Irma is an 82-year-old widow who lives alone. She has a history of hypertension. At the age of 67, she had a mild stroke but recovered with no physical impairments. Lately, she has been complaining of dizziness and fatigue.

Irma used to be an avid fan of all the cooking shows and took pride in fixing gourmet meals for friends and her husband. Her husband died 6 years ago and since his death, she lost all interest in cooking. A year ago, her smoke alarm went off when she fell asleep and left the stove on.  Now Irma is afraid of using the stove for fear of starting a fire. Her meals consist of a boiled egg and toast with orange juice for breakfast and a cup of canned soup in the evening. She has no variety in her meals and eats little protein or vegetables.

Irma has no children and her younger siblings live in another state. She occasionally walks to the community center and participates in some of the activities for seniors.  Her physician reported that she is exhibiting signs of early dementia and may not be able to live alone much longer.

 

• What malnutrition indicators are prevalent with Irma?
• How is Irma’s aging impacting her nutrition?
• What are Irma’s nutritional needs as part of the older elderly population?
• Citing evidence-based resources, what health problems can we expect Irma to have as a result of being malnourished?
• What determinants of health are impacted in Irma’s malnutrition scenario?
• If Irma were living in your community/state, what resources would be available to her?
• The Community/state where student lives is Newport News, Virginia

A nurse is caring for a client in an acute care mental health unit. The nurse is planning care for a client who has a borderline personality disorder. Exhibit 1 Exhibit 2 For each potential nursing intervention, click to specify if the potential intervention is anticipated, nonessential, or contraindicated for the Nurses’ Notes client. Day 1 0700: Potential Intervention Anticipated Nonessential Contraindicated Encourage the client to O O O A client who has a history of borderline personality disorder is written in a journal. admitted with manifestations of anxiety and accompanied by Hold weekly staff their partner. The client is alert and oriented to person, place, O O O meeting to allow staff and time. The client presents with evidence of self-mutilation on time to express their upper extremities. Perspiration was noted on the face, chest, and feelings. back. The client reports a feeling of "emptiness" when asked how they are feeling at the current time. The client displays anger or Communicate O O O sarcasm when responding to staff. The client’s partner states behavioral expectations the injuries are self-inflicted and often occur after an argument. with the client’s family. Partner also reports the client has a history of substance use Limit consequences for O O O and excessive gambling. undesirable behavior while receiving treatment. Day 2 1000: Encourage the client to O O O self-reward for positive Client is participating in a milieu therapy session. Client states that outcomes. they are planning to open their own business as soon as they Bargain with the client are discharged from the hospital. The client exhibits O O O to establish behavioral manipulative behavior when interacting with staff and other expectations. clients.

What role did nurses play at the advent of the concepts of public health in the 1800s and early 1900s? Be sure to differentiate between individual and population-based care.

Donabedian’s framework for measuring healthcare quality comprises a triad of domains: Structure, process, and outcomes. Pretend you have just moved to a new city and are seeing a new cardiologist for the first time and were not satisfied with the encounter. Discuss how the visit’s quality was on each domain and what is your overall assessment of the provider’s quality? What recommendations would you make to improve quality?

The parents of an autistic child consult a psychiatric and mental health advanced practice PMHNP about their failure to relate to their child. The PMHNP decides that some education would be helpful to this family in dealing with the problem. What could the family NOT expect to receive as a result of the PMHNP’s teaching intervention?

Question 11 options:

	a) An objective perspective
	b) Decreased blame and guilt
	c) Clarification of expectations
	d) A solution to their problems

Question 12 (1 point)

 

According to Freudian theory, thoughts, feelings, and desires that are not in immediate awareness, but can be recalled to consciousness, are considered:

Question 12 options:

	a) Conscious
	b) Preconscious
	c) Subconscious
	d) Unconscious

Question 13 (1 point)

 

The goal of Art therapy and Music therapy is:

Question 13 options:

	a) To assist clients in passing time in the hospital productively.
	b) To teach clients a new skill or hobby.
	c) To evaluate clients for possible job training.
	d) To stimulate the expression of feelings

Question 14 (1 point)

 

The focus of Strategic Family Therapy is to:

Question 14 options:

	a) Emphasize symptoms
	b) Change analogies and metaphors in the family
	c) Help the family to be more democratic
	d) Identify and solve all family problems

Question 15 (1 point)

 

According to Glasser, the cause of all psychiatric problems is:

Question 15 options:

	a) Neurosis
	b) Irresponsibility
	c) Childhood training
	d) Irrational beliefs

Question 16 (1 point)

 

A mother brings her adolescent son in to be seen by a psychiatric and mental health advanced practice PMHNP. The mother wishes to hospitalize the boy. She indicates that she can no longer control his behavior and that he is dating girls of whom she does not approve and staying out past his curfew. Based on the boy’s right to treatment in the least restrictive setting, what is the psychiatric and mental health advanced practice PMHNP’s best response?

Question 16 options:

	a) Determine the most secure facility to hospitalize the child because he is probably a “run risk.”
	b) Seek a Day Treatment Program since the child’s behavior is not dangerous.
	c) Offer to work with the mother and son in regard to appropriate expectations and discipline.
	d) Tell the mother that all adolescents act that way and that she is wrong to be upset about this normal behavior.