Nokea
Which of the following medical conditions can produce a mild neurocognitive disorder and mild impairments in social/occupational functioning?
- A. Parkinson's disease
- B. Huntington's disease
- C. Creutzfeldt-Jakob disease
- D. HIV
Correct Answer: D
Rationale: HIV can cause mild neurocognitive disorder via brain inflammation, affecting daily functioning.
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A psychiatric technician remarks to the nurse, 'That client with dependent personality disorder is so clingy! I almost hate to see her coming my way.' The response by the nurse that will be helpful to the technician is:
- A. I think everyone feels that way. It's difficult to have someone clinging.'
- B. Clients with personality disorders have little regard for the rights of others.'
- C. The client fears having to function independently without direction from someone else.'
- D. The client is so preoccupied with perfection and structure that she's afraid to do anything at all.'
Correct Answer: C
Rationale: The correct answer is C: The client fears having to function independently without direction from someone else. This response is helpful because it provides insight into the underlying fear and motivation of the client's behavior. Clients with dependent personality disorder often have an excessive need to be taken care of and fear being alone or making decisions independently. This response acknowledges the client's struggle with autonomy and offers understanding without judgment.
Choice A is incorrect because it normalizes the technician's negative feelings, which does not address the client's needs. Choice B is incorrect because it makes a generalizing and negative statement about clients with personality disorders, which is stigmatizing and unhelpful. Choice D is incorrect because it describes features more commonly associated with obsessive-compulsive personality disorder, not dependent personality disorder.
To evaluate whether patient teaching for coping skills has been effective, the psychiatric-mental health nurse asks an adolescent patient to:
- A. consider the outcomes objectively
- B. keep a written journal
- C. perform a return demonstration
- D. set measurable goals
Correct Answer: C
Rationale: A return demonstration shows the patient can apply coping skills, providing tangible evidence of learning.
When planning nursing care for a client with a dependent personality disorder, the nurse recognizes which of the following as characteristic behavior for someone with this disorder? The client:
- A. Perceives his or her behavior to be embarrassing
- B. Believes he or she cannot function without help of others
- C. Exaggerates the potential dangers of ordinary situations
- D. Demands excessive attention from others
Correct Answer: B
Rationale: The correct answer is B because individuals with dependent personality disorder typically believe they cannot function without the help of others. This is a key characteristic of the disorder as they rely heavily on others for decision-making and day-to-day tasks. This behavior stems from an intense fear of separation and abandonment.
Choice A (perceiving behavior as embarrassing) is incorrect as it is more aligned with social anxiety disorder rather than dependent personality disorder. Choice C (exaggerating dangers) is incorrect as it is more characteristic of individuals with anxiety disorders. Choice D (demanding excessive attention) is incorrect as it is more typical of individuals with histrionic personality disorder.
A new nurse asks, 'My elderly patient's CT scan of the head shows many Lewy bodies are present. What should I do about assessing for pain?' Select the best response from the nurse manager.
- A. Ask the patient's family if they think the patient is experiencing pain.
- B. Use a visual analog scale to help the patient determine the presence and severity of pain.
- C. There are special scales for assessing patients with dementia. Let's review how to use them.
- D. The perception of pain is diminished by this type of dementia. Focus your assessment on the patient's mental status.
Correct Answer: C
Rationale: The correct answer is C because patients with Lewy body dementia may have difficulty expressing pain. Special pain assessment scales designed for patients with dementia can help in accurately assessing pain levels. These scales take into account nonverbal cues and behavioral changes that may indicate pain. By using these specialized tools, the nurse can ensure a more comprehensive assessment of the patient's pain experience.
Choice A is incorrect because relying solely on family members' perceptions may not accurately reflect the patient's actual pain experience.
Choice B is not the best option because a visual analog scale may not be suitable for patients with dementia who may have cognitive impairments affecting their ability to use such tools effectively.
Choice D is incorrect as it assumes that pain perception is diminished in Lewy body dementia without considering that patients may still experience pain but have difficulty communicating it. Focusing solely on mental status may overlook important pain indicators.
A 17-year-old client is admitted to the ED after being alternately hyperalert and difficult to arouse. His symptoms all started within the last few hours, during which time he became disoriented and confused. His behavior was agitated and restless, and his memory was impaired, especially for recent events. The client displayed some delusions and misinterpretations of his surroundings. The nurse's first action should be to:
- A. Take the client's vital signs
- B. Restrain the client to prevent injury
- C. Obtain a pm order for a psychotropic medication
- D. Ask the client for information about his medications
Correct Answer: A
Rationale: The correct answer is A: Take the client's vital signs. The first step in assessing any client in the emergency department is to ensure their physiological stability. Vital signs provide essential information about the client's current physical condition, such as heart rate, blood pressure, respiratory rate, and temperature. In this case, the client's alternating states of hyperalertness and difficulty in arousal, disorientation, confusion, agitation, memory impairment, delusions, and misinterpretations of surroundings indicate a potential medical emergency. Therefore, taking the client's vital signs is crucial to determine if there are any immediate life-threatening conditions that need to be addressed promptly.
Summary of other choices:
B: Restrain the client to prevent injury - Restraint should only be used as a last resort for safety concerns and after assessing the client's physical condition.
C: Obtain a PRN order for a psychotropic medication - Administering psychotropic medication should not be the first action without assessing the client's physical condition and