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Which psychosocial factor obtained during an assessment of an older client places the client most at risk for abuse?
- A. The client resides in an apartment in a low-income neighborhood.
- B. The client shows several signs and symptoms of clinical depression.
- C. The client is completely dependent on family members for both food and medicine.
- D. The client has been diagnosed with and is being treated for several chronic illnesses.
Correct Answer: C
Rationale: Elder abuse is sometimes the result of frustrated adult children who find themselves caring for dependent parents. Increasing demands by parents for care and financial support can cause resentment and a feeling of being burdened. The issues of abuse are not bound to socioeconomic status (option 1). Option 2 relates to depression rather than the risk for abuse. Option 4 relates to a physical factor rather than a psychosocial factor.
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The nurse is admitting a client with schizophrenia. The client is extremely socially withdrawn, is unable to perform activities of daily living, has an inappropriate affect, and has grimacing mannerisms. The nurse understands that this client is experiencing which type of schizophrenia?
- A. residual schizophrenia
- B. paranoid schizophrenia
- C. catatonic schizophrenia
- D. disorganized schizophrenia
- E. undifferentiated schizophrenia
Correct Answer: D
Rationale: Disorganized schizophrenia is characterized by social withdrawal, inappropriate affect, grimacing, and impaired daily functioning. Residual (A) involves milder symptoms, paranoid (B) involves delusions, catatonic (C) involves motor issues, and undifferentiated (E) lacks specific features.
A client diagnosed with diabetes mellitus has expressed frustration with learning the diabetic regimen and insulin administration. Which should be the initial action by the home care nurse?
- A. Attempt to identify the cause of the frustration.
- B. Call the primary health care provider to discuss the client's problem.
- C. Offer to administer the insulin on a daily basis until the client is ready to learn.
- D. Continue with teaching, knowing that the client will overcome any frustrations.
Correct Answer: A
Rationale: The home care nurse must determine what is causing the client's frustration. The issue needs to be addressed by the nurse before involving the provider. Administering the insulin provides only a short-term solution. Continuing to teach may only further block the learning process.
A client with the diagnosis of mania is placed in a seclusion room after an outburst of violent behavior that involved a physical assault on another client. Which intervention should the nurse include in the plan of care before seclusion?
- A. Ask the client if she understands why the seclusion is necessary.
- B. Remain silent because verbal interaction would be too stimulating.
- C. Tell the client that she will be allowed to come out when she can behave.
- D. Inform the client that she is being secluded to help regain her self-control.
Correct Answer: D
Rationale: Seclusion is a process in which a client is placed alone in a specially designed room for protection and close supervision. This client is removed to a nonstimulating environment as a result of her behavior. Options 1, 2, and 3 are nontherapeutic actions. Additionally, option 2 implies punishment. It is best to directly inform the client of the purpose of the seclusion.
The nurse in the newborn nursery is caring for a preterm infant. Which is the best method the nurse can implement to assist the parents with developing attachment behaviors?
- A. Support visits by family and friends.
- B. Encourage the parents to touch and speak to their infant.
- C. Report only positive qualities and progress to the parents.
- D. Provide information regarding infant development and stimulation.
Correct Answer: B
Rationale: Parents' involvement through touch and voice establishes and initiates the bonding process in the parent-infant relationship. Their active participation builds their confidence and supports the parenting role. Family visits will not encourage parental attachments. Providing information and emphasizing only positives are not incorrect actions, but they do not relate to the attachment process.
The significant other of a client diagnosed with Graves' disease expresses concern regarding the client's bursts of temper, nervousness, and an inability to concentrate on even trivial tasks. On the basis of this information, the nurse should identify which concern for the client?
- A. Grief
- B. Socialization issues
- C. Issues related to sensory perception
- D. Trouble with coping with a disease process
Correct Answer: D
Rationale: A client with Graves' disease may become irritable, nervous, or depressed. The signs and symptoms in the question support option 4. The information in the question does not support the remaining options.