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A client who has been diagnosed as having bulimia nervosa is hospitalized for treatment of electrolyte imbalance. Just before lunch is finished, the client leaves the table and walks quickly in the direction of the bathroom. The nurse should say:
- A. No one is allowed to leave the dining room during meals.'
- B. I must accompany you when you go to the bathroom.'
- C. I think I understand your plan, and I cannot permit you to carry it out.'
- D. Wouldn't it be preferable to exercise rather than vomit?'
Correct Answer: B
Rationale: The correct answer is B because accompanying the client to the bathroom is essential to prevent purging behavior associated with bulimia nervosa. By doing so, the nurse can provide support, monitor the client, and intervene if necessary to ensure the client's safety. Choice A is incorrect as it may come across as punitive and restrictive. Choice C is incorrect as it may escalate the situation and lead to confrontation. Choice D is incorrect as it suggests an alternative behavior without addressing the immediate concern of potential purging. Accompanying the client to the bathroom is the most appropriate and therapeutic response in this situation.
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Which outcome is realistic for a client with stage 1 Alzheimer's disease?
- A. Appropriate long-term placement will be arranged to maintain caregiver's health and well-being.
- B. The client will maintain the highest possible functional level within his or her capacity.
- C. All day-to-day decisions will be made by the caregiver to relieve client of stress.
- D. The client will remain fully functional physically, since Alzheimer's affects only the brain.
Correct Answer: B
Rationale: The correct answer is B because in stage 1 Alzheimer's, individuals can still maintain a relatively high level of functionality. This is because in the early stages, the cognitive decline is mild and individuals can still perform daily tasks independently. It is important to focus on maximizing the client's functional abilities through cognitive exercises and support services.
Choice A is incorrect because long-term placement may not be necessary in stage 1 and should only be considered if the caregiver's health is at risk. Choice C is incorrect because individuals with Alzheimer's should be encouraged to make decisions to maintain their sense of autonomy. Choice D is incorrect because Alzheimer's is a progressive disease that affects both cognitive and physical functions over time.
A patient diagnosed with dementia associated with excessive alcohol use tells a nurse, "Last week I had to take my baby to the hospital for major surgery. That's why I've been so nervous and needed to come here."Â The nurse is aware that the patient has never parented any children. The symptom described can be assessed as:
- A. akathisia.
- B. confabulation.
- C. intellectualization.
- D. magical thinking.
Correct Answer: B
Rationale: The correct answer is B: confabulation. Confabulation is the production of fabricated or distorted memories without the conscious intention to deceive. In this case, the patient is creating a false memory about having a baby and needing to take it to the hospital, which is not based on reality. Akathisia (A) is a movement disorder associated with restlessness, not memory distortion. Intellectualization (C) is a defense mechanism involving excessive focus on facts to avoid uncomfortable emotions, not memory fabrication. Magical thinking (D) involves believing that one's thoughts can influence events, not creating false memories.
Sleep disorders that are characterized by abnormal behavioral or physical events during sleep are called:
- A. insomnia.
- B. dyssomnias.
- C. hypersomnia.
- D. parasomnias.
Correct Answer: D
Rationale: The correct answer is D: parasomnias. Parasomnias are sleep disorders involving abnormal behaviors or physical events during sleep, such as sleepwalking or night terrors. This is the correct choice because it specifically addresses the description provided in the question.
A: Insomnia is characterized by difficulty falling or staying asleep, not abnormal behaviors during sleep.
B: Dyssomnias are a broad category of sleep disorders affecting the timing, quality, or amount of sleep, not necessarily involving abnormal behaviors during sleep.
C: Hypersomnia is a sleep disorder characterized by excessive daytime sleepiness, not abnormal behaviors during sleep.
In summary, the other choices do not align with the description of sleep disorders involving abnormal behavioral or physical events during sleep, making D the correct answer.
The highest priority for assessment by nurses caring for older adults who self-administer medications is:
- A. use of multiple drugs with anticholinergic effects.
- B. overuse of medications for erectile dysfunction.
- C. missed doses of medications for arthritis.
- D. trading medications with acquaintances.
Correct Answer: A
Rationale: Anticholinergic effects are cumulative in older adults and often have adverse consequences related to accidents and injuries (A), making it the highest priority. The other issues (B, C, D) may be relevant but are less critical.
What is the priority nursing intervention for a patient with bulimia nervosa who is engaging in purging behaviors?
- A. Monitor electrolyte levels and cardiac function.
- B. Encourage self-monitoring of food intake.
- C. Provide emotional support and promote body image acceptance.
- D. Focus on encouraging weight loss through diet control.
Correct Answer: A
Rationale: The correct answer is A. The priority nursing intervention for a patient with bulimia nervosa engaging in purging behaviors is to monitor electrolyte levels and cardiac function. This is crucial due to the potential electrolyte imbalances and cardiac complications resulting from purging behaviors. Monitoring these parameters helps prevent life-threatening conditions such as hypokalemia and arrhythmias.
Option B is incorrect as self-monitoring of food intake may not address the immediate health risks associated with purging behaviors. Option C is also incorrect as emotional support and body image acceptance are important but not the immediate priority in this case. Option D is incorrect as focusing on weight loss through diet control can exacerbate the patient's eating disorder behaviors and does not address the urgent medical concerns associated with purging.