A systemic approach to assessing a client's mental status and making a diagnosis is approached using a combination of which two systemic techniques?
A) Problem assessment and linear questions
B) Problem assessment and multi-modal questions
C) Problem assessment and circular questions
D) None of these is correct
C
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What are frequent challenges in working with European Americans?
A) ?Anger, resentment, and feelings of low self-worth arise when historical discriminatory practices such as anti-Semitism are discussed. B) ?Low self-esteem, fear of deportation, and being unwelcome by religious denominations. C) ?Little social support, racial discrimination, and single-parent households. D) ?Anger, resentment, and feelings of low self-worth arise when anticipated benefits or rewards fail to materialize.
Does Mrs. Washington exhibit symptoms of depression? If so, could her cognitive symptoms be secondary to her depression?
DSM Diagnosis 294.10 Major Neurocognitive disorder due to Alzheimer’s disease, with behavioral disturbance, severe 310.0 Alzheimer’s disease Hypertension, lumbago, urinary retention, constipation Rationale The client’s NCD began approximately one year ago with a gradual decline in her cognitive functioning. The cognitive deficits consist of the following: memory impairment, impaired ability to carry out motor activities (getting in and out of bath) including fine motor activities (knitting); and disturbance in executive functioning as evidenced by disorganization and problems with sequencing. A medical factor does not seem to be a contributing influence for the dementia, although urinary retention may often lead to a urinary tract infection, which can cause delirium if left untreated over time. Mrs. Washington has become increasingly confused and exhibits aggression due to confusion, especially in the evening hours. Additional Information Required As discussed, Alzheimer’s disease needs to be diagnosed by a physician and medical examinations and tests are used to rule out other conditions that may account for Mrs. Washington’s symptoms. Treatment Mr. Washington was at the point where he was no longer able to cope with the demanding care of a person who suffers from dementia. The social work intern discussed options other than long-term care, such as behavioral strategies to control some of her symptoms mood and respite care. Mr. Washington was emphatic, however, that he was no longer able to attend to her care in his home. While his mother was in the hospital, the social work intern helped Mr. Washington find several facilities that would accommodate his mother for rehabilitation and later long term care. Long-term care also required an application for Medicaid, even though Medicare and a commercial insurance company covered Mrs. Washington. This was a challenge for Mr. Washington who never had to deal with the paperwork; his brother, who had recently moved out of state, assumed these tasks previously. Mr. Washington chose several facilities that would be able to accommodate his mother; he visited them and gave the social work intern a preference list. The social work intern performed the initial referrals. Physical and occupational therapy is another important aspect of the care with people who suffer from Alzheimer’s disease. Physical and sensory stimulation activities are empirically validated as effective with those clients (Bharani & Snowden, 2005). Mrs. Washington started those therapies while in the hospital and they will continue after her discharge. Another aspect of the treatment plan for Mrs. Washington is medication. Mr. Washington reported that his mother takes medication for the symptoms of the dementia. She will be evaluated as a candidate for one of the cholinesterase inhibitors, which have been shown to slow the progression of Alzheimer’s disease in some cases (Olsen, Poulsen, & Lublin, 2005). She may also be prescribed a low dose of an antipsychotic medication if her agitation continues to be an issue in her care and behavior. Because all of these drugs are associated with adverse effects in older adults, the client’s tolerance of them will be carefully monitored Critical Perspective Alzheimer’s disease is a serious, highly debilitating condition that is best treated when diagnosed early. Still, the absence of tests to positively determine the disorder makes the diagnosis difficult. In Mrs. Washington’s case it is possible that her symptoms may be due to some other organic cause that cannot be determined. For that reason it is important for assessment to be an ongoing process, by the medical and social services team, to insure that the client is being treated for the correct disorder. Because AD is a “rule in” diagnosis, there is always the possibility that it is an incorrect diagnosis, especially in the early stages.
All of the following are advantages of experiments over other research designs EXCEPT:
a. experiments can be less costly than other research designs. b. the sampling done in experiments makes the results more generalizable than is the case with other research designs. c. it is more logical to infer causal relationships in experiments than in other research designs. d. researchers in experiments have more control over variables and events than in other research designs.
Which of the following is a behavioral indicator of a level of stress that is too high?
A. making good decisions B. high pitched nervous laughter C. exhilaration D. ability to sleep well