Mental Health Exam 2

Electroconvulsive therapy (ECT) is most commonly prescribed for major depression. ECT involves passing electric currents through the brain to induce a controlled seizure. It is typically used when other treatments, such as medication and therapy, have not been effective in treating severe depression. ECT has been shown to be particularly effective in cases where depression is accompanied by suicidal tendencies, psychotic features, or a lack of response to other treatments. It is not typically used as a first-line treatment for bipolar disorder, paranoid schizophrenia, or obsessive-compulsive disorder.

Clint's belief that the CIA is looking for him and will kill him if they find him is an example of a delusion of persecution. This type of delusion involves a false belief that one is being targeted, harassed, or harmed by others. In Clint's case, he believes that a powerful organization is after him, which is a common manifestation of delusions in individuals with schizophrenia.

The priority nursing diagnosis for Margaret would be "Risk for suicide" because she has expressed thoughts of not having anything more to live for and has become socially withdrawn since her husband's death. These symptoms indicate a high risk for suicide and should be addressed as a priority to ensure her safety and well-being.

During the first visit, Ann would address the problem of "Risk for injury" because Mrs. W is a 78-year-old widow who lives alone and has been diagnosed with depression. Depression can often lead to a lack of motivation, decreased energy levels, and impaired concentration, which can increase the risk of accidents and injuries. Therefore, Ann would prioritize assessing and addressing any potential safety hazards in Mrs. W's home to prevent any accidents or injuries from occurring.

The correct answer is a. This statement is appropriate because trazodone can cause orthostatic hypotension, which can lead to dizziness or lightheadedness when standing up. By advising Mrs. W to go slowly when transitioning from a seated or lying down position, the nurse is helping to prevent falls or injury.

Education for clients taking MAOIs should include information about a tyramine-restricted diet, as MAOIs can interact with tyramine-rich foods and cause a hypertensive crisis. Clients should also be educated about the need to avoid concurrent use of over-the-counter medications without physician notification, as certain medications can interact with MAOIs and cause adverse effects. This education is important to ensure the safety and effectiveness of the medication.

The nurse should assess this behavioral change as a potential warning sign that John may have decided to carry out his suicide plan. Sudden shifts from a depressed state to a cheerful mood can sometimes indicate that an individual has made a decision to end their life. It is important for the nurse to carefully evaluate John's current mental state and ensure his safety.

The priority nursing diagnosis for Margaret is "Risk for injury related to hyperactivity." This is because Margaret is displaying symptoms of agitation, pacing, demanding behavior, and speaking loudly, which indicate hyperactivity. Additionally, her sister-in-law reports that Margaret eats very little, is losing weight, and almost never sleeps, which further supports the diagnosis of hyperactivity. The risk for injury is high due to Margaret's agitated and hyperactive state, making it important for the nurse to prioritize interventions to prevent any harm or accidents.

The outcome criterion that would most accurately measure achievement of the nursing diagnosis "Risk for Suicide related to feelings of hopelessness from loss of relationship" is option a, "The client has experienced no physical harm to herself." This criterion indicates that the client has not engaged in any self-harming behaviors, which is a significant indicator of progress in addressing the risk for suicide. It shows that the client has been able to maintain her physical safety and well-being, which is a positive outcome in managing the identified risk.

Freudian psychoanalytic theory suggests that Theresa's suicide attempt can be explained by her anger towards her boyfriend for breaking up with her, which she has internalized and directed towards herself. This theory focuses on the unconscious mind and the influence of unresolved conflicts and repressed emotions on behavior. According to Freud, individuals may turn their anger inward in the form of self-destructive behaviors, such as self-harm or suicide attempts, as a way to cope with their feelings of anger and frustration.

