Post Simulation Quiz: Mental Health
Case: George Palo
Considering Mr. Palo's history and assessment findings, which factor is most likely the
primary contributor to his recent weight loss?
Your Response: Depression
Rationale: A commonly observed physical response to depression is poor appetite
and the resulting weight loss. Although nausea and vomiting are possible side
effects of galantamine, there are no assessment data to suggest the patient is
experiencing either. Both living alone and dementia (including Alzheimer disease),
especially in its later stages, can affect the patient's interest in preparing and
eating food, but neither has the high degree of influence presented by depression.
Which nursing interventions implemented during Mr. Palo's assessment will assist him
to communicate as effectively as his cognitive deterioration allows? (Select all that
apply.)
Your Response:
✓ Allowing ample time for the patient to respond to questions, ✓ Phrasing
questions so as to require simple answers
✓ Arranging for frequent breaks in the assessment process
✓ Providing simple explanations about why questions are being asked
Rationale:The nurse provides simple explanations as often as patients need them,
such as "I'm asking these questions so the staff can see how your health is." It
, helps to ask simple questions (those that require simple answers) rather than
compound questions, and to allow patients ample time to answer. Patients may
become confused or tire easily, so frequent breaks in the interview may be
needed. Although it might become necessary to rely on family for answers to
assessment questions, Mr. Palo appears capable of being the primary information
provider. Relying on his daughter at this point would be nontherapeutic because it
would minimize his role in the assessment process.
Which assessment findings would indicate that Mr. Palo is experiencing both insufficient
nutritional and fluid intake? (Select all that apply.)
Your Response:
✓ Weight loss
✓ General weakness
✓ Altered mental status
✓ Poor skin turgor
Rationale: Indications of poor nutritional and fluid intake would include all the
options with the exception of bradycardia. Such deficiencies would result in
tachycardia and hypotension.
Which statement made by Mr. Palo would demonstrate that his religious belief system is
influential in his decision not to consider suicide?
Your Response: "No! He gives it and only He can take it away."
Rationale: Suicidal thoughts are common in people with mood disorders,
especially depression. An individual's belief systems and values can influence his
or her decision concerning the act of suicide. Mr. Palo's reference to his belief in
the time of death being determined only by God supports the religious influence
on his decision. The other statements express various ethical objections to suicide
but do not indicate that they are based on his religious belief system.
Case: George Palo
Considering Mr. Palo's history and assessment findings, which factor is most likely the
primary contributor to his recent weight loss?
Your Response: Depression
Rationale: A commonly observed physical response to depression is poor appetite
and the resulting weight loss. Although nausea and vomiting are possible side
effects of galantamine, there are no assessment data to suggest the patient is
experiencing either. Both living alone and dementia (including Alzheimer disease),
especially in its later stages, can affect the patient's interest in preparing and
eating food, but neither has the high degree of influence presented by depression.
Which nursing interventions implemented during Mr. Palo's assessment will assist him
to communicate as effectively as his cognitive deterioration allows? (Select all that
apply.)
Your Response:
✓ Allowing ample time for the patient to respond to questions, ✓ Phrasing
questions so as to require simple answers
✓ Arranging for frequent breaks in the assessment process
✓ Providing simple explanations about why questions are being asked
Rationale:The nurse provides simple explanations as often as patients need them,
such as "I'm asking these questions so the staff can see how your health is." It
, helps to ask simple questions (those that require simple answers) rather than
compound questions, and to allow patients ample time to answer. Patients may
become confused or tire easily, so frequent breaks in the interview may be
needed. Although it might become necessary to rely on family for answers to
assessment questions, Mr. Palo appears capable of being the primary information
provider. Relying on his daughter at this point would be nontherapeutic because it
would minimize his role in the assessment process.
Which assessment findings would indicate that Mr. Palo is experiencing both insufficient
nutritional and fluid intake? (Select all that apply.)
Your Response:
✓ Weight loss
✓ General weakness
✓ Altered mental status
✓ Poor skin turgor
Rationale: Indications of poor nutritional and fluid intake would include all the
options with the exception of bradycardia. Such deficiencies would result in
tachycardia and hypotension.
Which statement made by Mr. Palo would demonstrate that his religious belief system is
influential in his decision not to consider suicide?
Your Response: "No! He gives it and only He can take it away."
Rationale: Suicidal thoughts are common in people with mood disorders,
especially depression. An individual's belief systems and values can influence his
or her decision concerning the act of suicide. Mr. Palo's reference to his belief in
the time of death being determined only by God supports the religious influence
on his decision. The other statements express various ethical objections to suicide
but do not indicate that they are based on his religious belief system.
