Population Based Health Care

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A client who was treated for anorexia nervosa is seen by the therapist for a follow-up visit 1 month after discharge from the hospital. Which statement indicates that the client has met the goal 'Demonstrate improvement in body image with more realistic view of body shape and size?'

  • A. When I go shopping, I always select clothes that are several sizes too large for me.'
  • B. My boyfriend says I really look good now that I'm out of the hospital.'
  • C. I had my class picture taken, and I think it looks really good.'
  • D. My mother bought me a whole new wardrobe since I've been home.'
Correct Answer: C

Rationale: The correct answer is C because the client's statement reflects a positive and self-affirming perception of themselves. By stating that they think their class picture looks really good, it shows an improvement in body image and a more realistic view of their body shape and size. This indicates progress towards the goal of developing a healthier self-perception.

Choice A is incorrect because selecting clothes that are several sizes too large may still indicate body image distortion and dissatisfaction. Choice B is incorrect because relying on external validation from a boyfriend does not necessarily reflect an internalized improvement in body image. Choice D is incorrect as the mother buying a new wardrobe does not directly address the client's perception of their body image or shape.

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A patient diagnosed with schizophrenia tells the community mental health nurse, 'I threw away my pills because they interfere with Gods voice.' The nurse identifies the etiology of the patients ineffective management of the medication regime as:

  • A. inadequate discharge planning
  • B. poor therapeutic alliance with clinicians
  • C. dislike of antipsychotic medication side effects
  • D. impaired reasoning secondary to the schizophrenia
Correct Answer: D

Rationale: The patients ineffective management of the medication regime is most closely related to impaired reasoning. The patient believes in being an exalted personage who hears Gods voice, rather than an individual with a serious mental disorder who needs medication to control symptoms. Data do not suggest any of the other factors often related to medication nonadherence.

A severely depressed patient with psychomotor retardation has begun activities therapy. His schedule is: 9 AM, ceramics; 10 AM, exercise group; 11 AM to noon, open; noon, lunch. The nurse creating the patient's schedule should opt to fill the hour block from 11 AM to noon with:

  • A. Group therapy.
  • B. A rest period.
  • C. Reminiscence group.
  • D. Individual counseling.
Correct Answer: B

Rationale: The correct answer is B: A rest period. Providing a rest period during the hour block from 11 AM to noon is crucial for a severely depressed patient with psychomotor retardation. This patient may experience fatigue and decreased energy levels due to their condition. Allowing for a rest period can help prevent overstimulation and promote relaxation, which is essential for mental well-being. Group therapy (choice A) may be too overwhelming for the patient at this time. Reminiscence group (choice C) may not be as beneficial for immediate symptom management. Individual counseling (choice D) may be helpful but may not align with the patient's immediate need for rest and relaxation.

A 5-year-old boy is diagnosed in the Emergency Department as having measles, the first symptoms having started 2 days previously. He has a 2-year-old sister, who has received the recommended immunisation schedule. Which one of the following is the most appropriate treatment?

  • A. Treat him symptomatically and send him home.
  • B. Refer him to the infectious diseases hospital.
  • C. Give him gamma globulin.
  • D. Give gamma goblin to the sister.
Correct Answer: A

Rationale: Measles is managed symptomatically at home (A) unless complications arise. The vaccinated sister is protected, so hospitalization (B), gamma globulin (C, D), or premature reassurance (E) are unnecessary.

Which of the following is a common physical sign of anorexia nervosa?

  • A. Hypoglycemia and tachycardia.
  • B. Severe weight loss and dry skin.
  • C. Increased appetite and excessive weight gain.
  • D. High blood pressure and rapid heart rate.
Correct Answer: B

Rationale: The correct answer is B: Severe weight loss and dry skin. In anorexia nervosa, individuals typically experience significant weight loss due to severe restriction of food intake. This leads to a low body weight, which is a key physical sign of the disorder. Dry skin is also common in anorexia nervosa due to malnutrition.

Rationale:
A: Hypoglycemia and tachycardia are not specific physical signs of anorexia nervosa. While tachycardia (rapid heart rate) can occur due to the stress on the body, it is not as specific as severe weight loss.
C: Increased appetite and excessive weight gain are not characteristic of anorexia nervosa, as individuals with this disorder typically have a distorted body image and fear gaining weight.
D: High blood pressure and rapid heart rate are not typical physical signs of anorexia nervosa. Anorexia nervosa is more commonly associated with low blood pressure due to mal

An older adult patient was diagnosed with schizophrenia at age 18. A nurse at the outpatient medication clinic interviews this patient. Which communication strategy will be most helpful?

  • A. Ask questions that can be answered with yes or no.
  • B. Ask clear, simple questions using concrete language.
  • C. Use silence often and let the patient take the lead.
  • D. Use open-ended, indirect questions.
Correct Answer: B

Rationale: Communication with individuals who have schizophrenia might be difficult because of their various thought disorders. The nurse can be most effective by using simple language, keeping to concrete concepts, and clarifying and validating as needed (B). Yes/no questions (A) limit information, silence (C) may not engage, and open-ended questions (D) may confuse.

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