When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value?

Correct Answer: C

Rationale: The correct answer is C: Medications the patient has recently taken. This information is crucial because certain medications can cause symptoms of delirium or exacerbate confusion in elderly patients. By reviewing the patient's recent medications, healthcare providers can identify potential drug-induced causes of confusion and adjust the treatment accordingly. Choice A (Evidence of spasticity or flaccidity) is incorrect because these symptoms are more related to neurological conditions such as stroke or spinal cord injury, not specifically delirium. Choice B (The patient’s level of motor activity) is not as relevant in distinguishing delirium from other problems as medication history, as motor activity can be influenced by various factors. Choice D (Level of preoccupation with somatic symptoms) is also less relevant compared to medication history in differentiating delirium, as somatic symptoms may not always directly indicate the underlying cause of confusion in elderly patients.

Correct Answer: A

Rationale: The correct answer is A: Implement suicide precautions. This is the highest priority because the patient has a plan for suicide, which poses an immediate risk to their safety. Implementing suicide precautions involves ensuring the patient's environment is safe, removing any potential means of self-harm, and closely monitoring the patient to prevent any suicide attempts. Choice B is incorrect because offering high-calorie snacks and fluids frequently addresses the physical aspect of weight loss but does not address the immediate safety concern of suicide. Choice C is incorrect because assisting the patient to identify personal strengths is important for building self-esteem but is not the highest priority when the patient is at risk for suicide. Choice D is incorrect because observing the patient for therapeutic effects of antidepressant medication is important but not as urgent as ensuring the patient's safety in the case of suicidal ideation.

Correct Answer: B

Rationale: The correct answer is B because it seeks clarification and prompts the patient to specify who they are referring to when they say "everybody." This response shows active listening and encourages deeper communication. Choice A offers sympathy but doesn't address the issue directly. Choice C dismisses the significance of "frobitzing." Choice D asks for the reason behind "frobitzing" without seeking clarification on the people involved.

Correct Answer: B

Rationale: The correct answer is B: Comparing the child’s experiences to the new material. At the age of 8, children are in the concrete operational stage according to Piaget's cognitive development theory. This stage is characterized by the ability to think logically about concrete events and understand the concept of conservation. By comparing the child's experiences to the new material, the parents are helping the child make connections between what they already know and the new information, which facilitates understanding. Drawing and illustrations (choice A) are helpful for visual learners but may not necessarily tap into the child's cognitive development stage. Encouraging the child to talk about new information (choice C) is beneficial for communication skills but may not directly address cognitive development. Asking the child to give a reason for how they feel about new information (choice D) focuses more on emotions rather than cognitive understanding.

Correct Answer: B

Rationale: The correct answer is B: Adult day care program. This option best meets the needs of the patient as it provides supervision, safety, recreation, and social interaction during the day while allowing the family to care for the patient during the evening and night. Adult day care programs offer a structured environment with trained staff to ensure the patient's safety and provide activities to stimulate cognitive function. Explanation of other choices: A: Skilled nursing facility - Not ideal as the patient does not require 24-hour nursing care. C: Partial hospitalization - Typically for individuals needing intensive mental health services, not suitable for this patient's needs. D: Group home - Usually for individuals who need more permanent residential care, not appropriate for the patient's situation.

Correct Answer: C

Rationale: The correct answer is C: Repeating, milk, milk, milk, milk until given a drink. This behavior is a characteristic of children with autism, known as echolalia. Echolalia is the repetition of words or phrases spoken by others, often used by individuals with autism to communicate or self-soothe. This behavior is a common feature of autism spectrum disorder and is indicative of language difficulties and communication challenges. Choices A, B, and D are incorrect because they do not specifically relate to behaviors typically observed in children with autism. Referring to an imaginary friend (A) is not exclusive to autism, asking to telephone friends on weekends (B) is a social behavior that can be seen in children without autism, and insisting on a dim light in the bedroom (D) is a preference that does not directly relate to the core characteristics of autism.

Correct Answer: B, D

Rationale: In Piaget's formal operations stage, children develop abstract thinking, planning abilities, and logical reasoning. Planning a trip and selecting appropriate clothing demonstrate these skills. Becoming sad over the pet's death and identifying objects by capacity are more related to emotional and concrete operational stages.

Correct Answer: D

Rationale: The correct answer is D: Adventitious crisis. This type of crisis is triggered by external events such as moving to a retirement center after 50 years in the same home. The sudden change in environment can lead to distress and challenges for the elderly couple, causing an adventitious crisis. Acute grief (A) and traumatic grief (B) are typically associated with the loss of a loved one, not a change in lifestyle. Chronic sorrow (C) refers to ongoing grief related to a chronic illness or disability, which is not the case in this scenario.

Correct Answer: A

Rationale: The correct answer is A because promoting mental and spiritual health across the lifespan addresses bereavement proactively by providing support and resources before, during, and after losses occur. This approach allows individuals to build resilience and cope effectively with grief. Choice B is incorrect as it focuses on impending loss, missing the opportunity for early intervention. Choice C is incorrect as immediate intervention may not be suitable for everyone and may overlook the importance of ongoing support. Choice D is incorrect as waiting for the patient to request intervention may delay support and hinder the healing process.