Nokea
A history reveals that a patient virtually stopped eating 5 months ago and lost 25% of body weight. The nurse says, 'Describe what you think about your present weight and how you look.' Which response would be most consistent with anorexia nervosa?
- A. I'm fat and ugly.'
- B. What I think about myself is my business.'
- C. I'm grossly underweight, but I cover it well.'
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A. This response is most consistent with anorexia nervosa because it reflects a distorted body image common in individuals with this condition. Anorexia nervosa is characterized by an intense fear of gaining weight and a distorted body image, leading to extreme weight loss and restrictive eating habits. Choice B suggests a lack of insight or denial, which is not typical of anorexia nervosa. Choice C acknowledges being underweight but does not reflect the negative body image associated with anorexia nervosa. Choice D is incorrect as option A aligns with the characteristic body image distortion seen in anorexia nervosa.
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Which measure is critical to achieving desired outcomes in the nurse-client relationship? The nurse:
- A. develops trust in the client.
- B. uses autodiagnosis.
- C. relies on the client liking the nurse rather than limit-setting to achieve structure.
- D. analyzes the relationships among biologic, familial, and sociocultural factors that contributed to the client's disorder.
Correct Answer: B
Rationale: The correct answer is B: uses autodiagnosis. Autodiagnosis is critical in the nurse-client relationship as it involves self-awareness and reflection by the nurse to understand their own biases, emotions, and reactions. This self-awareness allows the nurse to effectively manage their responses, maintain professionalism, and provide quality care to the client. By being aware of their own thoughts and feelings, nurses can better empathize with the client, build trust, and communicate effectively. This approach helps prevent potential conflicts and misunderstandings, leading to better outcomes in the nurse-client relationship.
Summary:
A: Developing trust in the client is important but not the most critical measure.
C: Relying on the client liking the nurse is not professional and may compromise boundaries.
D: Analyzing biologic, familial, and sociocultural factors is important but not as critical as self-awareness through autodiagnosis.
A 10-year-old boy presents with a history of central abdominal pain of a few hours' duration. On examination he has minimal tenderness in the right iliac fossa and no abnormal findings on rectal examination. Which of the following alternatives should be carried out?
- A. Arrange a barium meal follow through.
- B. Arrange to see the patient later on in the day for review.
- C. Send the patient away with instructions to return if the pain becomes worse.
- D. Tell the patient to come back in a week.
Correct Answer: B
Rationale: Early appendicitis can present subtly. Minimal right iliac fossa tenderness warrants observation, so reviewing later (B) is appropriate. Imaging (A), dismissal (C, D), or immediate surgery (E) without further assessment are not justified yet.
Which is a common physical finding in patients with bulimia nervosa?
- A. Low blood pressure and bradycardia.
- B. Hyperactivity and increased energy.
- C. Dental enamel erosion and swollen parotid glands.
- D. Constipation and abdominal bloating.
Correct Answer: C
Rationale: The correct answer is C, dental enamel erosion and swollen parotid glands, in patients with bulimia nervosa. This is due to frequent self-induced vomiting. Enamel erosion is caused by stomach acid exposure during vomiting. Swollen parotid glands result from repeated purging. Choices A, B, and D are incorrect because low blood pressure and bradycardia are more common in anorexia nervosa, hyperactivity and increased energy are not typical in bulimia nervosa, and constipation and abdominal bloating are not specific to this disorder.
An 11-year-old child stays home from school to care for his siblings while his mother works, is demeaned by his father, and has negative self-perceptions. Which intervention(s) would be appropriate? Select all that apply.
- A. Crisis intervention
- B. Create a safety plan.
- C. Refer to family therapy.
- D. Refer for case management.
Correct Answer: A
Rationale: The correct answer is A: Crisis intervention. This is appropriate because the child is experiencing multiple stressors that require immediate support. Crisis intervention focuses on providing immediate assistance to individuals in distress and can help address the child's current emotional and psychological needs.
Summary of other choices:
B: Creating a safety plan may be relevant if there are safety concerns, but it does not address the child's emotional well-being.
C: Referring to family therapy may be beneficial in addressing family dynamics, but it may not be the most urgent intervention in this case.
D: Referring for case management is important for coordinating services, but it may not provide the immediate emotional support needed in this situation.
A disorder that interrupts normal sleep patterns and is characterized by repeated, brief jerks of the arms and legs that occur every 20 to 60 seconds during the beginning of sleep is called:
- A. Insomnia.
- B. Narcolepsy.
- C. Hypersomnia.
- D. None of the above.
Correct Answer: D
Rationale: The correct answer is D: None of the above. The disorder described in the question is Periodic Limb Movement Disorder (PLMD), not any of the options provided. PLMD involves involuntary movements during sleep, which are different from the symptoms of insomnia, narcolepsy, or hypersomnia. Insomnia is difficulty falling or staying asleep, narcolepsy is a neurological disorder characterized by excessive daytime sleepiness, and hypersomnia is excessive daytime sleepiness despite getting enough sleep. Therefore, the correct answer is D as none of the provided options accurately describe the specific disorder mentioned in the question.