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Which theory of etiology of Alzheimer's disease, suggested by current research, might the nurse use to help a family understand that this disorder is not of psychosocial origin? Alzheimer's disease is associated with:
- A. @-amyloid protein deposits in the brain
- B. Abnormal serotonin reuptake
- C. Excessive acetylcholine in the frontal cortex
- D. Prion infection of gray matter
Correct Answer: A
Rationale: The correct answer is A: @-amyloid protein deposits in the brain. This theory of Alzheimer's etiology is supported by current research, indicating that the accumulation of @-amyloid protein plaques in the brain is a key characteristic of the disease. These plaques lead to neuronal damage and cognitive decline. Option B, abnormal serotonin reuptake, is not associated with Alzheimer's. Option C, excessive acetylcholine in the frontal cortex, is incorrect as Alzheimer's is characterized by acetylcholine deficiency. Option D, prion infection of gray matter, is not linked to Alzheimer's disease. In summary, the presence of @-amyloid protein deposits in the brain is a key feature of Alzheimer's pathology, distinguishing it from psychosocial origins.
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A student transfers from a hometown college to a university 200 miles away after breaking up with her boyfriend of 2 years. She was slow to make friends at the university. The history shows a close relationship with her mother and sister. She began eating large quantities when she felt sad, and then she induced vomiting. When the student's schoolwork declined, she sought help from the university health clinic. During the initial interview, what priority issue should the nurse address?
- A. Losses
- B. Sleep patterns
- C. School activities
- D. Menstrual flow
Correct Answer: A
Rationale: The correct answer, Losses (choice A), should be the priority issue for the nurse to address during the initial interview with the student. The rationale is as follows:
1. **Emotional Impact of Breakup**: The student's recent breakup is a significant loss that can trigger emotional distress.
2. **Social Isolation**: Slow to make friends at the university could indicate feelings of loneliness and isolation, further exacerbating the impact of the breakup.
3. **Eating Disorder Behaviors**: Eating large quantities and inducing vomiting are maladaptive coping mechanisms linked to emotional distress and loss.
4. **Academic Decline**: The decline in schoolwork could be a manifestation of the student's emotional struggles related to loss.
5. **Relationship with Family**: Close relationship with her mother and sister may also influence how she copes with losses and seeks support.
Summary:
- **Sleep Patterns (choice B)**: While important, sleep patterns are secondary to addressing the student's emotional distress and coping mechanisms related
A nurse works a rape telephone hotline. Communication should focus on:
- A. Explaining immediate steps victims should take;
- B. Providing callers with a sympathetic listener.
- C. Obtaining information for law enforcement.
- D. Arranging long-term counseling.
Correct Answer: A
Rationale: The correct answer is A because in cases of sexual assault, immediate steps such as seeking medical attention, preserving evidence, and contacting authorities are crucial. Providing sympathy (B) is important but secondary to ensuring victims' safety. Obtaining information for law enforcement (C) should only be done if victims consent, as their safety and well-being are the priority. Long-term counseling (D) is important but not the immediate focus on a hotline call.
A 35-year-old woman who is being interviewed by the advanced practice nurse indicates that she has few friends, fears criticism from others, and withholds information about her thoughts and feelings because she anticipates a negative reaction. Based on these data, the nurse suspects that Sarah may later be diagnosed as having:
- A. Borderline personality disorder
- B. Histrionic personality disorder
- C. Avoidant personality disorder
- D. Schizoid personality disorder
Correct Answer: C
Rationale: The correct answer is C: Avoidant personality disorder. This is because the woman's fear of criticism, avoidance of sharing thoughts/feelings, and limited social circle are indicative of social inhibition and feelings of inadequacy, which are key features of avoidant personality disorder.
A: Borderline personality disorder is characterized by unstable relationships, self-image, and emotions, as well as impulsivity and fear of abandonment.
B: Histrionic personality disorder involves attention-seeking behavior, emotions that are shallow and rapidly shifting, and the need to be the center of attention.
D: Schizoid personality disorder is marked by social detachment, limited emotional expression, and preference for solitary activities.
A nurse finds a patient with anorexia nervosa vigorously exercising before gaining the agreed-upon weekly weight. Select the nurse's best comment.
- A. It bothers me to see you exercising.
- B. You and I will have to sit down and discuss this problem.
- C. Let's discuss the relationship between exercise and weight loss and how that affects your body.
- D. According to our agreement, exercising is not permitted until you have gained a specific amount of weight.
Correct Answer: D
Rationale: The correct answer is D because it directly addresses the behavior in relation to the agreed-upon plan and sets clear boundaries. By stating that exercising is not permitted until the patient has gained a specific amount of weight, the nurse reinforces the importance of following the treatment plan to ensure the patient's health and well-being.
A: This response does not address the behavior in a constructive manner and may come across as judgmental.
B: While discussing the problem is important, it does not provide clear guidance on addressing the immediate issue of exercising before reaching the weight goal.
C: While discussing the relationship between exercise and weight loss can be helpful, it does not provide a clear directive on what action should be taken in this specific situation.
Most individuals with Alzheimer's disease are cared for in:
- A. Nursing homes
- B. Their homes
- C. Mental health facilities
- D. Long-term care facilities specifically set up for clients with Alzheimer's
Correct Answer: B
Rationale: The correct answer is B: Their homes. Most individuals with Alzheimer's disease are cared for in their homes because it allows for familiar surroundings and routines, which can help reduce confusion and anxiety. Home care also promotes independence and maintains a sense of normalcy. Nursing homes (choice A) may be necessary for individuals with advanced Alzheimer's who require round-the-clock care. Mental health facilities (choice C) are not typically designed to provide specialized care for Alzheimer's. Long-term care facilities specifically for Alzheimer's clients (choice D) are a subset of nursing homes and may not be the most common setting for care.