Nokea
A 35-year-old woman who is being interviewed by the advanced practice nurse indicates that she has few friends, fears criticism from others, and withholds information about her thoughts and feelings because she anticipates a negative reaction. Based on these data, the nurse suspects that Sarah may later be diagnosed as having:
- A. Borderline personality disorder
- B. Histrionic personality disorder
- C. Avoidant personality disorder
- D. Schizoid personality disorder
Correct Answer: C
Rationale: The correct answer is C: Avoidant personality disorder. This is because the woman's fear of criticism, avoidance of sharing thoughts/feelings, and limited social circle are indicative of social inhibition and feelings of inadequacy, which are key features of avoidant personality disorder.
A: Borderline personality disorder is characterized by unstable relationships, self-image, and emotions, as well as impulsivity and fear of abandonment.
B: Histrionic personality disorder involves attention-seeking behavior, emotions that are shallow and rapidly shifting, and the need to be the center of attention.
D: Schizoid personality disorder is marked by social detachment, limited emotional expression, and preference for solitary activities.
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Which of the following is a characteristic of bulimia nervosa?
- A. Severe caloric restriction and weight loss.
- B. Binge eating followed by compensatory behaviors like vomiting.
- C. Extreme preoccupation with body image and excessive exercise.
- D. Refusal to eat any food and self-imposed starvation.
Correct Answer: B
Rationale: The correct answer is B. Bulimia nervosa is characterized by recurrent episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, excessive exercise, or fasting. This behavior helps individuals to control their weight and manage guilt associated with binge eating. Choice A is incorrect as bulimia is not associated with severe caloric restriction and weight loss. Choice C is more characteristic of anorexia nervosa, not bulimia. Choice D describes anorexia nervosa, where individuals refuse to eat and engage in self-imposed starvation.
The home care nurse assessed a client with a history of dementia who had a herniorrhaphy at an ambulatory surgical center the previous day. The client lives in a senior retirement community and has no close family. The nurse assesses mild dysphasia. The client cannot remember why he has a bandage. He thinks he is in the army and that it is 1950. Appropriate planning for the client should include:
- A. Arranging an appointment at a geriatric assessment program; OT referral for swallowing therapy; teaching to manage public transportation
- B. Attending English class to improve speech; transferring finances to a conservator; employing an aide to help with medications
- C. Arranging Meals on Wheels, attending speech therapy; relocation to a skilled nursing facility if no improvement in 1 month
- D. Assessing diet and meal preparation; assessing environment for safety problems; referral to a dementia program
Correct Answer: D
Rationale: The correct answer, D, is the most appropriate plan because it addresses the client's current needs and safety concerns. Firstly, assessing diet and meal preparation is important due to the client's dysphasia, which may impact their ability to eat safely. Secondly, assessing the environment for safety problems is crucial as the client has dementia and may be at risk of accidents. Lastly, referral to a dementia program is necessary to provide specialized care and support for the client's condition.
Choices A, B, and C are incorrect because they do not directly address the specific needs of the client in terms of dementia, dysphasia, and safety concerns. They focus on unrelated interventions that are not as critical in this scenario.
A patient has not come out of her room for breakfast. The nurse finds the patient moving restlessly about her room in a disorganized manner. The patient is talking to herself, and her verbal responses to the nurse are nonsensical and suggest disorientation. The nurse notices that the patient's skin is hot and dry, and her pupils are somewhat dilated. All these symptoms are significant departures from the patient's recent presentation. The patient is likely experiencing ______, and the nurse should ______.
- A. anticholinergic toxicity"¦check vital signs and prepare to use a cooling blanket stat
- B. relapse of her psychosis"¦administer PRN antipsychotic drugs and notify her physician
- C. neuroleptic malignant syndrome"¦contact her physician for a transfer to intensive care
- D. agranulocytosis"¦hold her antipsychotic and draw blood for a complete blood count
Correct Answer: A
Rationale: The correct answer is A: anticholinergic toxicity. The patient's symptoms align with this diagnosis due to the disorganized behavior, nonsensical speech, disorientation, hot and dry skin, dilated pupils, and recent presentation changes. Anticholinergic toxicity can cause confusion, delirium, hyperthermia, and dilated pupils. Checking vital signs and preparing to use a cooling blanket are appropriate actions to manage the symptoms.
Choice B (relapse of psychosis) is incorrect because the symptoms are not typical of a psychotic relapse. Choice C (neuroleptic malignant syndrome) is incorrect as the symptoms do not completely align with this syndrome, which typically includes muscle rigidity and autonomic dysfunction. Choice D (agranulocytosis) is incorrect because it presents with low white blood cell count and not the symptoms described in the scenario.
Which statement by a parent of a teen with anorexia nervosa suggests a need for further education?
- A. I will make sure my teen eats three meals a day.
- B. It is important to monitor my teen's weight regularly.
- C. I should encourage my teen to keep a food journal.
- D. I should allow my teen to skip meals if she feels full.
Correct Answer: D
Rationale: The correct answer is D because allowing the teen to skip meals if she feels full can reinforce unhealthy eating behaviors associated with anorexia nervosa. This statement contradicts the essential goal of promoting regular and adequate meal intake to support recovery. Encouraging the teen to eat when not hungry may be necessary to restore normal eating patterns. Choices A, B, and C align with supporting the teen's nutritional needs and recovery process.
According to the map showing deaths resulting from poor air quality worldwide, which regions of the world have the poorest air quality?
- A. Brazil
- B. China
- C. Canada
- D. Australia
Correct Answer: B
Rationale: China has some of the poorest air quality globally due to industrial pollution and urbanization, as shown in air quality death maps.