The most common comorbid condition in children with bipolar disorder is attention-deficit/hyperactivity disorder (ADHD). Comorbidity refers to the presence of two or more disorders in the same individual. Bipolar disorder and ADHD often coexist in children, with studies showing a high prevalence of ADHD symptoms in children with bipolar disorder. This comorbidity can complicate the diagnosis and treatment of both disorders, as symptoms can overlap and interact with each other. Therefore, it is important for clinicians to carefully assess and address both bipolar disorder and ADHD symptoms in children to provide appropriate treatment and support.

The correct answer is c. The bipolar condition would be stabilized first before medication for the ADHD would be given. This is because treating the bipolar disorder is typically the priority in order to stabilize the child's mood and prevent any potential manic or depressive episodes. Once the bipolar disorder is under control, medication for ADHD can be considered to address the symptoms of inattention, hyperactivity, and impulsivity.

Before starting ECT therapy, it is essential to ensure that the consent form has been signed. This is important because ECT therapy is an invasive procedure that carries potential risks and side effects. By ensuring that the consent form has been signed, the healthcare team can confirm that the patient has been fully informed about the procedure, its potential benefits, risks, and alternatives, and has given their voluntary consent to undergo the therapy. This ensures that the patient's autonomy and right to make decisions about their own healthcare are respected and upheld.

The primary nursing intervention in working with Mrs. G, who has been diagnosed with NCD due to Alzheimer's disease, is to ensure that the environment is safe to prevent injury. This is because individuals with Alzheimer's disease often experience cognitive decline, memory loss, and confusion, which can increase their risk of accidents and injuries. By creating a safe environment, such as removing tripping hazards, securing furniture, and implementing safety measures, the nurse can minimize the risk of harm and promote the well-being of Mrs. G.

The nurse knows that multiple small strokes are not associated with an increased incidence of NCD (neurocognitive disorder) due to Alzheimer's disease. Alzheimer's disease is primarily caused by genetic factors (family history), head trauma, and advanced age. Multiple small strokes, on the other hand, can lead to a different type of dementia called vascular dementia. Therefore, the client's risk of developing Alzheimer's disease is not increased by multiple small strokes.

The statement made by Andrew, "I don't know why Carlo had to die and I didn't!" suggests that he is experiencing survivor's guilt. Survivor's guilt is a common psychological response to surviving a traumatic event while others did not. It is characterized by feelings of guilt, self-blame, and questioning why one survived while others did not. Andrew's statement reflects his struggle with understanding why he survived while his best friend did not, leading to feelings of guilt and questioning his own worthiness of survival.

This scenario demonstrates showing respect for the boundary of another because the counselor asked Karen if she would like a hug, allowing her to make a decision about her personal space and physical boundaries. This shows an understanding and consideration for Karen's autonomy and comfort level.

The Tidal Model is a framework used by mental health professionals to assist individuals with mental illness recovery. One of the components of this model is the individual's personal story. This refers to the unique experiences, beliefs, and values of the individual, which are important in understanding their mental health journey and tailoring appropriate interventions. By acknowledging and exploring the personal story, the nurse can gain insight into the individual's perspective and work collaboratively towards their recovery goals.

The nurse explains to the client that a wellness toolbox is a list of strategies the client has used in the past that help relieve disturbing symptoms. This means that the client can refer to this list whenever they are experiencing symptoms and use the strategies that have worked for them in the past to help alleviate those symptoms. It allows the client to have a personalized set of tools to manage their mental illness and promote their recovery.

The best response by the nurse is to ask Clara directly if she is thinking about wanting to die. This response shows empathy and concern for Clara's well-being, and allows her to express her feelings openly. It opens up a conversation about her mental health and allows the nurse to assess if Clara is at risk of self-harm or suicide.

The most characteristic behavior of agoraphobia is staying in one's home out of fear of being in a place from which they cannot escape. This fear often leads to avoidance of situations such as crowded places, public transportation, or open spaces. This behavior is consistent with the definition of agoraphobia, which is an anxiety disorder characterized by a fear of situations or places that may cause panic, embarrassment, or a feeling of being trapped.

