dementia
Borderline 1) behavior contract 2) dialectical behaivor therapy 3) bibliotherapy 4) safety plan
1
anorexia with recent rapid weight loss at90 CATASTROPHIZZING 1) life isnt workth living if i gain weight 2) dont pretend like you dont now how i am fat 3) if i could be skinny i know id be pop 4) when i lok in mirror i see obsese
1
NCD wander "i have to go home:
I am your nurse lets walk together adn go to your room
histronic personality disorder 1) promote appropriate behaivoro during group theapy 2) encourage client input in tx plan 3) communication using concrete 4) demonstrate assertive behavior
1
weight loss of 25 lbin 3 month 88lbs and believees she is fat which is priority 1) nutritional status 2) request mental health consult 3) plan a therpeutic diet 4) talk to a family members o find out more about the clients
1
comorbities with eating disorders 1) anxiety 2) ocd 3) schizo 4) breathing issues 5) depression
1, 2, 5
MSE on dimentia 1) grooming 2) lt memory 3) support systems 4) affect 5) pain
1, 2,4
a nurse is preparing to obtain a nursing diagnosis from a client who has anorexia which of the following shold the nurse ask 1) what is your relatipnship with fam 2) why do you want to lose weight 3) would you describe your currene eating habits 4) at what weight do you belivee you will look bettter 5) can you discuss oyur feelings about appearance
1, 3, 5
Dementia : when performing an MSE should include 1) ability to perform calc 2) loc 3) recall ability 4) LT 5) level of orientation
1, 3, 5 ability to perform calculation, recall, and loc,
alzheimers assess home safety which suggestions 1) install childproof locks 2) rugs over elecrtical cords 3) mark tcleaning supplies with tape 4) place clients mattress on floor 5) install light above the stairs
1,45 rugs are bad, cleaning uspplies shoudl be locekd
anorexia body mass of 17.3 what are the nursing intervention 1) small frequent meals 2) monitor weiht 3) allow them to choose meals 4) stay with the client during meals and 1 hr affter 5) offer specific priv for sustained weight gain
1245
assessment anorexia 1) amenorrhea 2) verbalized desire to gain weight 3) altered body image 4) hyperactivity 5) brady
1345
Borderline personality they say why dont you shut up already i can read it myself 1) we do this everyday why ru so angry with me 2) i dont like it when you address me with that tone of voice 3) i know you can do it yourself, the issue is will you 4) fine here is the schedule and i expect you to be on time to therapy
2
anorexia nervosa and over exercise to avoid weight gain what NI? 1) praise the client for looking at herslef in mirror 2) establish contract with client requiering her to tao talk to nurse when she feels urge 3) confront the client abotu damage over overexercising 4) restrict client from being weighed
2
delirum 1) a clien tasks what time it is 2) a client asks family members will be arriving after vising 1 hour before 3) a client requests extra plankets even though its hot
2
early stage of alzheimers a new prescription for DONEPEZIL the nusrse should includ what 1) avoid oTC acetoomiphen 2) progression of cog decline to slow with this 3) screen for kidney disease prior 4) stop taking if diarrhea or nauseous
2
anorexia sign 1) tach 2) constipation 3) metrorrhagia 4) hyperkalemia
2 1-brady 3-amnorhhea 4-hypokalemia
medical record for anorexia 1) decreased cholesterol 2) low bone density 3) heavy monthly period 4) heat intolerance
2 Increased cholestrol, no periods, cold intolerance
deleirum and uti which of the following should nurse expect 1) history of grad mem loss 2) family report personality change 3) hallucination 4) unaltered LOC 5) restlessness
2, 3, 5
a nurse is performing an admission assessment of a client who has bulimia with purging 1) amnorrhea 2) hypokaemia 3) mottling of ksin 4) slightly elevated body weight 5) presecnce of laguna on the face
2,4 1- anorexia 3-anorexia 5-anorexia hypokalmia is expected with pruging type bulimia
bulimia nervosoa and has stopped purging. she is afriad shes going to get weight 1) many clients are conserted but the dieticien willl ensure you dont get too mayn calories 2) instead of worry about weight try to focus on other problem 3) i understand your concenrs but first lets talk about recent acocomplishment 4) youre not overweight and sthe staff will not let you gain weight
3
personality and manipulative behiavor 1) allow manipulations 2) create a strict schedule for the clients activities to discoruage 3) institute consequences 4) bargain
3
