Deck 18: Common Clinical Problems: Psychological

Question 1

A female older patient with early-onset Alzheimer's disease goes into male patients' rooms, crawls into bed with them, and fondles their genital areas. What does the nurse need to consider in developing nursing interventions to deal with this behavior?
1) The patient has the right to express sexual feelings.
2) The problem is the staff's attitude toward sexual expression.
3) The patient's behavior may demonstrate a need for affection and touch.
4) Patients have the right to express sexual needs and demonstrate sexual behaviors.

Answer 1

3

Question 2

The nurse says to an older patient, "Would you like to attend bingo or sit outside with the garden club?" What is the nurse doing?
1) Providing guided choices
2) Assessing the patient's interests
3) Determining if the patient likes to sit outside
4) Determining if the patient wants to be around people

Answer 2

1

Question 3

A resident in a long-term care facility has the right to have the least restrictive treatment to promote health. Which treatment would be questionable under these guidelines?
1) Administering a sedative to a resident who has been complaining of insomnia
2) Fastening a Velcro belt on a wheelchair-bound resident who is able to unfasten himself or herself
3) Taping an arm board to a resident's wrist to promote the flow of an IV that stops when the resident bends his or her wrist
4) Applying a soft waist restraint on a resident who repeatedly falls after climbing over the side rails of the bed to go to the bathroom

Answer 3

4

Question 4

The nursing assistants refuse to care for a patient with Alzheimer's disease because he becomes very agitated at times during bathing. What is the best response by the licensed practical nurse?
1) Tell the patient that the behavior is unacceptable and restraints will need to be used.
2) Tell the staff to take turns caring for the patient and set up a revolving assignment schedule.
3) Review the plan of care with the interdisciplinary team to develop strategies to decrease the patient's agitation during bathing.
4) Transfer the patient to another section of the facility to take the stress off of the nursing assistants who have been caring for him since his admission.

Question 5

An older patient in a nursing facility tells the nurse that she knows she didn't commit any crimes and wants to see her attorney. What should the nurse suspect this patient is experiencing?
1) Illusion
2) Delusion
3) Paranoia
4) Hallucination

Question 6

The family is upset because of the behaviors exhibited by an older patient experiencing delirium. What should the nurse instruct the family to do during this time? Select all that apply.
1) Reduce stress.
2) Turn on the television.
3) Engage in conversation.
4) Limit the number of visitors.
5) Maintain a quiet environment.

Question 7

The nurse is visiting the home of an older patient who has just been forced to retire from a position at the local factory. Which statement would help draw the patient into a discussion about the job loss?
1) "Why be upset? You will feel fine in time."
2) "It is normal to feel lost when you are forced to retire."
3) "How did you feel when the factory forced you to retire?"
4) "Retirement is a great opportunity to try new things that you did not have the time to do while working."

Question 8

An older patient calls for the nurse because there are alligators in the bathroom. What should the nurse do first?
1) Stay calm.
2) Get help from another staff member.
3) Tell the patient that the alligators are real.
4) Explain that the alligators are not there but realize it is a problem for the patient.

Question 9

An older patient who refuses food and medication is diagnosed with failure to thrive. What is this disorder associated with?
1) Depression
2) Chronic mental illness
3) Gastrointestinal dysfunction
4) Knowledge deficit related to health promotion practices

Question 10

While making a routine visit to an older patient's home, the nurse notices a pile of digoxin and potassium wrapped in a napkin. For what should the nurse assess this patient?
1) Diabetes
2) Dementia
3) Failure to thrive
4) Suicidal thoughts

Question 11

An older patient who is disoriented believes that a fire has destroyed the city. What question should the nurse ask this patient?
1) "Can you see the city?"
2) "Why do you think that?"
3) "Why is this an issue with you?"
4) "What is the worst that will happen?"

Question 12

An older patient with a psychological problem is reluctant to speak to the nurse. Which technique should the nurse use to diffuse the older person's tension?
1) Use humor.
2) Ask closed questions.
3) Sit with the patient in silence.
4) Tell the patient that refusing to talk is not an option.

Question 13

An older patient is fearful, crying out that birds are flying around her room. What psychological condition is this patient most likely demonstrating?
1) Illusion
2) Paranoia
3) Somatization
4) Hallucination

Question 14

The nurse is caring for an older patient experiencing disorientation. What direction should the nurse provide when preparing the patient for bed?
1) "Unbutton your shirt."
2) "Put on your pajamas."
3) "Take off your clothes."
4) "Hang up your clothes."

Question 15

An older patient grabs the nurse by the arm with one hand and begins to strike the nurse with the other hand. What should the nurse do?
1) Cover the face.
2) Push the patient away.
3) Pinch the patient's hand.
4) Release the patient's hand by rotating away from the thumb.