Population Specific Care

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A catatonic patient admitted in a stuporous condition begins to demonstrate increased motor activity. During his assessment, the psychiatrist raises the patient's arm above his head and releases it. The patient maintains the position his arm was placed in, immobile in that position for 15 minutes, moving only when the nurse gently lowers his arm. What symptom is demonstrated by this assessment technique?

  • A. Echopraxia
  • B. Waxy flexibility
  • C. Depersonalization
  • D. Thought withdrawal
Correct Answer: B

Rationale: The correct answer is B: Waxy flexibility. This symptom is demonstrated by the patient's ability to maintain the position his arm was placed in, immobile, for an extended period of time. This is characteristic of catatonia, where individuals exhibit increased motor activity and abnormal posturing. Waxy flexibility refers to the tendency of catatonic patients to maintain positions that they are placed in by others, almost as if their limbs are made of wax and can be molded into different positions.

Explanation for other choices:
A: Echopraxia involves mimicking the movements of others, which is not demonstrated in this scenario.
C: Depersonalization refers to feeling detached from oneself, which is not evident in the patient's behavior during the assessment.
D: Thought withdrawal is a symptom of schizophrenia where thoughts are believed to be removed from one's mind by an external force, which is not relevant to the patient's motor behavior in this case.

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A woman has been severely beaten by her husband, has no relatives or friends in the community, is afraid to return home, has no financial resources of her own, and has no job skills. Which would be the most important referral for the nurse to make?

  • A. Community food cupboard
  • B. Vocational counseling
  • C. Law enforcement
  • D. Safe house or shelter
Correct Answer: D

Rationale: The correct answer is D: Safe house or shelter. This option is the most important referral because the woman is in immediate danger and needs a safe place to stay away from her abusive husband. It prioritizes her safety and well-being. Referring her to a safe house can provide her with protection, resources, and support to help her escape the abusive situation.

Choice A (Community food cupboard) is incorrect as it does not address the woman's immediate safety needs. Choice B (Vocational counseling) is also not the most urgent referral in this situation as the woman's safety should be the priority. Choice C (Law enforcement) might be necessary in the long run, but the immediate concern is ensuring the woman's safety by referring her to a safe house or shelter.

An adult diagnosed with a serious mental illness says, I do not need help with money management. I have excellent ideas about investments. This patient usually does not have money to buy groceries by the middle of the month. The nurse assesses the patient as demonstrating:

  • A. rationalization.
  • B. identification.
  • C. anosognosia.
  • D. projection.
Correct Answer: C

Rationale: The patient shows anosognosia (C), an inability to recognize deficits due to illness, believing in their financial acumen despite evidence. This isn't rationalization (A), identification (B), or projection (D).

A nurse is assessing a patient with anorexia nervosa. Which of the following findings would be a priority for intervention?

  • A. Weight loss of 2 pounds over the past week.
  • B. Denial of the need for nutrition rehabilitation.
  • C. Body image disturbance and self-imposed starvation.
  • D. Refusal to participate in social activities.
Correct Answer: C

Rationale: The correct answer is C: Body image disturbance and self-imposed starvation. This is a priority because it directly addresses the core issues of anorexia nervosa and poses immediate risks to the patient's health. Body image disturbance contributes to the patient's self-imposed starvation, which can lead to severe malnutrition and other serious complications. Addressing this issue is crucial for the patient's well-being.

A: Weight loss of 2 pounds over the past week is concerning but may not be an immediate priority compared to addressing the underlying psychological issues.
B: Denial of the need for nutrition rehabilitation is important to address but may not pose an immediate threat to the patient's health compared to self-imposed starvation.
D: Refusal to participate in social activities may be a consequence of anorexia nervosa but does not directly address the urgent need to address body image disturbance and self-imposed starvation.

Which is the most appropriate initial goal for a nurse when attempting to overcome personal negative attitudes about a patient who has a history of returning to an abusive spouse?

  • A. Exploring own attitudes and values toward survivors of violence
  • B. Identifying the dysfunctional behaviors exhibited by the violent family
  • C. Concentrating on identifying any possible personal abusive relationships
  • D. Attending seminars on the psychological impact of being the victim of abuse
Correct Answer: A

Rationale: The correct answer is A because exploring one's own attitudes and values towards survivors of violence is crucial in overcoming personal negative attitudes. By reflecting on personal biases, the nurse can gain self-awareness and empathy, enabling better care for the patient. Choice B is incorrect as it focuses on the abuser's behaviors, not the nurse's attitudes. Choice C is incorrect as it shifts the focus to the nurse's personal relationships. Choice D is incorrect as attending seminars does not directly address the nurse's personal attitudes.

What is the most important goal for a nurse when providing care for a patient with bulimia nervosa?

  • A. To promote weight loss through strict dietary control.
  • B. To help the patient eliminate purging behaviors and develop healthy eating habits.
  • C. To encourage excessive exercise to balance caloric intake.
  • D. To focus solely on addressing body image issues.
Correct Answer: B

Rationale: The correct answer is B: To help the patient eliminate purging behaviors and develop healthy eating habits. This goal is important because it addresses the core issues of bulimia nervosa, which are unhealthy purging behaviors and distorted eating patterns. By helping the patient stop purging and establish healthy eating habits, the nurse can promote long-term recovery and overall well-being.

Choice A is incorrect because promoting weight loss through strict dietary control can exacerbate the patient's unhealthy relationship with food and body image. Choice C is incorrect as encouraging excessive exercise can contribute to a cycle of compulsive behaviors and worsen the patient's physical and mental health. Choice D is incorrect because focusing solely on body image issues neglects the underlying psychological factors contributing to bulimia nervosa.

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