An Asian American patient rarely showed eye contact. This nursing ...

[sammy]

An Asian American patient rarely showed eye contact. This nursing diagnosis was formulated: Situational low self-esteem related to poor social skills as evidenced by lack of eye contact.
 
  Interventions to raise the patient's self-esteem were not successful; the patient's eye contact did not improve. Select the best analysis of this scenario. a. The patient's poor eye contact is indicative of anger and hostility that have not been addressed.
  b. The nurse should not have independently assessed, diagnosed, and planned for this patient.
  c. The patient's eye contact should have been addressed by role-playing to increase comfort.
  d. The nurse should have assessed the patient's culture before making this diagnosis and plan.

Question 2

An 83-year-old man becomes lost while driving. He pulls into a driveway to turn around and cannot figure out how to put his car in reverse, so he drives into the yard, makes a circle, and drives back out of the driveway.
 
  The police who observe this action pull him over, quickly determine that he is cognitively impaired, and take him to the emergency room. Which evaluations would the emergency room nurse expect to see ordered? Select all that apply. a. Folate and b12 levels
  b. Electrolytes and serum creatinine
  c. Hearing and vision screening
  d. Psychological testing
  e. Mental status examination
  f. Brain imaging

[pami445]

Answer to Question 1

D
The amount of eye contact a person engages in is often culturally determined. In some cultures, eye contact is considered insolent. In others, eye contact is expected. Asian Americans often prefer not to engage in direct eye contact.

Answer to Question 2

A, B, C, E, F
Many medical and psychiatric disorders can present as dementia and must be ruled out before a diagnosis of dementia is reached. Evaluation must address all issues that potentially affect mental status, including nutritional elements necessary for brain function, metabolic factors, sensory changes, and brain imaging to detect structural changes such as atrophy. A complete mental status examination identifies nervous system deficits such as impaired memory or executive function. The only examination here that is not typically performed in the emergency room is psychological testing, which is a lengthy process that requires a psychologist and thus is rarely feasible in the emergency room.