Mavis Brown is a 75-year-old patient in your nursing home. She has Alzheimer's disease. Mavis comes to you at the desk one day and is crying. She says, 'You all hate me. Everyone hates me!' Your therapeutic reply is:

Correct Answer: C

Rationale: In this scenario, the correct therapeutic reply is option C, "You seem upset, Mavis. Let's go for a walk and talk." This response demonstrates empathy, active listening, and a person-centered approach, which are crucial when caring for patients with Alzheimer's disease. Option A, "Nobody here hates you, Mavis," may come across as dismissive and invalidating of Mavis's feelings. People with Alzheimer's may have difficulty processing reassurances and may need more concrete actions to address their emotional distress. Option B, "Why do you feel hated, Mavis?" might make Mavis feel defensive or misunderstood. It puts the onus on her to explain her emotions when she may not have the cognitive capacity to do so, given her condition. Option D, "It's time for your medication, Mavis," neglects Mavis's emotional needs and reduces her distress to a medical problem. It fails to address her current emotional state and does not promote a therapeutic nurse-patient relationship. Educationally, this scenario highlights the importance of communication skills, empathy, and person-centered care when interacting with patients with psychobiologic disorders like Alzheimer's disease. Active listening, acknowledging emotions, and offering support are essential strategies in managing challenging behaviors and emotions in patients with cognitive impairments.

Correct Answer: B

Rationale: The correct answer is B) Alzheimer's Disease. Alzheimer's Disease is a progressive neurodegenerative disorder characterized by cognitive decline, memory loss, confusion, and behavioral changes. In the case of Andrea's mother, the gradual onset and worsening of forgetfulness over 15 years are indicative of a chronic, degenerative condition like Alzheimer's. Option A) Depression is unlikely to be the correct diagnosis in this case because although depression can affect memory and cognitive function, the gradual decline over 15 years is more characteristic of a neurodegenerative disorder like Alzheimer's. Option C) Hyperthyroidism is also an unlikely diagnosis as it typically presents with symptoms such as weight loss, tremors, and heat intolerance, rather than primarily cognitive decline and memory loss. Option D) Delirium is characterized by acute changes in cognition and attention, often due to an underlying medical condition or medication, and does not align with the chronic, progressive nature of Andrea's mother's symptoms. In an educational context, understanding the differences between these conditions is crucial for healthcare professionals to accurately assess and diagnose patients presenting with cognitive changes. Recognizing the distinct clinical features of each condition is essential for providing appropriate care and interventions tailored to the specific needs of the patient.

Correct Answer: C

Rationale: The correct answer is C) Cocaine. Poor impulse control, rapid speech, and hypertension are characteristic symptoms of cocaine abuse due to its stimulant effects on the central nervous system. Cocaine increases the levels of dopamine in the brain, leading to a surge in energy, talkativeness, and heightened alertness. These effects contribute to the impulsive behavior and rapid speech seen in individuals abusing cocaine. Additionally, cocaine can also lead to increased blood pressure and heart rate, resulting in hypertension. Alcohol (option A) is a depressant that typically causes slowed speech, sedation, and decreased inhibitions, rather than rapid speech and poor impulse control. Heroin (option B) is an opioid that produces effects such as euphoria, drowsiness, and respiratory depression, not rapid speech and hypertension. LSD (option D) is a hallucinogen that can cause altered perceptions and sensations but is not typically associated with poor impulse control, rapid speech, or hypertension. In an educational context, understanding the specific effects of different substances on the body is crucial for healthcare professionals, especially nurses and doctors working in settings where substance abuse is prevalent. Recognizing the signs and symptoms of substance abuse, such as those exhibited by individuals using cocaine, is essential for providing appropriate care, interventions, and support to patients struggling with addiction. This knowledge also informs patient education and prevention efforts aimed at promoting healthy behaviors and reducing substance abuse-related harm.

Correct Answer: B

Rationale: The correct answer is B) Blackouts. When a person experiences blackouts while drinking, it means they have gaps in their memory and cannot recall events or activities that occurred during the time they were under the influence of alcohol. This is due to the disruptive effects of alcohol on the brain's ability to form new memories. It is a common phenomenon among individuals who consume large amounts of alcohol in a short period of time. Option A) Denial is incorrect because denial refers to a defense mechanism where a person refuses to acknowledge or accept a reality or truth. It is not related to memory loss caused by alcohol consumption. Option C) Psychosis is also incorrect in this context, as psychosis involves a loss of touch with reality, including symptoms like hallucinations and delusions, which are not typically associated with alcohol-induced memory blackouts. Option D) Depression is not the correct answer either, as depression is a mood disorder characterized by persistent feelings of sadness and hopelessness, and it is not directly related to memory impairment caused by alcohol. Educationally, understanding the phenomenon of blackouts caused by alcohol consumption is crucial for healthcare providers working with patients who have substance use disorders. It highlights the importance of educating patients about the risks associated with excessive alcohol consumption and the potential consequences on memory and overall health. It also underscores the significance of assessing patients for alcohol-related memory deficits and providing appropriate interventions and support.

Correct Answer: B

Rationale: In this scenario, option B is indicative of a codependent relationship because the wife is enabling her husband's drinking by covering up for him at work. Codependency is a dysfunctional relationship where one person enables another's addiction, poor mental health, or irresponsible behavior. By calling his job and lying for him, the wife is perpetuating his drinking problem and preventing him from facing consequences, thus reinforcing his behavior. Option A does not necessarily indicate codependency as setting personal boundaries and recognizing one's limit is a healthy response to dealing with a loved one's addiction. Option C shows empathy towards the children's feelings, but it does not directly enable the husband's behavior. Option D, stating that the husband is drinking less, does not signify codependency either. Educationally, understanding codependency is crucial for nurses as they often encounter patients with psychobiologic disorders and their families. By recognizing signs of codependency, nurses can provide appropriate support and interventions to help both the patient and their loved ones break free from enabling behaviors and foster healthier relationships.