Nokea
A client with schizophrenia tells the nurse that he is the President of the United States, and no logical reasoning with the client convinces him otherwise. This client is experiencing a:
- A. Mutism
- B. Delusion
- C. Neologism
- D. Flight of ideas
Correct Answer: B
Rationale: The correct answer is B: Delusion. A delusion is a fixed false belief that is not based on reality, such as believing one is a famous figure like the President. In this scenario, the client's belief is firmly held despite evidence to the contrary, indicating a delusion. Mutism (A) is a lack of verbal communication, not applicable here. Neologism (C) is creating new words or phrases, not seen in this example. Flight of ideas (D) is a rapid, continuous flow of speech with abrupt topic changes, which is not demonstrated in the client's behavior described.
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Which complication is most likely in a patient with bulimia nervosa who purges frequently?
- A. Dehydration and electrolyte imbalances.
- B. Increased appetite and weight gain.
- C. Improved digestion and nutrient absorption.
- D. High blood pressure and rapid heart rate.
Correct Answer: A
Rationale: The correct answer is A: Dehydration and electrolyte imbalances. Purging in bulimia nervosa involves self-induced vomiting or misuse of laxatives, leading to fluid and electrolyte loss. This can result in dehydration, electrolyte imbalances, and potentially life-threatening complications like cardiac arrhythmias. Increased appetite and weight gain (B) are less likely due to purging. Improved digestion and nutrient absorption (C) are not associated with frequent purging. High blood pressure and rapid heart rate (D) may occur in severe cases but are not the most likely complication.
An older adult patient who lives with a daughter and attends the Alzheimer day hospital program exhibits bilateral bruising for the second time on both upper outer arms. When the nurse questions the patient about the bruising, the patient starts to cry and pleads, 'Please don't say anything. It's not my daughter's fault. I just bruise easily.' Which intervention reflects the best management of this situation?
- A. Call the daughter to discuss both the bruising and her parent's reaction.
- B. Report the elder abuse, and inform the patient and the daughter of your intention.
- C. Notify the patient's social worker of the bruising after a complete assessment has been completed.
- D. Inform the patient and the daughter of your intention to document the bruising and arrange for appropriate counseling.
Correct Answer: B
Rationale: The correct answer is B: Report the elder abuse and inform the patient and the daughter of your intention. This is the best intervention as it prioritizes the safety and well-being of the older adult. Here's the rationale:
1. The patient's repeated bruising and fear of disclosure indicate potential abuse.
2. Reporting elder abuse is mandatory to ensure protection for the patient.
3. Informing the patient and daughter shows transparency and involves them in the process.
4. It is crucial to address the situation promptly to prevent further harm.
Summary:
A: Calling the daughter may escalate the situation and compromise the patient's safety.
C: Notifying the social worker without addressing the abuse directly may delay necessary action.
D: Counseling may be beneficial, but addressing the abuse is a priority to ensure the patient's safety.
Which characteristic fits the usual profile of an individual diagnosed with pedophilic disorder?
- A. Homosexual
- B. Ritualistic behaviors
- C. Seeks access to children
- D. Self-confident professional
Correct Answer: C
Rationale: The correct answer is C because an individual diagnosed with pedophilic disorder typically seeks access to children for sexual purposes. This behavior is a key characteristic of pedophilia. Homosexuality (A) is not a defining factor in pedophilic disorder. Ritualistic behaviors (B) are not specific to pedophilia but may be present in some cases. Being a self-confident professional (D) does not correlate with pedophilic tendencies. In summary, seeking access to children (C) aligns with the diagnostic criteria for pedophilic disorder, making it the most fitting characteristic.
A nurse is planning care for a patient with bulimia nervosa. Which goal should be included in the care plan?
- A. The patient will engage in daily exercise to prevent weight gain.
- B. The patient will maintain a healthy, balanced diet without purging behaviors.
- C. The patient will gain 1-2 pounds per week.
- D. The patient will eliminate binge eating and purging behaviors entirely.
Correct Answer: B
Rationale: Step-by-step rationale:
1. Maintaining a healthy, balanced diet without purging behaviors is crucial for managing bulimia nervosa.
2. This goal promotes physical health and addresses the underlying disordered eating habits.
3. It focuses on establishing sustainable eating patterns to support overall well-being.
4. It helps prevent complications associated with bulimia, such as electrolyte imbalances.
Summary:
- Option A is incorrect as excessive exercise can be a compensatory behavior in eating disorders.
- Option C is incorrect as rapid weight gain is not recommended in the treatment of bulimia.
- Option D is incorrect as complete elimination of binge eating and purging may be unrealistic initially.
A nurse has recently been assigned to a unit that specializes in the care of patients diagnosed with eating disorders. The nurse should consider which of the following actions as having priority when preparing for this new assignment?
- A. Becoming familiar with the unit's policies and procedures.
- B. Arranging to mentor with a nurse who has experience on the unit.
- C. Self-reflecting on personal feelings regarding body weight and size.
- D. Attending an educational seminar that focuses on maladaptive eating disorders.
Correct Answer: C
Rationale: The correct answer is C. Self-reflecting on personal feelings regarding body weight and size is crucial for the nurse to be aware of any biases or triggers that may affect patient care. Understanding personal attitudes towards body image can prevent unintentional harm or judgment towards patients.
A: Becoming familiar with the unit's policies and procedures is important but not the top priority when dealing with patients with eating disorders.
B: Arranging to mentor with a nurse who has experience on the unit can be helpful but does not address the nurse's personal biases.
D: Attending an educational seminar is valuable but may not address the nurse's own attitudes towards body image.