dementia from alzheimers which of the following should be in care 1) post a written schedule 2) overhead loudspeaker to announce events 3) provide consistent daily routine 4) allow client to choose free time activities
3 1-picture and symbols are better choices can increase anxiety
NI for dementia 1) cog stimulating enviornment 2) rotate staff 3) limit clients choices to activities 4) use confrontation to manage behavior
3 low cog enviornment consistent staff distraction
who has anorexia nervose sign of cog distortion 1) i really need to get into shape 2) i like to cut my food into small piecs 30 if i eat one piece of candy i may as well eat ten 4) i cant afford to gain weight
3- all or nothing
late stage of alcheimzersclients nutrition 1) verfiy that a current power of attorney doc is on file 2) offer finger food 3) provide info on respite car 4) schedule the chilent for placement of enteral feeding tube
3break from caregiving
anorexia intervention 1) compliment for weight gain 2) allow client to eat at any time 3) provide privacy when firneds visit 4) schedule regular weigh in times
4
anorexia with binge eating and purging 1) allow client to selefct preffered meal times 2) establish consequences for purging 3) provide hgh fat diet at strat 4) implement one on one during meal time
4
client refuses discuss of feelngs until 5 min prior of the session 1) go over the agreed upon time, as the client is finally able to say something 2) arrange another nurse 3) set up an extra meeting time 4) end as agreed, btu tell the client he can continue at the end
4
Kevin is remanded by the courts for psychiatric treatment. His police record, which dates to his early teenage years, includes delinquency, running away, auto theft, and vandalism. He dropped out of school at age 16 and has been living on his own since then. His history suggests maladaptive coping, which is associated with: A. Antisocial personality disorder B. Borderline personality disorder C. Obsessive-compulsive personality disorder D. Narcissistic personality disorder
Answer A. Antisocial personality disorder The client's history of delinquency, running away from home, vandalism, and dropping out of school are characteristic of antisocial personality disorder. This maladaptive coping pattern is manifested by a disregard for societal norms of behavior and an inability to relate meaningfully to others. Option B: In borderline personality disorder, the client exhibits mood instability, poor self-image, identity disturbance, and labile affect. Option C: Obsessive-compulsive personality disorder is characterized by a preoccupation with impulses and thoughts that the client realizes are senseless but can't control. Option D: Narcissistic personality disorder is marked by a pattern of self-involvement, grandiosity, and demand for constant attention.
During postprandial monitoring, a female client with bulimia nervosa tells the nurse, "You can sit with me, but you're just wasting your time. After you had sat with me yesterday, I was still able to purge. Today, my goal is to do it twice." What is the nurse's best response? A. "I trust you not to purge." B. "How are you purging and when do you do it?" C. "Don't worry. I won't allow you to purge today." D. "I know it's important for you to feel in control, but I'll monitor you for 90 minutes after you eat."
Answer D. "I know it's important for you to feel in control, but I'll monitor you for 90 minutes after you eat." This response acknowledges that the client is testing limits and that the nurse is setting them by performing postprandial monitoring to prevent self-induced emesis. Clients with bulimia nervosa need to feel in control of the diet because they feel they lack control over all other aspects of their lives. Option A: Because their therapeutic relationships with caregivers are less important than their need to purge, they don't fear betraying the nurse's trust by engaging in the activity. They commonly plot to purge and rarely share their secrets about it. Options B and C: An authoritarian or challenging response may trigger a power struggle between the nurse and client.
Mr. Lim who is diagnosed with moderate dementia has frequent catastrophic reactions during shower time. Which of the following interventions should be implemented in the plan of care? Select all that apply. A. Assign consistent staff members to assist the client . B. Accomplish the task quickly, with several staff members assisting. C. Schedule the client's shower at the same time of day. D. Sedate the client 30 minutes prior to showering. E. Tell the client to remain calm while showering. F. Use a calm, supportive, quiet manner when assisting the client.
