would be most therapeutic?
- A. "You've forgotten that your husband's dead, haven't you?"Â
- B. "Just try to sleep. He won't be home for a long time yet."Â
- C. "You must miss him a lot. It almost seems he's here with you."Â
- D. "Your husband died 10 years ago. He won't be coming here."Â
Correct Answer: C
Rationale: The correct answer is C because it validates the patient's feelings without directly confronting or contradicting her belief. By acknowledging the patient's emotions and creating a sense of empathy, the nurse establishes a therapeutic rapport. Choice A is incorrect as it may be perceived as confrontational and insensitive. Choice B dismisses the patient's feelings and can be invalidating. Choice D is direct and may cause distress or confusion to the patient. In summary, option C is the best choice as it shows empathy and understanding towards the patient's emotional state.
A patient with anorexia nervosa begins to refuse food. The nurse should first:
- A. Speak with the patient's family about the refusal.
- B. Focus on the patient's emotional distress and discuss it.
- C. Redirect the patient to a different activity to distract them.
- D. Encourage the patient to eat a small, manageable portion of food.
Correct Answer: D
Rationale: The correct answer is D because encouraging the patient to eat a small, manageable portion of food is the most immediate and vital intervention in addressing the patient's refusal to eat. This step is crucial in preventing further complications associated with anorexia nervosa, such as malnutrition and dehydration. By starting with a small portion, the patient can gradually reintroduce food and begin the process of recovery.
A: Speaking with the family may be important but not the first step in addressing the patient's refusal to eat.
B: Focusing on emotional distress is important but addressing the physical need for food should take priority.
C: Redirecting the patient to a different activity may temporarily distract them but does not address the underlying issue of malnutrition.