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A child, aged 11 years, stays home from school to care for his siblings while his mother works, because the family cannot afford a babysitter. The home is cluttered and dirty. When asked about his parents, the child reluctantly reveals that he thinks his father does not like him very much because he calls him 'stupid' and says he can never do anything right. This should be assessed as:
- A. physical abuse.
- B. sexual abuse.
- C. emotional abuse.
- D. economic abuse.
Correct Answer: C
Rationale: Explanation:
C: Emotional abuse is the correct assessment as the father's behavior of calling the child 'stupid' and criticizing him can cause psychological harm. This behavior undermines the child's self-esteem and mental well-being. The child's reluctance to speak about his parents also indicates emotional distress.
Incorrect choices:
A: Physical abuse involves causing physical harm, which is not evident in the scenario.
B: Sexual abuse involves inappropriate sexual behavior, which is not indicated in the scenario.
D: Economic abuse involves financial control or exploitation, which is not the primary issue in this scenario.
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The nurse is caring for a patient with anorexia nervosa. Which intervention is a priority?
- A. Establish a no-contact rule with the patient's family.
- B. Monitor the patient's food intake and weight closely.
- C. Encourage the patient to exercise to improve health.
- D. Focus primarily on addressing the patient's body image issues.
Correct Answer: B
Rationale: The correct answer is B because monitoring food intake and weight closely is crucial in managing anorexia nervosa to prevent further complications like malnutrition and dehydration. By closely monitoring these factors, the nurse can ensure the patient is receiving adequate nutrition and is not losing weight rapidly. Establishing a no-contact rule with the family (A) could hinder the patient's support system. Encouraging exercise (C) may worsen excessive calorie expenditure. Focusing on body image (D) is important but addressing immediate health risks takes precedence.
A 17-year-old patient with anorexia nervosa has just been released from the hospital. To facilitate recovery at home, the psychiatric-mental health nurse instructs the family to:
- A. discourage the patient from sneaking food between meals, by unobtrusively reducing access to the kitchen
- B. encourage the patient's interest in menu planning, food magazines, and cooking lessons, by leaving information and materials around the house
- C. permit the patient to eat her meals privately to discourage family preoccupation with meals
- D. recommend that the patient joins in routine family meals and clears the dishes after dinner, even if they do not eat
Correct Answer: D
Rationale: Involving the patient in family meals normalizes eating behavior and provides structure, supporting recovery without enabling secrecy or avoidance.
Which statement by a patient with an eating disorder reflects a correct understanding of the condition?
- A. Gaining 1 pound is as much of a disaster as gaining 100 pounds.
- B. I was happy when I was a size 4, so I must diet to that size.
- C. I've been coping with my feelings by overeating.
- D. Binging is the only way I can soothe myself.
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the emotional aspect of eating disorders. Coping with feelings by overeating indicates insight into using food to manage emotions, a common characteristic of eating disorders. This understanding is crucial for addressing the underlying issues contributing to the disorder.
A: Incorrect. This statement suggests an extreme and distorted view of weight gain, which is not reflective of a healthy understanding of an eating disorder.
B: Incorrect. This statement implies a fixation on a specific size for happiness, which may perpetuate disordered eating behaviors.
D: Incorrect. This statement indicates reliance on binging as the sole coping mechanism, overlooking the emotional aspect of the disorder.
What is the most appropriate intervention for a patient with bulimia nervosa who is refusing to eat?
- A. Encourage the patient to eat small, frequent meals without pressure.
- B. Force the patient to eat larger meals to prevent further weight loss.
- C. Allow the patient to skip meals to avoid feeling overwhelmed.
- D. Focus only on addressing the patient's mental health concerns, not eating habits.
Correct Answer: A
Rationale: The correct answer is A because encouraging the patient to eat small, frequent meals without pressure promotes a balanced approach to eating. This intervention helps to establish a regular eating pattern and prevents episodes of binge-eating. It also respects the patient's autonomy and can help build trust between the patient and healthcare provider.
Choice B is incorrect because forcing the patient to eat larger meals can lead to increased anxiety and resistance, worsening the eating disorder. Choice C is incorrect as allowing the patient to skip meals can perpetuate unhealthy behaviors and reinforce the cycle of restriction and bingeing. Choice D is incorrect because neglecting the patient's eating habits can overlook a crucial aspect of their overall well-being and exacerbate the eating disorder.
Which symptom reported by a client, age 35, who was sexually abused as a child reflects the diagnosis of posttraumatic stress disorder (PTSD)?
- A. Reexperiencing the traumatic event
- B. Refusing to go to public places from which escape may be difficult
- C. Seeking advice and guidance prior to making any significant decision
- D. Ruminating over the abuse with friends and acquaintances
Correct Answer: A
Rationale: The correct answer is A: Reexperiencing the traumatic event. This symptom is a key criterion for diagnosing PTSD according to the DSM-5. It includes flashbacks, nightmares, or intrusive thoughts related to the traumatic event. This symptom indicates that the client is experiencing distressing memories of the past abuse, which is a common feature of PTSD.
Choice B is incorrect because it describes agoraphobia, a separate anxiety disorder, not specific to PTSD. Choice C is incorrect as seeking advice is not a diagnostic criterion for PTSD. Choice D is incorrect because ruminating over the abuse with others may reflect coping mechanisms or seeking support, but it does not necessarily indicate PTSD.