Which assessment data suggests a person who appears to have dementia instead has depression and pseudodementia?

Correct Answer: B

Rationale: The correct answer is B because impaired concentration is a key indicator of depression and pseudodementia rather than dementia. In depression, individuals may experience difficulties focusing and maintaining attention, leading to impaired concentration. Pseudodementia, which mimics dementia but is caused by depression, also presents with similar cognitive symptoms like impaired concentration. Choices A and C are incorrect because impaired judgment and significant losses or crises can be present in both dementia and depression, making them less specific to differentiating between the two conditions. Choice D is incorrect as choice B clearly distinguishes the cognitive symptomatology between dementia and depression/pseudodementia.

Correct Answer: A

Rationale: The correct answer is A: Insomnia. Insomnia refers to the inability to fall asleep or stay asleep, leading to difficulties in getting enough sleep. It is a common sleep disorder affecting many people. Narcolepsy (B) is a disorder characterized by excessive daytime sleepiness and sudden sleep attacks. Hypersomnia (C) is a condition involving excessive daytime sleepiness but differs from insomnia. Choice D is incorrect as the term "insomnia" precisely describes the inability to fall or stay asleep.

Correct Answer: D

Rationale: The correct answer is D because encouraging the patient to eat a small, manageable portion of food is the most immediate and vital intervention in addressing the patient's refusal to eat. This step is crucial in preventing further complications associated with anorexia nervosa, such as malnutrition and dehydration. By starting with a small portion, the patient can gradually reintroduce food and begin the process of recovery. A: Speaking with the family may be important but not the first step in addressing the patient's refusal to eat. B: Focusing on emotional distress is important but addressing the physical need for food should take priority. C: Redirecting the patient to a different activity may temporarily distract them but does not address the underlying issue of malnutrition.

Correct Answer: C

Rationale: The correct response is C: Explaining that weight gain is part of the treatment plan. This answer is correct because in treating anorexia nervosa, it is essential for patients to understand that weight gain is necessary for recovery and overall health improvement. By explaining this, the nurse can help the patient develop a more positive attitude towards weight gain and recognize it as a crucial aspect of the treatment process. Choices A, B, and D are incorrect: A: Minimizing the patient's concerns may invalidate their feelings and hinder therapeutic communication. B: Encouraging weight loss would be counterproductive and reinforce the patient's negative behaviors and beliefs. D: Simply agreeing with the patient's view on body image without addressing the need for weight gain would not promote positive change or support the patient's recovery.

Correct Answer: D

Rationale: The correct answer is D: Denial of hunger at all times. In anorexia nervosa without bingeing or purging, patients typically deny hunger despite severe weight loss. This is due to their distorted body image and fear of gaining weight. Assessing for denial of hunger helps in understanding their mindset and severity of the disorder. Explanation of why other choices are incorrect: A: Extroverted personality traits - Anorexia nervosa is often associated with introverted personality traits, not extroverted. B: Abuse of diuretics and laxatives - This behavior is more characteristic of bulimia nervosa, not anorexia nervosa without bingeing or purging. C: Claims of sexual activity - This choice is unrelated to the typical features of anorexia nervosa without bingeing or purging.