Population Specific Care

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A nurse is assessing a patient with anorexia nervosa. Which of the following findings would be a priority for intervention?

  • A. Weight loss of 2 pounds over the past week.
  • B. Denial of the need for nutrition rehabilitation.
  • C. Body image disturbance and self-imposed starvation.
  • D. Refusal to participate in social activities.
Correct Answer: C

Rationale: The correct answer is C: Body image disturbance and self-imposed starvation. This is a priority because it directly addresses the core issues of anorexia nervosa and poses immediate risks to the patient's health. Body image disturbance contributes to the patient's self-imposed starvation, which can lead to severe malnutrition and other serious complications. Addressing this issue is crucial for the patient's well-being.

A: Weight loss of 2 pounds over the past week is concerning but may not be an immediate priority compared to addressing the underlying psychological issues.
B: Denial of the need for nutrition rehabilitation is important to address but may not pose an immediate threat to the patient's health compared to self-imposed starvation.
D: Refusal to participate in social activities may be a consequence of anorexia nervosa but does not directly address the urgent need to address body image disturbance and self-imposed starvation.

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Schizophrenia is usually diagnosed in:

  • A. Infancy
  • B. Childhood
  • C. Early adulthood
  • D. Old age
Correct Answer: C

Rationale: Schizophrenia typically emerges in early adulthood (late teens to early 20s), though symptoms may appear earlier or later in rare cases.

A woman has been severely beaten by her husband, has no relatives or friends in the community, is afraid to return home, has no financial resources of her own, and has no job skills. Which would be the most important referral for the nurse to make?

  • A. Community food cupboard
  • B. Vocational counseling
  • C. Law enforcement
  • D. Safe house or shelter
Correct Answer: D

Rationale: The correct answer is D: Safe house or shelter. This option is the most important referral because the woman is in immediate danger and needs a safe place to stay away from her abusive husband. It prioritizes her safety and well-being. Referring her to a safe house can provide her with protection, resources, and support to help her escape the abusive situation.

Choice A (Community food cupboard) is incorrect as it does not address the woman's immediate safety needs. Choice B (Vocational counseling) is also not the most urgent referral in this situation as the woman's safety should be the priority. Choice C (Law enforcement) might be necessary in the long run, but the immediate concern is ensuring the woman's safety by referring her to a safe house or shelter.

What is an appropriate goal for a nurse when working with a patient who has anorexia nervosa?

  • A. The patient will achieve rapid weight gain and improve self-esteem.
  • B. The patient will restore nutritional balance through safe weight gain.
  • C. The patient will accept their body image without therapeutic intervention.
  • D. The patient will maintain a healthy weight without any professional assistance.
Correct Answer: B

Rationale: The correct answer is B because restoring nutritional balance through safe weight gain is a realistic and appropriate goal for a nurse working with a patient with anorexia nervosa. This goal focuses on the patient's physical health and addresses the underlying issue of malnutrition. Rapid weight gain (A) may be dangerous and unsustainable. Accepting body image without intervention (C) ignores the severity of the disorder. Maintaining a healthy weight without professional assistance (D) is unlikely for someone with anorexia nervosa who requires specialized care.

A new nurse asks, 'My elderly patient has Lewy body disease. What should I do about assessing for pain?' Select the best response from the nurse manager.

  • A. Ask the patients family if they think the patient is experiencing pain.'
  • B. Use a visual analog scale to help the patient determine the presence and severity of pain.'
  • C. There are special scales for assessing patients with dementia. Lets review how to use them.'
  • D. The perception of pain is diminished by this type of dementia. Focus your assessment on the patients mental status.'
Correct Answer: C

Rationale: Lewy body disease is a form of dementia. There are special scales to assess the presence and severity of pain in patients with dementia. The Pain Assessment in Advanced Dementia Scale evaluates breathing, negative vocalizations, body language, and consolability. A patient with dementia would be unable to use a visual analog scale. The family may be able to help the nurse gain perspective about the pain, but this strategy alone is inadequate. The other distracters are myths.

A male patient diagnosed with paranoid schizophrenia typically relates effectively with female staff but angrily tells the male nurse, 'You act like a homosexual. None of the men trust you or want to be around you.' The nurse, who is heterosexual, is perplexed by the patient's statements and discusses the event with his mentor. Which explanation most likely underlies the patient's behavior?

  • A. The patient was unleashing unconscious, hostile feelings toward the nurse.
  • B. The patient feared the nurse would reject him, so he coped by rejecting the nurse first.
  • C. It was the patient's way of distancing himself from potential emotional intimacy.
  • D. The patient was coping with homosexual urges by projecting them onto the nurse.
Correct Answer: D

Rationale: The correct answer is D because the patient is exhibiting the defense mechanism of projection by attributing his own uncomfortable feelings (homosexual urges) to the nurse. This defense mechanism allows the patient to disown his feelings and project them onto others. This behavior is common in individuals struggling with their own conflicting desires or impulses.

Incorrect choices:
A: Unconscious hostile feelings are not necessarily the root cause in this scenario.
B: The patient's behavior is not about preemptively rejecting the nurse due to fear of rejection.
C: While emotional intimacy may play a role, the patient's behavior is more about projection of his own feelings onto the nurse rather than distancing himself.

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