The nurse assesses the speech pattern of the patient’s:
Thought content
Thought process
Affect
The Correct Answer is B
Choice A reason:
Thought content refers to the actual ideas and themes that a person expresses. It includes what the person is thinking about, such as delusions, obsessions, or preoccupations. Assessing thought content involves understanding the specific topics and beliefs the patient discusses.
Choice B reason:
Thought process refers to the way in which thoughts are organized and connected. Describing a patient’s speech as hesitant, slow, and with thought blocking indicates issues with the thought process. Thought blocking, where a person’s speech is interrupted by sudden silences, suggests difficulty in maintaining a coherent flow of ideas.
Choice C reason:
Affect refers to the observable expression of emotion. It includes the patient’s facial expressions, tone of voice, and body language. While affect can provide clues about a person’s emotional state, it does not directly relate to the organization of their thoughts.
Choice D reason:
Mood refers to the patient’s sustained emotional state, such as feeling depressed, anxious, or euphoric. While mood can influence speech patterns, the description of hesitant, slow speech with thought blocking specifically pertains to thought process rather than mood.
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Correct Answer is B
Explanation
Choice A reason:
While some may consider tricyclic antidepressants outdated, they are still used for certain conditions, including neuropathic pain. The primary concern with their use in elderly clients is not their age but their side effect profile.
Choice B reason:
Tricyclic antidepressants, including nortriptyline, can increase cardiac side effects and urinary retention, which are significant concerns in elderly clients. These medications can cause orthostatic hypotension, arrhythmias, and exacerbate urinary retention, making them less suitable for older adults with pre-existing health conditions.
Choice C reason:
The timing of medication administration (e.g., only taken at night) is not the primary issue with tricyclic antidepressants. The concern lies in their side effects, which can be particularly problematic for elderly clients.
Choice D reason:
While the cost of medication can be a factor in treatment decisions, it is not the primary reason tricyclic antidepressants are contraindicated in elderly clients. The main concern is their potential to cause serious side effects.
Correct Answer is B
Explanation
Choice A reason:
Saying “If you don’t stop this, you are going to get an infection and I will have to call the doctor” is not an effective way to address Tiffany’s behavior. This statement is likely to increase her anxiety and does not help her understand or manage her triggers.
Choice B reason:
Asking “Can you tell me about what increases your anxiety?” is the best approach. This question is open-ended and non-judgmental, encouraging Tiffany to share her thoughts and feelings. Understanding her triggers is essential for developing effective coping strategies and interventions.
Choice C reason:
Ignoring the behavior and asking other questions is not appropriate. It is important to address Tiffany’s anxiety and compulsive behaviors directly to provide appropriate support and interventions.
Choice D reason:
Asking “Why do you keep washing your hands? They are starting to bleed!” is likely to be perceived as critical and may increase Tiffany’s anxiety. It is important to approach the topic with empathy and understanding, focusing on identifying triggers and developing coping strategies.