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Which of the following would indicate that a therapeutic activity program for a client with Alzheimer's disease had been successful? Client demonstrates:
- A. Accurate recent memory, positive emotional response, increased verbal expression
- B. Increased attention span, verbal expression of remote memory, positive emotional response
- C. Positive use of perseveration, reduction in use of habitual skills, improved abstract reasoning
- D. Positive emotional response, ability to remember multiple steps, accurate recent memory
Correct Answer: B
Rationale: The correct answer is B because increased attention span, verbal expression of remote memory, and positive emotional response indicate successful therapeutic program for Alzheimer's client. Attention span and verbal expression show cognitive improvement, while positive emotional response indicates overall well-being. Option A lacks improvement in remote memory. Option C mentions reduction in habitual skills, which is not desirable. Option D emphasizes recent memory and remembering multiple steps, but doesn't cover improvement in attention span or remote memory.
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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.
An appropriate intervention for a client with an identified nursing diagnosis of Situational low self-esteem would be:
- A. Encouraging verbalization of feelings in a safe environment
- B. Attempting to determine triggers to hallucinations
- C. Engaging client in activities designed to permit success
- D. Providing large muscle activities to relieve stress
Correct Answer: C
Rationale: The correct answer is C: Engaging client in activities designed to permit success. This intervention is appropriate for addressing situational low self-esteem as it focuses on building the client's self-confidence through successful experiences. Engaging in activities that the client can excel at helps boost self-esteem and self-worth. By providing opportunities for success, the client can gain a sense of accomplishment, leading to improved self-esteem.
A: Encouraging verbalization of feelings in a safe environment may be beneficial for emotional expression, but it does not directly address building self-esteem through success.
B: Attempting to determine triggers to hallucinations is unrelated to addressing situational low self-esteem.
D: Providing large muscle activities to relieve stress may be helpful for stress management but does not directly target improving self-esteem through success.
Which of the following is a potential complication of untreated bulimia nervosa?
- A. Severe dehydration and electrolyte imbalances.
- B. Rapid weight gain and fluid retention.
- C. Chronic constipation and digestive issues.
- D. Severe malnutrition and organ failure.
Correct Answer: A
Rationale: The correct answer is A: Severe dehydration and electrolyte imbalances. Untreated bulimia nervosa involves recurrent episodes of binge-eating followed by compensatory behaviors like purging. Purging can lead to fluid loss and electrolyte imbalances, causing dehydration. This can result in serious health complications such as cardiac arrhythmias and kidney damage. Rapid weight gain and fluid retention (B) are more associated with binge-eating disorder, not bulimia nervosa. Chronic constipation and digestive issues (C) are more commonly seen in anorexia nervosa. Severe malnutrition and organ failure (D) are potential complications of anorexia nervosa rather than bulimia nervosa.
DSM stands for
- A. diagnostic schedule of medicine
- B. diagnostic and statistical manual
- C. depressive scale modalities
- D. doctor of surgical medicine
Correct Answer: B
Rationale: DSM refers to the Diagnostic and Statistical Manual of Mental Disorders, a key classification tool.
A family discusses the impact of a seriously mental ill member. Insurance partially covered treatment expenses, but the family spent much of their savings for care. The patients sibling says, 'My parents have no time for me.' The parents are concerned that when they are older, there will be no one to care for the patient. Which response by the nurse would be most helpful?
- A. Acknowledge their concerns and consult with the treatment team about ways to bring the patients symptoms under better control
- B. Give them names of financial advisors that could help them save or borrow sufficient funds to leave a trust fund to care for their loved one
- C. Refer them to crisis intervention services to learn ways to manage caregiver stress and provide titles of some helpful books for families
- D. Discuss benefits of participating in National Alliance on Mental Illness (NAMI) programs and ways to help the patient become more independent
Correct Answer: D
Rationale: The family has raised a number of concerns, but the major issues appear to be the effects caregiving has had on the family and their concerns about the patients future. The National Alliance on Mental Illness (NAMI) offers support, education, resources, and access to other families who have experience with the issues now facing this family. NAMI can help address caregiver burden and planning for the future needs of SMI persons. Improving the patients symptom control and general functioning can help reduce caregiver burden but would likely be a slow process, whereas NAMI involvement could benefit them on a number of fronts, possibly in a shorter time period. The family will need more than financial planning; their issues go beyond financial. The family is distressed but not in crisis. Crisis intervention is not an appropriate resource for the longer-term issues and needs affecting this family.