Age Specific Care Competency

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A client being treated for anorexia nervosa is 5 feet 10 inches tall and weighs 100 pounds. The client believes she is overweight. On the days the client is scheduled to be weighed, the nurse should be prepared for the client to:

  • A. eagerly ask for information about her present weight.
  • B. dress in several layers of clothing.
  • C. suggest that the scale numbers be hidden from her view.
  • D. remind the nurse that she is ready to be weighed.
Correct Answer: B

Rationale: Correct Answer: B - Dress in several layers of clothing.

Rationale: An individual with anorexia nervosa often engages in behaviors to manipulate their weight, such as wearing heavy clothing to increase their weight on the scale. This behavior is a result of distorted body image and fear of gaining weight. By dressing in several layers of clothing, the client may attempt to influence the scale reading to align with their perceived body image.

Summary of other choices:
A: Eagerly asking for information about her present weight is unlikely as individuals with anorexia nervosa typically avoid discussions or confrontations related to their weight.
C: Suggesting that the scale numbers be hidden is not as likely as the client may want to see the numbers to validate their belief of being overweight.
D: Reminding the nurse that she is ready to be weighed may occur, but it does not address the behavior of dressing in layers to manipulate weight.

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The nurse is interviewing a client who presents with a dislocated shoulder. She demonstrates signs of anxiety and poor eye contact and turns to her partner for answers, allowing him to answer for her. Bruises on her breast and upper arm are visible. The nurse asks the partner to go to the admitting office to give insurance information. While the partner is out of the room, which question is most important to ask?

  • A. Have you been with your partner long?'
  • B. Have you ever been physically or emotionally hurt by someone?'
  • C. Are you an abused woman?'
  • D. Shall I notify the police that you would like to press charges?'
Correct Answer: B

Rationale: The correct answer is B: "Have you ever been physically or emotionally hurt by someone?" This question is important as it directly addresses the potential abuse the client may be experiencing. It allows the nurse to assess for any history of abuse, which could be contributing to the client's anxiety and behavior. It also opens up an opportunity for the client to disclose any abuse they may be facing.

Choice A is incorrect because the length of the relationship with the partner is not as crucial as addressing the potential abuse. Choice C is also incorrect because it is too direct and may not encourage the client to open up about their experiences. Choice D is incorrect as it assumes the client wants to press charges without first assessing the situation and the client's wishes.

A student transfers from a hometown college to a university 200 miles away after breaking up with her boyfriend of 2 years. She was slow to make friends at the university. The history shows a close relationship with her mother and sister. She began eating large quantities when she felt sad, and then she induced vomiting. When the student's schoolwork declined, she sought help. During the initial interview, what priority issue should the nurse address?

  • A. Losses.
  • B. Sleep patterns.
  • C. School activities.
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A: Losses. The priority issue the nurse should address is the student's losses, such as the breakup with her boyfriend and the difficulty in making friends at the new university. This is important because these losses may be contributing to her emotional distress and maladaptive coping mechanisms like binge-eating and induced vomiting. The nurse needs to explore these losses to understand the root cause of the student's behavior and provide appropriate support.

Choice B: Sleep patterns, and Choice C: School activities are not the priority issues in this scenario. While sleep patterns and school activities are important aspects of the student's life, the primary concern here is addressing the emotional impact of the losses she has experienced.

Choice D: None of the above is incorrect because losses are indeed the priority issue that needs to be addressed in this situation. Ignoring the emotional impact of the student's losses could hinder the effectiveness of any interventions or support provided.

Which of the following is characteristic of a dissociative disorder?

  • A. phobic disorder
  • B. amnesia
  • C. paranoia
  • D. depression
Correct Answer: B

Rationale: Dissociative disorders feature disruptions like amnesia, distinguishing them from phobias or paranoia.

A delusion is defined as seeing something that is not real

  • A. TRUE
  • B. FALSE
Correct Answer: B

Rationale: A delusion is a fixed false belief, not a perception (hallucination involves seeing/hearing something not real).

A patient has acute anxiety related to an automobile accident 2 hours ago. The patient needs teaching about drugs from which group?

  • A. Tricyclic antidepressants
  • B. Antipsychotic drugs
  • C. Antimanic drugs
  • D. Benzodiazepines
Correct Answer: D

Rationale: The correct answer is D: Benzodiazepines. Benzodiazepines are commonly used in the treatment of acute anxiety due to their rapid onset of action and effectiveness in managing symptoms such as panic attacks. They work by enhancing the inhibitory neurotransmitter GABA, leading to sedative and anxiolytic effects. Tricyclic antidepressants (Choice A) are not the first-line treatment for acute anxiety. Antipsychotic drugs (Choice B) are primarily used for conditions such as schizophrenia and bipolar disorder, not acute anxiety. Antimanic drugs (Choice C) are used to manage symptoms of mania in conditions like bipolar disorder, not acute anxiety. Therefore, the correct choice is Benzodiazepines due to their rapid efficacy and established role in managing acute anxiety.

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