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Appropriate teaching for a patient with bulimia nervosa who binges and purges is:
- A. Not to skip meals or restrict food.
- B. To eat a small meal after purging.
- C. To eat a large breakfast but no lunch.
- D. None of the above.
Correct Answer: A
Rationale: Step-by-step rationale:
1. A: Not skipping meals or restricting food promotes regular eating patterns, helps stabilize blood sugar levels, and reduces the urge to binge.
2. B: Eating a small meal after purging could reinforce the binge-purge cycle and is not a healthy approach.
3. C: Eating a large breakfast but skipping lunch can lead to imbalanced eating habits and is not recommended for treating bulimia nervosa.
4. D: None of the above options provide a comprehensive and effective approach to managing bulimia nervosa symptoms.
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Which disorder is associated with persons with a body weight that is normal or even slightly above average?
- A. Pica.
- B. Bulimia.
- C. Obesity.
- D. Anorexia nervosa.
Correct Answer: B
Rationale: The correct answer is B: Bulimia. Individuals with bulimia nervosa typically have a normal or slightly above average body weight due to the cycle of binge eating and purging behaviors. This is because they consume large amounts of food during binges but then engage in compensatory behaviors such as vomiting or excessive exercise to prevent weight gain. In contrast, choices A (Pica) and D (Anorexia nervosa) are associated with low body weight. Choice C (Obesity) is characterized by excess body weight. Bulimia is the only disorder in the list where individuals can have a normal or slightly above average body weight due to the nature of their eating behaviors.
Which of the following is an effective communication technique that should be included in the teaching plan for the family members of a woman in whom Alzheimer's disease has been diagnosed recently?
- A. Use simple, familiar words, along with short and simple sentences.
- B. If the client tends to pace a lot, be sure to encourage her to sit during interactions.
- C. If she doesn't understand the communication, change key words.
- D. Use hand gestures when speaking to try to explain what is being said.
Correct Answer: A
Rationale: The correct answer is A: Use simple, familiar words, along with short and simple sentences. This is an effective communication technique for individuals with Alzheimer's disease as it helps in enhancing understanding and reduces confusion. Complex language or sentences may be difficult for the patient to comprehend.
Choice B is incorrect because encouraging the client to sit during interactions does not directly relate to effective communication techniques. Choice C is incorrect as changing key words can lead to further confusion and may not aid in understanding. Choice D is incorrect because using hand gestures may not always effectively convey the message and can potentially cause more confusion for individuals with Alzheimer's disease.
A client with anorexia nervosa has refused meal trays and supplemental feedings for 3 days following admission to the general hospital. The nurse can anticipate that intervention will include:
- A. IV infusions beginning immediately and continuing for 48 hours after client begins eating.
- B. Tube feedings until the client eats 90% of all meals for 1 day.
- C. Placing the client on suicide precautions and one-to-one observation.
- D. Limiting peer group visitors for 2 weeks.
Correct Answer: B
Rationale: The correct answer is B. Tube feedings until the client eats 90% of all meals for 1 day. This intervention is appropriate for a client with anorexia nervosa who is refusing to eat. Tube feedings ensure adequate nutrition while also encouraging the client to resume eating orally. It is a gradual approach that aims to transition the client back to regular eating habits.
Explanation for why other choices are incorrect:
A: IV infusions are not the first-line intervention for a client with anorexia nervosa refusing to eat. This choice does not address the underlying issue of the client's refusal to eat.
C: Placing the client on suicide precautions and one-to-one observation is not indicated solely based on refusal to eat. This choice does not address the nutritional needs of the client.
D: Limiting peer group visitors for 2 weeks does not address the client's refusal to eat and is not a relevant intervention in this situation.
A widow, aged 72 years, lives alone and is visited weekly by her son. She takes digoxin, hydrochlorothiazide, and an antihypertensive drug. She also has a prescription for diazepam (Valium) as needed for moderate to severe anxiety. When the son visited today, he found his mother confused and disoriented, with an unsteady gait. The nurse assessed the patient as having several cognitive problems, including memory and attention deficits and fluctuating levels of orientation. The nurse confirms that the patient's symptoms developed:
- A. Over the past few days.
- B. Over the past few weeks.
- C. Over the past few months.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Over the past few days. The sudden onset of confusion, disorientation, and cognitive deficits in the elderly patient suggests an acute change in her condition. This acute change is more indicative of a recent event or medication-related issue rather than a gradual decline over weeks or months. The sudden onset could be due to factors such as medication interactions, overdose, or underlying medical conditions. It is crucial to investigate recent changes in medications, lab results, or any other potential triggers that might have led to this acute cognitive decline. Choices B, C, and D are incorrect because they imply a gradual decline over weeks, months, or no specific timeframe, which does not align with the sudden onset observed in the patient.
A 14-year-old client on the eating disorders unit refuses to eat her meals and says to the nurse on the unit, 'You can't make me eat! There is nothing wrong with me.' The nurse will assess this as use of which defense mechanism?
- A. Repression.
- B. Rationalization.
- C. Sublimation.
- D. Denial.
Correct Answer: D
Rationale: The correct answer is D: Denial. Denial is a defense mechanism where an individual refuses to acknowledge reality to avoid discomfort. In this scenario, the client is denying the seriousness of their situation by refusing to eat and claiming there is nothing wrong. Repression (A) involves unconsciously blocking out unpleasant thoughts or feelings. Rationalization (B) is creating logical explanations to justify behavior. Sublimation (C) is redirecting negative impulses into positive behaviors. In this case, denial is the most fitting defense mechanism as the client is refusing to accept the reality of their eating disorder.