Crises occur when an individual experiences a stressor and perceives coping strategies to be ineffective. This means that when a person is faced with a difficult situation or event (stressor) and they feel that their usual methods of dealing with it are not working, they may enter a crisis. In this state, the individual may feel overwhelmed and unable to effectively manage or resolve the stressor, leading to increased distress and potential negative outcomes.

The most appropriate way to communicate with an elderly person who is deaf in his right ear is to speak face-to-face in a low-pitched voice. Speaking face-to-face ensures that the person can see your facial expressions and lip movements, which can aid in understanding. Speaking in a low-pitched voice helps to amplify the sound and make it easier for the person to hear, compensating for the hearing loss in the right ear.

Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat body dysmorphic disorder (BDD). BDD is a mental disorder characterized by an excessive preoccupation with perceived flaws in one's appearance. SSRIs like fluoxetine can help reduce obsessive thoughts and compulsive behaviors associated with BDD. Alprazolam and Diazepam are benzodiazepines used to treat anxiety disorders, while Olanzapine is an antipsychotic medication used to treat schizophrenia and bipolar disorder. Therefore, fluoxetine is the most appropriate medication for Joanie's condition.

The success of long-term psychotherapy with Theresa, who attempted suicide following a breakup with her boyfriend, could be measured by her increased sense of self-worth. This indicates that therapy has helped her develop a more positive perception of herself, which is crucial for her overall mental well-being and resilience. It suggests that she has gained confidence, self-acceptance, and a healthier self-image, which can contribute to her ability to cope with challenges and maintain a stable emotional state.

The most appropriate nursing intervention for Marie would be to begin grief work and assist her in recognizing areas of self-worth separate from her children. This intervention acknowledges Marie's feelings of loss and helps her navigate through the grieving process. By helping her identify her own self-worth, the nurse can support Marie in finding new sources of fulfillment and purpose in her life. This intervention promotes Marie's emotional well-being and helps her cope with the changes in her life.

Serving as a case manager for a mentally ill homeless client represents a nursing intervention at the tertiary level of prevention. Tertiary prevention focuses on minimizing the impact of a disease or illness that has already occurred and aims to prevent further complications or disabilities. In this case, the nurse is providing support and resources to a mentally ill homeless client, helping to manage their condition and prevent any further deterioration in their health. This intervention is aimed at reducing the negative consequences of the client's mental illness and homelessness.

Electroconvulsive therapy (ECT) is a treatment that involves passing electric currents through the brain to induce a controlled seizure. It is believed to have a therapeutic response by increasing the levels of serotonin, norepinephrine, and dopamine. These neurotransmitters play a crucial role in regulating mood, emotions, and overall mental well-being. By increasing their levels, ECT may help alleviate symptoms of depression and other mental disorders. Stimulation of the CNS (option a) is a general effect of ECT, but it does not specifically explain the therapeutic response. Decreasing the levels of acetylcholine and monoamine oxidase (option b) and altering sodium metabolism within nerve and muscle cells (option d) are not supported by current understanding of ECT's mechanism of action.

Margaret's belief that her sister-in-law is jealous of her and trying to make her look insane is an example of a delusion of persecution. Delusions of persecution involve false beliefs that one is being targeted, harmed, or conspired against by others. In this case, Margaret's belief is not based on reality and is a symptom of her manic episode.

The most appropriate nursing intervention in this situation is to set limits on the amount of time Sandy may engage in the ritualistic behavior. This intervention acknowledges the progress Sandy has made in feeling more comfortable and less ill-at-ease, while also addressing the need to gradually decrease and eventually eliminate the ritualistic behaviors. By setting limits, the nurse is providing structure and guidance to help Sandy continue her progress towards recovery from OCD.

