Population Specific Care

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Which intervention would best address the nursing diagnosis of Imbalanced nutrition for elderly patients in stages 2 to 3 of Alzheimer's disease?

  • A. Monitor the frequency and characteristics of bowel movements.
  • B. Offer finger foods the patient can take away from the table.
  • C. Monitor intake and output, and take patient weights each week.
  • D. Provide protein-dense foods to provide for neurological regrowth.
Correct Answer: B

Rationale: The correct answer is B: Offer finger foods the patient can take away from the table. This intervention is best suited for elderly patients in stages 2 to 3 of Alzheimer's disease as it promotes independent eating, encourages increased food intake, and addresses potential behavioral issues related to Alzheimer's. By offering finger foods that the patient can take away from the table, it allows for easier access to food, enhances the patient's ability to feed themselves, and reduces frustration or confusion that may arise during meal times. This approach supports the patient's autonomy and dignity while also addressing the nursing diagnosis of Imbalanced nutrition.

Choice A is incorrect because monitoring bowel movements does not directly address the nutritional needs of the patient. Choice C focuses more on fluid balance rather than nutrition intake. Choice D is incorrect as providing protein-dense foods does not specifically target the challenges faced by elderly patients with Alzheimer's disease in stages 2 to 3.

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A patient living in community housing for the elderly says, 'I dont go to the senior citizens club. They play cards and talk about the past because thats all they can do.' The nurse analyzes these remarks to represent:

  • A. failure to achieve developmental tasks
  • B. thinking associated with ageism
  • C. hypercritical behavior
  • D. paranoid thinking
Correct Answer: B

Rationale: Ageism is negative stereotyping and devaluation of people based on their age. Older adults might be as guilty of ageism as younger individuals. The other options are not substantiated by the information given in the scenario.

The head nurse on a unit that serves persons with cognitive impairment is concerned about her staff, many of whom seem to be becoming 'burned out' by their challenging work. Which response by the head nurse is most likely to minimize staff frustration and burnout on the unit? Select all that apply.

  • A. Educate staff regarding realistic expectations for this patient population.
  • B. Arrange for 12-hour shifts so that staff can have more days off per week.
  • C. Guide staff to use small, realistic goals as their measure of patient progress.
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A because educating staff about realistic expectations for working with persons with cognitive impairment can help them understand the challenges they may face and develop appropriate coping strategies. This knowledge can reduce frustration and burnout by promoting a better understanding of the patients' needs and behaviors.

Choice B, arranging for 12-hour shifts, may actually increase staff burnout as longer shifts can be physically and mentally taxing. Choice C, guiding staff to use small, realistic goals, while helpful in patient care, may not directly address staff burnout. Therefore, the most effective approach to minimize staff frustration and burnout in this scenario is education on realistic expectations.

A rape victim tells the nurse, "I should not have been out on the street alone." Select the nurse's most helpful response.

  • A. Rape can happen anywhere.
  • B. Blaming yourself increases your anxiety and discomfort.
  • C. You are right. You should not have been alone on the street at night.
  • D. You feel as though this would not have happened if you had not been alone.
Correct Answer: D

Rationale: The correct answer is D because it acknowledges the victim's feelings without placing blame or judgment. By reflecting the victim's feelings back to them, the nurse validates their experience and shows empathy. This response encourages the victim to express their emotions and helps in building trust with the nurse.

Other choices are incorrect:
A: This choice does not address the victim's feelings of self-blame and does not provide the needed support.
B: While this choice acknowledges the negative impact of self-blame, it does not directly address the victim's statement.
C: This choice may be perceived as dismissive or blaming, which can further harm the victim's emotional well-being.

A nurse is caring for a patient who is confused, disoriented in all three spheres, and experiencing visual hallucinations. While preparing to provide personal care, the nurse should:

  • A. ask the patient, "Do you remember who I am?"
  • B. speak minimally so as not to disturb the patient.
  • C. pat the patient on the forearm and say, "Let's get started."
  • D. explain to the patient what will happen during the care.
Correct Answer: D

Rationale: The correct answer is D because explaining to the patient what will happen during care is essential to provide a sense of orientation and reduce anxiety in a confused patient. This approach helps the patient understand the situation and feel more in control, which can decrease agitation. Choice A is incorrect as the patient's memory deficit may lead to further confusion. Choice B is incorrect as minimal communication may not address the patient's needs. Choice C is incorrect as physical touch without explanation may escalate the patient's hallucinations.

A patient's medical record documents sexual masochism. This patient derives sexual pleasure

  • A. from inanimate objects.
  • B. by inflicting pain on a partner.
  • C. when sexually humiliated by a partner.
  • D. from touching a nonconsenting person.
Correct Answer: C

Rationale: The correct answer is C because sexual masochism involves deriving sexual pleasure from being humiliated or degraded by a partner. This behavior is characterized by finding arousal in receiving physical or emotional pain or humiliation during sexual activities. Choices A, B, and D are incorrect because they do not align with the specific behavior associated with sexual masochism. Choice A refers to objectophilia, choice B describes sadism, and choice D pertains to non-consensual sexual behavior, none of which are indicative of sexual masochism.

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