Nokea
Which nursing diagnosis is likely to apply to an individual diagnosed with a serious mental illness who is homeless?
- A. Insomnia
- B. Substance abuse
- C. Chronic low self-esteem
- D. Impaired environmental interpretation syndrome
Correct Answer: C
Rationale: Many individuals with serious mental illness do not live with their families and become homeless. Life on the street or in a shelter has a negative influence on the individuals self-esteem, making this nursing diagnosis one that should be considered. Substance abuse is not an approved NANDA-International diagnosis. Insomnia may be noted in some patients but is not a universal problem. Impaired environmental interpretation syndrome refers to persistent disorientation, which is not seen in a majority of the homeless.
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A 75-year-old male client is brought to the clinic by his son. The son states, 'Ever since Mom died, Dad hasn't been the same. At first he just seemed sad, but now he seems to get mixed up about everything.' The nurse is aware that based on the client's history, the source of confusion is most likely:
- A. Dementia
- B. Depression from the loss of his wife
- C. Hypoxia of the brain
- D. Delirium from medications
Correct Answer: B
Rationale: Correct Answer: B - Depression from the loss of his wife
Rationale: Given the client's recent loss of his wife and subsequent changes in behavior, the most likely cause of his confusion is depression. Depression can manifest as cognitive impairment in older adults, leading to symptoms such as confusion and memory problems. Additionally, grief and loss can exacerbate depressive symptoms in elderly individuals, further contributing to cognitive difficulties.
Summary of other choices:
A: Dementia - Dementia typically presents with gradual cognitive decline over time, not a sudden onset following a specific event like the loss of a loved one.
C: Hypoxia of the brain - Hypoxia would likely present with more acute symptoms and physical signs, such as shortness of breath or cyanosis.
D: Delirium from medications - Delirium is characterized by acute onset and fluctuating course, often related to medication changes or other medical conditions, rather than an emotional trigger like grief.
Which of the following is the first-line treatment for Anorexia Nervosa?
- A. Family-Based Therapy
- B. Cognitive Behavioural Therapy
- C. Psychodynamic therapy
- D. Humanistic therapy
Correct Answer: A
Rationale: Family-Based Therapy (FBT) is the evidence-based first-line treatment for Anorexia Nervosa in adolescents, per NICE and APA guidelines.
Which service would be expected to provide resources 24 hours a day, 7 days a week if needed for persons with serious mental illness?
- A. Clubhouse model
- B. Cognitive Behavioral Therapy (CBT)
- C. Assertive Community Treatment (ACT)
- D. Cognitive Enhancement Therapy (CET)
Correct Answer: C
Rationale: Assertive Community Treatment (ACT) (C) offers 24/7 multidisciplinary support in the patient's environment, unlike the Clubhouse model (A), CBT (B), or CET (D), which lack such availability.
A physically frail elderly patient with mild cognitive impairments needs services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this patient during the evening and night. Which type of facility should the nurse suggest to meet this patient's needs?
- A. Adult day care program
- B. Skilled nursing facility
- C. Partial hospitalization
- D. Group home
Correct Answer: A
Rationale: The correct answer is A: Adult day care program. This option is suitable as it provides supervision, safety, recreation, and social interaction during the day while allowing the family to care for the patient in the evening and night. Adult day care programs offer a structured environment with trained staff to ensure the patient's safety and provide social engagement.
- Option B, Skilled nursing facility, is not the best choice as it usually provides round-the-clock care, which may not be necessary in this case.
- Option C, Partial hospitalization, is more focused on intensive psychiatric treatment and therapy, which may not align with the patient's needs.
- Option D, Group home, is designed for individuals who need 24-hour care and supervision, which exceeds the patient's current requirements.
Which of the following is a form of child abuse that is known to cause intellectual disability?
- A. Shaken baby syndrome
- B. Abused child syndrome
- C. Battered baby syndrome
- D. Damaged infant syndrome
Correct Answer: A
Rationale: Shaken Baby Syndrome: A form of child abuse causing intellectual disability through traumatic brain injury from violent shaking.