Buspirone is a medication that is used to treat generalized anxiety disorder. Unlike Xanax, which is a benzodiazepine that is typically taken on an as-needed basis for acute anxiety symptoms, buspirone is a medication that needs to be taken daily in order to be effective. It works by affecting certain chemicals in the brain that are involved in anxiety. Taking buspirone daily helps to maintain a consistent level of the medication in the body, which can help to reduce anxiety symptoms over time. Therefore, the nurse's response that buspirone must be taken daily in order to be effective is appropriate.

The cause of Mrs. G's NCD due to Alzheimer's disease is unknown. This means that the exact reason for the disorder is not currently understood. Alzheimer's disease is a progressive neurological disorder that affects memory, thinking, and behavior. While research has identified certain risk factors, such as age and genetics, the specific cause of the disease remains uncertain.

A nursing school graduate failing the NCLEX exam and a 15-year-old high school girl not being selected for the cheerleading squad are examples of focal stimuli. Focal stimuli refer to specific events or situations that have a significant impact on an individual's behavior or emotions. In both cases, the individuals experience a negative outcome that can influence their future actions and decisions. These events stand out and have a direct impact on the individuals involved, making them examples of focal stimuli.

The client's statement, "I have schizophrenia. Nothing can be done. I might as well die," suggests a sense of hopelessness and resignation. This aligns with the moratorium stage of the Psychological Recovery Model. In this stage, individuals may feel overwhelmed by their illness and believe that there is no possibility for improvement or recovery. They may be stuck in a state of inaction and lack motivation to seek help or make changes. The nurse would assess the client to be in the moratorium stage based on their negative beliefs and lack of hope for the future.

In the preparation stage of the Psychological Recovery Model, the nurse focuses on providing education and information to the client about the effects of their illness and how to recognize, monitor, and manage symptoms. This is important as it helps the client develop a better understanding of their condition and empowers them to take an active role in their own recovery. By teaching about the effects of the illness and symptom management, the nurse is helping the client build knowledge and skills necessary for their recovery journey.

Electrolyte imbalances and folate deficiency are both examples of treatable forms of neurocognitive disorder (NCD). Electrolyte imbalances can disrupt normal brain function, leading to cognitive impairment, but can be corrected through proper management of electrolyte levels. Folate deficiency can also cause cognitive impairment, but can be reversed through folate supplementation or dietary changes. Multiple sclerosis and multiple small brain infarcts are not treatable or reversible causes of NCD, while HIV disease can be managed but not completely reversed.

Mr. B is at high risk for suicide because he is a white man who has recently experienced a significant loss (his wife's death) and is living alone. These factors, along with his depression, increase his vulnerability to suicidal thoughts and behaviors. The answer choice highlights the specific risk factors that apply to Mr. B's situation, making it the correct answer.

Family therapy for clients with schizophrenia and their families primarily focuses on promoting family interaction and increasing understanding of the illness. This approach recognizes the importance of involving the entire family in the treatment process and aims to improve communication, support, and empathy within the family unit. By increasing understanding of the illness, family members can better comprehend the challenges and symptoms experienced by the client, leading to improved coping strategies and a more supportive environment for the client's recovery.

Mr. B, being a 79-year-old man, is likely experiencing age-related changes in his cardiovascular system. As people age, their cardiovascular system undergoes certain changes, such as decreased elasticity of blood vessels and reduced efficiency of the heart. These changes can lead to symptoms like fatigue and shortness of breath during physical exertion. While a sedentary lifestyle, the effects of pathological depression, and medication side effects can also contribute to these symptoms, age-related changes in the cardiovascular system are the most likely explanation in this case.

Elderly individuals may have a higher pain threshold, which means they may not feel the water as hot as it actually is. This puts them at risk of burning themselves if the water temperature is too high. Therefore, it is important for the nurse to check the temperature of the water before the elderly individual gets into the shower to ensure their safety and prevent burns.

