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A nurse and social worker co-lead a reminiscence group for eight young-old adults. Which activity is most appropriate to include in the group?
- A. Mild aerobic exercise
- B. Singing a song from World War II
- C. Discussing national leadership during the Vietnam War
- D. Identifying the most troubling story in today's newspaper
Correct Answer: C
Rationale: The correct answer is C. Discussing national leadership during the Vietnam War is most appropriate as it aligns with the reminiscence therapy goal of recalling past experiences to promote social interaction and cognitive stimulation. It is relevant to the age group of young-old adults who may have lived through that era, sparking meaningful discussions. Choice A does not directly relate to reminiscence therapy. Choice B may not resonate with all group members. Choice D focuses on negative news, which is not conducive to the therapeutic purpose.
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A patient with borderline personality disorder cut her wrists while out on a pass. For future planning, staff should consider that the reason for the self-mutilation is probably related to:
- A. an inherited disorder that manifests itself as an incapacity to tolerate stress.
- B. fear of abandonment associated with relationships or increasing autonomy.
- C. use of projective identification and splitting to bring anxiety to manageable levels.
- D. a constitutional inability to regulate affect, predisposing to psychic disorganization.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Borderline personality disorder is characterized by fear of abandonment.
2. Self-mutilation can be a maladaptive coping mechanism to alleviate this fear.
3. The behavior is often triggered by perceived threats to relationships or autonomy.
4. Therefore, considering fear of abandonment in future planning is crucial.
Summary of other choices:
A: Inherited disorder is not the primary reason for self-mutilation in borderline personality disorder.
C: Projective identification and splitting are defense mechanisms, not primary reasons for self-mutilation.
D: Constitutional inability to regulate affect may contribute, but fear of abandonment is more central in borderline personality disorder.
The nurse caring for a school-age child who has been sexually abused by a close family member realizes that the child may resist disclosing the experience of being sexually abused because the child:
- A. Realizes that repeated questioning by others will occur
- B. Fears being blamed or disbelieved
- C. Fears becoming an object of pity at school
- D. Is embarrassed about facing family members
Correct Answer: B
Rationale: The correct answer is B: Fears being blamed or disbelieved. This is because children who have been sexually abused often fear that they will not be believed or may be blamed for what happened. This fear can prevent them from disclosing the abuse. Choice A is incorrect because repeated questioning may not be the primary reason for the child's resistance. Choice C is incorrect because the child's fear of being pitied at school is not typically a main concern when disclosing sexual abuse. Choice D is incorrect because embarrassment about facing family members may be a factor, but the fear of blame or disbelief is usually a more significant barrier to disclosure in cases of sexual abuse.
Trends that have contributed to the recent increase in eating disorders in the United States include a(n):
- A. more competitive workplace.
- B. increase in the number of divorces.
- C. focus on being thin as a measure of attractiveness.
- D. increase in the number of nonnutritional foods consumed.
Correct Answer: C
Rationale: The correct answer is C: focus on being thin as a measure of attractiveness. This is because societal pressures and media influence have placed a strong emphasis on thinness as the ideal body type, leading to increased body dissatisfaction and disordered eating behaviors. Option A (more competitive workplace) and B (increase in the number of divorces) are not directly linked to eating disorders, while option D (increase in the number of nonnutritional foods consumed) may contribute to health issues but not specifically to eating disorders. In conclusion, the societal focus on thinness has a significant impact on the rise of eating disorders in the United States.
An individual is seeking treatment for bulimia nervosa. The therapist decides to use cognitive behavioral therapy and medication. For what medication can a nurse expect to develop a patient education program?
- A. A selective serotonin reuptake inhibitor (SSRI).
- B. Lithium.
- C. Acamprosate.
- D. A benzodiazepine.
Correct Answer: A
Rationale: The correct answer is A: A selective serotonin reuptake inhibitor (SSRI). SSRIs are commonly used in treating bulimia nervosa due to their effectiveness in reducing binge eating and purging behaviors. They work by increasing serotonin levels in the brain, which helps regulate mood and appetite control. A nurse would develop a patient education program for SSRIs to explain their mechanism of action, potential side effects, how to take them correctly, and the importance of compliance.
Summary:
- Lithium is not typically used for bulimia nervosa and is more commonly used for bipolar disorder.
- Acamprosate is used for alcohol dependence, not bulimia nervosa.
- Benzodiazepines are not indicated for bulimia nervosa and are typically used for anxiety disorders or insomnia.
In most anxiety disorders, the person's distress is
- A. focused on a specific situation
- B. related to ordinary life stresses
- C. greatly out of proportion to the situation
- D. based on a physical cause
Correct Answer: C
Rationale: Anxiety disorders feature exaggerated distress disproportionate to the trigger, unlike normal stress.