A new nurse asks, 'My elderly patient's CT scan of the head shows many Lewy bodies are present. What should I do about assessing for pain?' Select the best response from the nurse manager.

Correct Answer: C

Rationale: The correct answer is C because patients with Lewy body dementia may have difficulty expressing pain. Special pain assessment scales designed for patients with dementia can help in accurately assessing pain levels. These scales take into account nonverbal cues and behavioral changes that may indicate pain. By using these specialized tools, the nurse can ensure a more comprehensive assessment of the patient's pain experience. Choice A is incorrect because relying solely on family members' perceptions may not accurately reflect the patient's actual pain experience. Choice B is not the best option because a visual analog scale may not be suitable for patients with dementia who may have cognitive impairments affecting their ability to use such tools effectively. Choice D is incorrect as it assumes that pain perception is diminished in Lewy body dementia without considering that patients may still experience pain but have difficulty communicating it. Focusing solely on mental status may overlook important pain indicators.

Correct Answer: B

Rationale: Perfectionism is the most likely personality characteristic in a patient with anorexia nervosa because individuals with this disorder often exhibit an intense desire for control, rigid thinking patterns, and a relentless pursuit of thinness. This perfectionistic trait can manifest as strict adherence to self-imposed rules around food intake and excessive exercise. Open displays of emotion (choice A) are less common due to emotional suppression related to the disorder. Optimism (choice C) is unlikely as anorexia nervosa is associated with negative self-perceptions and low self-esteem. Flexibility (choice D) is also unlikely due to the rigid and inflexible behaviors typical of individuals with anorexia nervosa.

Correct Answer: D

Rationale: The correct answer is D: SSRI. Paroxetine belongs to the class of selective serotonin reuptake inhibitors (SSRIs), which work by primarily increasing the levels of serotonin in the brain. This mechanism differs from tricyclic antidepressants like Tofranil (imipramine) and MAO inhibitors. SSRIs are known for having fewer side effects compared to tricyclic antidepressants and MAO inhibitors. Therefore, the nurse should inform the patient that the side effects experienced with Tofranil are not necessarily indicative of what they will experience with Paxil due to the different drug classes.

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.

Correct Answer: A

Rationale: The correct answer is A: Conducting passive range-of-motion exercises. This intervention is the highest priority because it addresses the physical needs of the patient by preventing complications such as muscle stiffness and contractures due to prolonged immobility. Passive range-of-motion exercises also promote circulation and prevent pressure ulcers. Choice B is incorrect because excessive stimuli can overwhelm the patient. Choice C is incorrect as it assumes the patient is responding when they may not be. Choice D is incorrect as the patient may not be ready or able to participate in activities due to their catatonic state.