A nurse is caring for a client who has Alzheimer's disease and is having difficulty with multitasking. Which of the following cognitive deficits is the client experiencing?

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Executive function. Alzheimer's disease is characterized by progressive cognitive decline, particularly in areas such as memory, language, and executive function. Executive function refers to the ability to plan, organize, and manage tasks effectively, including multitasking. Individuals with Alzheimer's often struggle with executive functions due to damage in the frontal lobes of the brain. Option A) Perceptual-motor deficits involve coordination and movement issues, which are not typically associated with Alzheimer's disease. Option B) Learning and memory deficits are common in Alzheimer's but do not directly relate to the ability to multitask. Option D) Complex attention involves sustained focus and concentration, which is different from the ability to multitask and manage multiple tasks simultaneously. Educationally, understanding the specific cognitive deficits associated with Alzheimer's disease is crucial for nurses caring for patients with this condition. By recognizing the impact of executive function impairment on multitasking abilities, nurses can provide appropriate support and interventions to help patients maintain their independence and quality of life.

Correct Answer: C

Rationale: In the scenario where a patient diagnosed with major depressive disorder expresses a desire to commit suicide, the nurse's priority intervention is option C: Ensure the patient is in a safe environment and not at risk for harm. This intervention takes precedence as it addresses the immediate safety and well-being of the patient. Ensuring the patient is in a safe environment involves removing any potential means for self-harm, closely monitoring the patient, and possibly initiating the appropriate interventions such as suicide precautions or involving the mental health team for further assessment and management. Option A, reassuring the patient that they are not alone, and option B, encouraging the patient to express their feelings and emotions, are important aspects of therapeutic communication and support in mental health nursing. However, in a situation where there is an imminent risk of harm, ensuring the patient's safety must take precedence over these interventions. Option D, asking the patient to sign a no-suicide contract, is not an appropriate intervention in this critical situation. No-suicide contracts do not guarantee safety or prevent suicide attempts. They should not be used as a substitute for proper risk assessment and safety planning. In an educational context, it is crucial for nurses to prioritize patient safety in mental health crises. Understanding the hierarchy of interventions and the importance of immediate risk assessment and management is essential for providing effective and safe care to patients experiencing suicidal ideation. Effective communication skills and therapeutic interventions play a vital role in supporting these patients, but safety always comes first in such critical situations.

Correct Answer: B

Rationale: The most appropriate intervention for a patient diagnosed with generalized anxiety disorder is to provide relaxation techniques such as deep breathing (Option B). This is because deep breathing exercises are a widely recognized evidence-based strategy for managing anxiety. Deep breathing helps activate the body's relaxation response, which can counter the physiological arousal associated with anxiety. Encouraging the patient to confront their fears directly (Option A) may actually exacerbate their anxiety and lead to increased distress. It is important not to push individuals with anxiety disorders into situations that may trigger overwhelming anxiety. Reassuring the patient that their anxiety is not warranted (Option C) is not helpful as it may invalidate their feelings and experiences. Anxiety disorders are real and valid mental health conditions that require understanding and appropriate interventions. Encouraging the patient to avoid stressful situations whenever possible (Option D) can contribute to the perpetuation of anxiety and limit the individual's ability to cope and adapt to challenging circumstances. Avoidance can lead to increased fear and avoidance behaviors, ultimately worsening the anxiety symptoms. In an educational context, it is crucial for healthcare providers, including nurses, to be well-versed in evidence-based interventions for anxiety disorders. By understanding the most effective strategies like deep breathing techniques, nurses can provide optimal care and support to patients with generalized anxiety disorder, promoting their overall well-being and mental health.

Correct Answer: B

Rationale: Assessing cognition involves determining a patient's judgment and decision making. In this case, the nurse would expect a response of 'Call my doctor' if the patient's cognition and judgment are intact. If the patient responds, 'I would stop eating' or 'I would just wait and see what happened,' the nurse would conclude that judgment is impaired. The other options refer to other aspects of the examination.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Nutritional deficiencies and electrolyte imbalances. This is the priority concern for the nurse because individuals with bulimia nervosa often engage in binge eating followed by purging behaviors like self-induced vomiting, which can lead to severe consequences such as electrolyte imbalances (e.g., hypokalemia) and nutritional deficiencies (e.g., low levels of vitamins and minerals). These complications can have serious implications on the patient's physical health, potentially leading to cardiac arrhythmias, muscle weakness, and other life-threatening conditions. Option B) Impulsivity and emotional dysregulation, while important factors in understanding and treating bulimia nervosa, are not the immediate priority in this case. Addressing nutritional deficiencies and electrolyte imbalances takes precedence due to their acute and potentially life-threatening nature. Option C) Distorted body image and low self-esteem are common psychosocial issues in individuals with bulimia nervosa but do not pose an immediate threat to the patient's physical health compared to the risks associated with electrolyte imbalances and nutritional deficiencies. Option D) Excessive exercise and weight loss are more commonly associated with anorexia nervosa rather than bulimia nervosa. While these behaviors can co-occur in some cases, they are not the primary concern in a patient presenting with binge eating and purging behaviors. Educationally, it is crucial for nurses and healthcare providers to prioritize the management of acute physical health concerns in individuals with eating disorders to prevent serious complications. Understanding the hierarchy of concerns allows for appropriate triaging and intervention to address the most critical issues first, ensuring the safety and well-being of the patient.