The priority nursing diagnosis for Mr. B would be "Complicated grieving." This is because Mr. B is exhibiting symptoms of depression, such as weight loss and social isolation, which could be indicative of unresolved grief. The statement from his son about Mr. B not crying when his wife died suggests that he may have suppressed his emotions, further indicating a complicated grieving process. Addressing this nursing diagnosis would be crucial in helping Mr. B cope with his loss and improve his overall well-being.

The appropriate interventions for a client on suicide precautions include removing all sharp objects, belts, and other potentially dangerous articles from the client's environment to ensure their safety. Accompanying the client to off-unit activities helps to provide supervision and support. Obtaining a promise from the client that they will not do anything to harm themselves for the next 12 hours is important to assess their immediate risk. Putting all of the client's possessions in storage and explaining that they may have them back when they are off suicide precautions is not an appropriate intervention as it may increase their distress and feelings of isolation.

Conducting a behavioral and needs assessment on John is a priority intervention for the nurse because it will help the nurse understand John's current situation, his physical and mental health needs, and any potential behavioral issues. This assessment will provide crucial information that will guide the nurse in developing an appropriate plan of care for John and determining the necessary interventions and resources he may require. Referring John to a social worker or helping him apply for Social Security benefits may be important steps in the future, but conducting the assessment is the first priority to ensure a comprehensive understanding of John's needs.

The best response for the nurse is option d because it directly addresses the concern of Mrs. W's statement about not having anything to live for anymore. By asking if she has been thinking about harming herself, the nurse shows concern for her well-being and opens up the opportunity for further discussion and possible intervention if necessary. This response acknowledges the seriousness of Mrs. W's statement and allows for a deeper exploration of her feelings.

Sam's priority nursing diagnosis at this time would be anxiety related to deficient knowledge about ECT. This is because Sam expresses fear and concern about the treatment, indicating a lack of understanding about what to expect. By addressing Sam's anxiety and providing education about ECT, the nurse can help alleviate Sam's fears and increase their understanding of the treatment, ultimately promoting a more positive experience.

Succinylcholine is administered to a client receiving ECT (Electroconvulsive therapy) to relax their muscles. ECT involves the induction of a controlled seizure in order to treat severe depression, mania, or catatonia. The muscle relaxation caused by succinylcholine helps to prevent injury during the seizure and allows for a smoother procedure.

Mental health recovery serves to provide empowerment to the client as it focuses on helping individuals regain control over their lives and make informed decisions about their mental health. It is a collaborative process as it involves a partnership between the individual and their healthcare providers, family, friends, and community to support their recovery journey. The statement a is false as mental health recovery can apply to a range of mental illnesses, not just severe and persistent ones. The statement c is false as mental health recovery is not solely based on the medical model but also takes into account social, psychological, and environmental factors.

Regular physical exercise during the day can help promote sleep in individuals with Alzheimer's disease. Exercise helps to reduce restlessness and increase fatigue, making it easier for Mrs. G to fall asleep and stay asleep at night. Additionally, exercise can help regulate the sleep-wake cycle and improve overall sleep quality. Therefore, ensuring that Mrs. G gets regular physical exercise during the day would be the best nursing action to promote sleep in her.

The correct answer is c. “This is the patio door, Mrs. G. Are you looking for the bathroom?” This statement reflects the most accurate assessment of the situation because it acknowledges Mrs. G's confusion and attempts to understand her needs. It also suggests a possible reason for her behavior, such as needing to use the bathroom. This response shows empathy and attempts to redirect Mrs. G in a way that addresses her immediate concerns.

The best description for the average number of ECT treatments given and the timing of administration is option b. One treatment every other day for a total of 6 to 12 treatments. This means that the patient will receive ECT treatments every other day, with a total of 6 to 12 treatments in total. This schedule allows for regular treatment over a period of time, providing the necessary therapy while allowing for recovery between sessions.

