A nurse is reviewing the medical record of a client who is being admitted with dementia. The nurse notes that the client has worked as a pest control specialist for the last 20 years. Which of the following types of dementia should the nurse expect the client to be experiencing?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Parkinson's disease. The nurse should expect the client to be experiencing Parkinson's disease based on the history of working as a pest control specialist for the last 20 years. Parkinson's disease is a neurodegenerative disorder that affects movement and is associated with exposure to certain chemicals, including pesticides. Individuals who have been in occupations involving pesticide exposure, like pest control specialists, have a higher risk of developing Parkinson's disease. The other options can be ruled out for the following reasons: A) Frontotemporal lobar degeneration: This type of dementia is not directly linked to pesticide exposure and is more commonly associated with changes in behavior and personality. B) Alzheimer's disease: While Alzheimer's disease is a common cause of dementia in older adults, it is not specifically linked to pesticide exposure. C) Prion disease: Prion diseases are rare and are not typically associated with occupational pesticide exposure. Educationally, understanding the relationship between occupational exposures and specific health conditions is crucial for nurses working in behavioral health. Recognizing the potential impact of environmental factors on health can guide nursing assessments, interventions, and patient education to promote better outcomes for individuals with dementia and other neurodegenerative disorders.

Correct Answer: D

Rationale: In this scenario, option D, releasing unauthorized information to the patient's employer, constitutes a breach of the patient's right to privacy. This act violates the patient's confidentiality by sharing sensitive healthcare information without proper authorization, which undermines trust in the nurse-patient relationship and can have serious legal and ethical implications. Option A, asking a family to share information about a patient's prehospitalization behavior, may be appropriate if consent is obtained from the patient or if it is necessary for the patient's care. It does not inherently breach privacy if done with proper consent and within legal and ethical boundaries. Option B, discussing the patient's history with other staff members during care planning, is a common practice in healthcare settings to ensure comprehensive and coordinated care. As long as the information is shared within the healthcare team for the purpose of providing quality care and is done in a secure and confidential manner, it does not violate privacy rights. Option C, documenting the patient's daily behaviors during hospitalization, is a standard practice in nursing to track and monitor patients' progress, ensure continuity of care, and communicate effectively with the healthcare team. As long as the documentation is kept confidential and only accessed by authorized personnel involved in the patient's care, it does not breach privacy. In an educational context, it is crucial for nurses to understand and uphold patients' rights to privacy and confidentiality. Nurses must adhere to legal and ethical standards regarding the handling of patient information to maintain trust, respect patient autonomy, and safeguard sensitive healthcare data. Training on privacy laws, policies, and best practices is essential to ensure nurses protect patient confidentiality and privacy rights in all aspects of care delivery.

Correct Answer: B

Rationale: The correct answer is B) Report increased suicidal thoughts. This is the priority information to give to the patient and family when starting SSRI antidepressant therapy due to the risk of increased suicidal ideation, especially in the early stages of treatment. This is crucial for patient safety and requires immediate attention from healthcare providers. Option A) Avoid exposure to bright sunlight is incorrect as there is no specific correlation between SSRIs and sunlight exposure. Option C) Restrict sodium intake to 1 g daily is irrelevant to SSRI therapy. Option D) Maintain a tyramine-free diet is more relevant to monoamine oxidase inhibitors (MAOIs) rather than SSRIs. In an educational context, understanding the potential side effects and monitoring parameters of antidepressant medications is essential for nurses working in adult behavioral health. Educating patients and families on what to expect and what symptoms to report can help ensure safe and effective treatment outcomes in managing major depressive disorder.

Correct Answer: D

Rationale: In this scenario, option D, releasing a patient's personal information to a third party without consent, constitutes a breach of a patient's right to privacy. Patient confidentiality is a fundamental principle in healthcare that must be upheld to build trust and ensure ethical practice. Sharing personal information without consent violates the patient's autonomy and right to privacy, potentially leading to legal and ethical consequences. Option A is incorrect because asking a family member about a patient's prehospitalization behavior without consent may be necessary for obtaining relevant information to provide quality care, especially if the patient is unable to provide this information themselves. Option B is incorrect as discussing a patient's diagnosis with another healthcare provider for treatment purposes falls within the scope of sharing information for continuity of care, which is permissible with the patient's implied consent in most cases. Option C is also incorrect as noting a patient's vital signs in the medical record for review by the healthcare team is a standard practice aimed at ensuring coordinated and effective care delivery. Educationally, this question highlights the importance of respecting patient privacy and confidentiality in nursing practice. Nurses must always seek informed consent before sharing patient information and be aware of the legal and ethical implications of breaching patient confidentiality. Understanding these principles is crucial for maintaining professionalism and trust in the nurse-patient relationship.

Correct Answer: A

Rationale: In caring for a patient with schizophrenia experiencing disorganized speech and behavior, providing a quiet environment with minimal distractions should be implemented first. This intervention is crucial as it helps reduce sensory overload and external stimuli that can exacerbate the patient's symptoms. By creating a calm and quiet space, the nurse can help the patient focus, feel more secure, and potentially decrease the intensity of their disorganized thoughts and behaviors. Encouraging the patient to express their feelings and thoughts (Option B) is important in therapeutic communication, but in this case, addressing the environmental factor takes precedence to help stabilize the patient. Assisting the patient with daily living activities (Option C) and reorienting them to reality (Option D) are important aspects of care but should follow after providing a conducive environment for the patient's well-being. In an educational context, understanding the prioritization of interventions based on the patient's immediate needs is crucial in psychiatric nursing. It is essential for nurses to prioritize interventions that address safety, comfort, and symptom management to provide effective care for patients with mental health disorders.