Answer: A, C, and F Maintaining a consistent routine with the same staff members will help decrease the client's anxiety that occurs whenever changes are made. A calm, quiet manner will be reassuring to the client, also helping to minimize anxiety. Option B: Moving quickly with several staffs will increase the client's anxiety and may precipitate a catastrophic reaction. Option D: The use of sedation is not indicated and may increase the risk of client injury from the side effect of drowsiness. Option E: Telling the client to remain calm is inappropriate because a client with dementia cannot respond to such a direction.
Which of the following outcome criteria is appropriate for the client with dementia? A. The client will return to an adequate level of self-functioning. B. The client will learn new coping mechanisms to handle anxiety . C. The client will seek out resources in the community for support. D. The client will follow an established schedule for activities of daily living.
Answer: D. The client will follow an established schedule for activities of daily living. Following established activity schedules is a realistic expectation for clients with dementia. Options A, B, and C: All of the remaining outcome statements require a higher level of cognitive ability that can be realistically expected of clients with this disorder.
A client is newly diagnosed with second stage NCD due to Alzheimer's disease. Which cognitive change would a nurse observe? a) Memory disturbance b) Confabulation c) Apraxia d) Inability to plan or organize
Correct answer: A In the second stage of the illness, losses in short-term memory are common and the individual may begin to lose things or forget names of people. It's at this stage that a diagnosis may be considered.
Hospitalized and diagnosed in the 4th stage of NCD due to Alzheimer's disease, a client, when asked about the previous evening, describes a wonderful evening spent on a cruise. Which symptom is the client exhibiting? a) Aphasia b) Confabulation c) Delirium d) Apraxia
Correct answer: B Confabulation is a behavioral reaction to memory loss in which the client fills in memory gaps with information about events that have not occurred. During the 4th stage of Alzheimer's dementia, a client will use confabulation in an effort to maintain self-esteem.
1. Which statement describes a theory of aging from a biological perspective? a) Personality traits change gradually but systematically throughout the life span. b) Staying active leads to satisfactory aging. c) Life span and longevity are predetermined by heredity. d) Old values take on new meanings in keeping with changing circumstances.
Correct answer: C According to genetic theory, aging is an involuntarily inherited process that operates over time to alter cellular or tissue structures. This biological theory suggests that life span and longevity are predetermined.
A client has recently been diagnosed with mild to moderate NCD due to Alzheimer's disease. Which medication would the nurse expect the physician to order for this client's cognitive impairment? a) Nortriptyline (Pamelor) b) Zaleplon (Sonata) c) Donepezil (Aricept) d) Quetiapine (Seroquel
Correct answer: C Donepezil is used to improve cognition in clients diagnosed with mild to moderate dementia associated with Alzheimer's disease. Its action improves cholinergic function by inhibiting acetlycholinesterase.
3. Which therapy is most effective in decreasing depression in elderly clients? a) Crisis intervention b) Group therapy c) Orientation therapy d) Reminiscence therapy
Correct answer: D Reminiscence therapy encourages clients to think about and reflect on the past. Studies have shown that clients who participate in this therapy have increased self-esteem and are less likely to suffer from depression. Reminiscence therapy helps older adults to work through their losses and maintain self-esteem.
2. An elderly client, newly admitted to a nursing home, refuses to participate in activities of daily living (ADLs). Which nursing intervention would best help the client to be as independent as possible in meeting self-care needs? a) Assign a variety of caregivers so that one person does not do everything for the client. b) Establish a specified amount of time for ADL completion. c) Set client expectations at the beginning of each day. d) Structure the activities of daily living to mirror previous home routines.
Correct answer: D Structuring the activities of daily living to mirror previous home routines can help foster independence in activities of daily living. Maintaining familiar routines will ease the transition to residential care and increase client compliance in meeting self-care needs.
Which statement is true about vascular dementia? a) Vascular dementia is reversible. b) Vascular dementia is characterized by plaques and tangles in the brain. c) Vascular dementia involves a gradual, progressive cognitive deterioration. d) Vascular dementia involves a variable pattern of cognitive functioning.
D n vascular dementia, clients suffer the equivalent of small strokes that destroy many areas of the brain. The pattern of deficits is variable, depending on which regions of the brain have been affected.
dementia first apears as _____ then progressing to __
forgetfullness than disorientation
malnutrition manifestation
lethargy depression decreased vital capacity, dry skin, cold intolerance decreased mental status
dementia is characterized by a ___ sidoer that is ____
progressive , irreversible