The most appropriate response by the nurse is option d because it acknowledges Clint's belief without dismissing or invalidating it. It shows empathy and understanding towards Clint's perspective while also expressing the nurse's own difficulty in accepting the belief. This response maintains a therapeutic and non-confrontational approach, which is important when working with individuals with schizophrenia.

The question asks which group is not included among the three client populations that benefit most from psychiatric home health care. The three populations mentioned are elderly individuals, individuals with severe and persistent mental illness, and individuals in acute crisis situations. The correct answer, option b, states that individuals living in poverty are not included in this group. This suggests that individuals living in poverty are not considered to be one of the three client populations that benefit most from psychiatric home health care.

Olanzepine, Carbamazepine, and Lamotrigine are all used in the treatment of bipolar disorder. Olanzepine is an atypical antipsychotic that helps to stabilize mood and reduce mania symptoms. Carbamazepine is an anticonvulsant that can help control mood swings and prevent future episodes. Lamotrigine is also an anticonvulsant that is effective in treating bipolar depression and preventing future episodes. Paroxetine is an antidepressant commonly used to treat depression but is not typically used for bipolar disorder. Tranylcypromine is a monoamine oxidase inhibitor (MAOI) used to treat depression but is not commonly used for bipolar disorder.

The nurse would instruct the client to be on the alert for tinnitus, severe diarrhea, and ataxia as signs and symptoms of lithium toxicity. Tinnitus refers to ringing in the ears, severe diarrhea is excessive and watery bowel movements, and ataxia is the loss of muscle coordination. These symptoms indicate that the client may be experiencing toxicity from the lithium therapy and should seek medical attention. Fever, sore throat, malaise (a general feeling of discomfort), occipital headache (headache at the back of the head), palpitations (rapid or irregular heartbeats), chest pain, skin rash, marked rise in blood pressure, and bradycardia (abnormally slow heart rate) are not specific symptoms of lithium toxicity.

Atropine sulfate is administered to a client receiving ECT in order to decrease secretions. ECT (electroconvulsive therapy) can cause excessive salivation and bronchial secretions, and atropine sulfate is a medication that helps to reduce these secretions. It works by blocking the action of acetylcholine, a neurotransmitter that stimulates secretions. By decreasing secretions, atropine sulfate can help to prevent complications such as aspiration pneumonia during ECT.

Chlorpromazine is ordered to decrease psychotic symptoms in the client with schizophrenia. Schizophrenia is a mental disorder characterized by delusions, hallucinations, disorganized thinking, and abnormal behavior. Chlorpromazine is a typical antipsychotic medication that works by blocking dopamine receptors in the brain, which helps to reduce the symptoms of psychosis. It is commonly used in the treatment of schizophrenia and other psychotic disorders.

Individuals with Alzheimer's disease may also show changes in personality, speech, and mobility. Personality changes can include shifts in behavior, mood, and temperament. Speech changes may manifest as difficulty finding words, forming sentences, or understanding language. Mobility changes can include difficulties with balance, coordination, and walking. Vision and hearing changes are not typically associated with Alzheimer's disease, although individuals with the disease may experience sensory impairments due to other causes.

Vascular NCD, also known as vascular dementia, is a type of dementia that is caused by reduced blood flow to the brain. It is characterized by a step-wise progression, meaning that the symptoms may worsen gradually over time, but there may also be periods where the person seems to be functioning relatively well. This is because the progression of the disease is not continuous, but rather occurs in a series of steps. Therefore, option b is the correct statement as it accurately describes the characteristic pattern of progression seen in vascular NCD.

Mrs. W's primary-care physician has diagnosed her as depressed, indicating that she may require regular visits from a psychiatric home health nurse. Option b states that Mrs. W is physically too weak to travel without risk of injury, which suggests that she may have physical limitations that make it difficult for her to leave her home. This aligns with the need for a home health nurse to provide care and support to Mrs. W in her own environment. The other options do not directly address Mrs. W's physical limitations or her need for home health visits.

