Nokea
You are a nurse meeting for the first time with a stage 3 Alzheimer's patient who is newly referred to your home health agency. Which assessment data about the patient and caregiver(s) would be most important to acquire during your first visit to the family's home?
- A. Is the house design such that patient access to exits and stairways can be restricted?
- B. Does the family understand that the disease is likely to prove fatal within 3 to 5 years?
- C. What resources is the patient's family able to access in their particular community?
- D. What activities or memories are most comforting and calming for the patient?
Correct Answer: A
Rationale: Step 1: Ensuring patient safety is the top priority in caring for a stage 3 Alzheimer's patient in a home setting.
Step 2: Restricting access to exits and stairways is crucial to prevent the patient from wandering or falling.
Step 3: This assessment data is essential for implementing safety measures and preventing potential harm to the patient.
Step 4: Choices B, C, and D, while important, do not directly address the immediate safety concerns of the patient.
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An elderly patient must be physically restrained. Who is responsible for the patients safety?
- A. The nurse assigned to care for the patient
- B. Unlicensed assistive personnel who apply the restraint
- C. Family member who agrees to application of the restraint
- D. Health care provider who prescribed application of restraint
Correct Answer: A
Rationale: Although restraint is prescribed by a health care provider, the restraint is a measure carried out by nursing staff. The nurse caring for the patient is responsible for safe application of restraining devices and for providing safe care while the patient is restrained. Nurses may delegate the application of restraining devices and the care of the patient in restraint, but the nurse remains responsible for outcomes. Even when family agree to restraint, nurses are responsible for providing safe outcomes.
A depressed patient is to have his first electroconvulsive therapy (ECT) session tomorrow morning. Which intervention would routinely be implemented in preparing the patient for treatment?
- A. Explaining that 20 or more treatments will be needed
- B. Advising the patient that memory loss is usually transient
- C. Preparing the patient to be restrained during the procedure
- D. Educating the patient about how ECT will end his depression
Correct Answer: B
Rationale: The correct answer is B: Advising the patient that memory loss is usually transient. This is because memory loss is a common side effect of ECT, but it is typically temporary and resolves after treatment. It is important to prepare the patient for potential memory issues to reduce anxiety and manage expectations. Choices A, C, and D are incorrect because explaining the number of treatments needed, preparing for restraint, or suggesting ECT will end depression are not standard interventions in preparing a patient for ECT.
The nurse reports to the interdisciplinary team that an antisocial patient lies to other patients, verbally abuses a patient with Alzheimer's disease, flatters his primary nurse, and is detached and superficial during counseling sessions. Which behavior should be the priority focus of limit setting?
- A. Lying to other patients
- B. Flattering the nursing staff
- C. Verbally abusing other patients
- D. Superficiality during counseling
Correct Answer: C
Rationale: The correct answer is C: Verbally abusing other patients should be the priority focus of limit setting. This behavior poses a direct threat to the safety and well-being of other patients. By addressing verbal abuse first, the nurse can establish boundaries and maintain a safe environment for all patients. Lying to other patients (A) may be addressed but is not as immediate a concern. Flattering the nursing staff (B) is manipulative but not as harmful as verbal abuse. Superficiality during counseling sessions (D) may indicate other issues but is not as urgent as addressing the verbal abuse.
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.
A patient diagnosed with serious mental illness was living successfully in a group home but wanted an apartment. The prospective landlord said, 'People like you have trouble getting along and paying their rent.' The patient and nurse meet for a problem-solving session. Which options should the nurse endorse? Select one tha does not apply.
- A. Coach the patient in ways to control symptoms effectively
- B. Seek out landlords less affected by the stigma associated with mental illness
- C. Threaten the landlord with legal action because of the discriminatory actions
- D. Have the case manager meet with the landlord to provide education about mental illness
Correct Answer: C
Rationale: Managing symptoms so that they are less obvious or socially disruptive can reduce negative reactions and reduce rejection due to stigma. Seeking a more receptive landlord might be the most expeditious route to housing for this patient. Educating the landlord to reduce stigma might make him more receptive and give the case manager an opportunity to address some of his concerns (e.g., the case manager could arrange a payee to assure that the rent is paid each month). However, threatening a lawsuit would increase the landlords defensiveness and would likely be a long and expensive undertaking. Delaying the patients efforts to become more independent is not clinically necessary according to the data noted here; the problem is the landlords bias and response, not the patients illness. It would be unethical to encourage falsification and poor role modeling to do so; further, if falsification is discovered, it could permit the landlord to refuse or cancel her lease.