Nokea
A short-term goal for a patient with Alzheimer disease is:
- A. Improved functioning in the least restrictive environment
- B. improved problem solving in activities of daily living
- C. increased self-esteem and improved self-concept
- D. regained sensory perception and cognitive function
Correct Answer: A
Rationale: Promoting function in a safe, least restrictive setting is realistic and achievable given Alzheimer's progressive nature.
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Which finding is most indicative of refeeding syndrome in a patient with anorexia nervosa?
- A. Increased energy and mental clarity after eating.
- B. Electrolyte imbalances, particularly hypophosphatemia.
- C. A sudden increase in appetite and food cravings.
- D. Rapid weight gain and hypertension.
Correct Answer: B
Rationale: The correct answer is B because refeeding syndrome is characterized by electrolyte imbalances, especially hypophosphatemia, due to rapid reintroduction of nutrition. This can lead to serious complications like cardiac arrhythmias and respiratory failure. Increased energy and mental clarity (A) are not specific to refeeding syndrome. A sudden increase in appetite and food cravings (C) may occur but are not indicative of refeeding syndrome. Rapid weight gain and hypertension (D) are not typically seen in refeeding syndrome.
A worker is characterized by her co-workers as 'painfully shy' and lacking in self-confidence. Her co-workers say she stays in her cubicle all day, never coming out for breaks or lunch. One day after falling on the ice in the parking lot, she goes to the nurse's office, where she apologizes for falling and mentions that she hopes the company will not fire her for being so clumsy. Which nursing approach or response would be most therapeutic?
- A. Remain professional and a bit detached so as not to arouse suspiciousness on her part.
- B. Reassure her that many others have fallen at work and not ever been criticized or fired.
- C. Acknowledge her concerns in a matter-of-fact manner and provide first aid as needed.
- D. Explain that an incident report about her fall will go to a manager who will contact her.
Correct Answer: B
Rationale: The correct answer is B because it focuses on reassurance and empathy, which are important in therapeutic communication. By reassuring the worker that others have fallen without facing negative consequences, the nurse is validating her feelings and reducing her anxiety. This approach helps build trust and rapport, essential for effective communication and support.
Choices A, C, and D are incorrect because they do not address the worker's emotional needs or provide the reassurance she requires. Option A suggests remaining detached, which may come across as uncaring. Option C focuses solely on providing first aid and does not acknowledge the worker's concerns. Option D introduces the fear of potential consequences without providing any reassurance or emotional support, which could increase the worker's anxiety.
When a psychiatric technician questions the nurse about comorbidity of eating disorders, which Axis I disorder would the nurse say is most commonly seen in clients with bulimia and anorexia nervosa?
- A. Anxiety disorders.
- B. Depressive disorders.
- C. Dissociative disorders.
- D. Somatoform disorders.
Correct Answer: B
Rationale: The correct answer is B: Depressive disorders. Depression is commonly seen in clients with bulimia and anorexia nervosa due to the psychological and emotional struggles associated with these eating disorders. Individuals may experience feelings of worthlessness, hopelessness, and sadness, contributing to depressive symptoms. This comorbidity is well-documented in clinical research. Anxiety disorders (Choice A), dissociative disorders (Choice C), and somatoform disorders (Choice D) are less commonly associated with eating disorders compared to depressive disorders, making them incorrect choices in this context.
What is the most important aspect of refeeding for a patient with anorexia nervosa?
- A. Refeeding should begin slowly to avoid complications.
- B. Rapid weight gain is essential to restore health.
- C. The patient should be encouraged to make independent food choices.
- D. Fluid intake should be restricted to avoid water retention.
Correct Answer: A
Rationale: The correct answer is A because refeeding should start slowly to prevent refeeding syndrome, a potentially life-threatening condition caused by rapid electrolyte shifts. Gradually increasing caloric intake allows the body to adjust and reduces the risk of complications. Rapid weight gain (B) is not recommended as it can lead to medical complications. Encouraging independent food choices (C) may not be suitable initially as structured meal plans are often necessary. Restricting fluid intake (D) is not advisable as adequate hydration is crucial during refeeding.
You are caring for a 13-year-old boy with a diagnosis of conduct disorder. Which of the following would you be most likely to expect given this diagnosis?
- A. Severe separation anxiety from parents
- B. Making up stories to make him appear more important
- C. History of cruelty to schoolmates and pets
- D. Insomnia and anorexia nervosa
Correct Answer: C
Rationale: Conduct disorder is associated with long-term problems with defiance, rule-breaking, and violating the basic rights of others, such as cruelty to peers and animals.