Habit-reversal therapy is a treatment commonly used for trichotillomania, which is a hair-pulling disorder. It aims to increase awareness of the hair-pulling behavior and replace it with a competing response. Awareness training helps the individual become more conscious of their hair-pulling habits. Competing response training involves teaching the individual to engage in a behavior that is incompatible with hair-pulling whenever they feel the urge to do so. Social support is also an important element in this therapy as it provides encouragement and understanding from others who may be going through similar experiences. Hypnotherapy and aversive therapy are not typically included in habit-reversal therapy for trichotillomania.

Donepezil (Aricept), Rivastigmine (Exelon), and Galantamine (Razadyne) have all been indicated for improvement in cognitive functioning in mild to moderate Alzheimer's disease. These medications are cholinesterase inhibitors, which work by increasing the levels of acetylcholine in the brain. Acetylcholine is a neurotransmitter that is involved in learning and memory. By increasing its levels, these medications can help to improve cognitive functioning in individuals with Alzheimer's disease. Risperidone (Risperdal) and Sertraline (Zoloft) are not indicated for this purpose and do not have the same mechanism of action.

The client developing tremors and a shuffling gait indicates the presence of extrapyramidal symptoms (EPS), which are common side effects of antipsychotic medications such as chlorpromazine. Benztropine is an anticholinergic medication that helps to alleviate EPS. Therefore, the nurse should administer benztropine as ordered when the client develops these symptoms. The other options do not specifically indicate a need for benztropine.

The nurse would include the information that the client should keep taking the medication, even if they don't feel it is helping, as it sometimes takes a while to take effect. This helps to emphasize the importance of continued adherence to the medication regimen. Additionally, the nurse would inform the client not to take the medication with migraine drugs "triptans" as there may be potential drug interactions between the two medications.

The nurse can expect to assess a client with major depressive disorder to have a slumped posture, delusional thinking, feelings of despair, and anorexia. Slumped posture is a common manifestation of depression, as individuals often experience a lack of energy and motivation. Delusional thinking can also occur in severe cases of depression, where the client may have distorted beliefs or thoughts. Feelings of despair are a hallmark symptom of major depressive disorder, as individuals often feel hopeless and have a negative outlook on life. Anorexia, or a loss of appetite, is another common manifestation of depression, as individuals may lose interest in food and experience weight loss.

The most appropriate interventions for helping a client with Alzheimer's disease with her ADLs are to assist her with step-by-step instructions and to encourage her and give her plenty of time to perform as many of her ADLs as possible independently. Assisting her with step-by-step instructions can help her understand and remember the tasks involved in her ADLs. Encouraging her and giving her time allows her to maintain her independence and promotes her sense of autonomy, which can be beneficial for her overall well-being.

The most appropriate nursing intervention with Jenny would be to make arrangements for her to start attending Alateen meetings. Alateen meetings are specifically designed to provide support and guidance to teenagers who have been affected by someone else's alcoholism. By attending these meetings, Jenny will have the opportunity to connect with others who are going through similar experiences, share her feelings, and learn coping strategies. This intervention can help Jenny feel supported and understood, and provide her with the tools she needs to navigate her situation more effectively.

Prolixin decanoate might be the best choice for John because it is an antipsychotic medication that can be administered as a long-acting injection. This would be beneficial for John as a homeless person with a history of nonadherence to his medication regimen. The long-acting injection would ensure that he receives consistent medication without the need for daily adherence. Additionally, Prolixin decanoate is commonly used to treat schizophrenia, which is a condition that John has a history of.

The nurse might analyze these data by considering that a diminished inflammatory response in the elderly increases healing time. This is supported by Stanley's age of 72 and his reported periods of confusion and forgetfulness, which may indicate age-related changes. The open sore on his arm that is smaller than before suggests that there is healing occurring, but at a slower rate due to the diminished inflammatory response commonly seen in the elderly. This explanation takes into account Stanley's age, symptoms, and the observed data of the open sore.