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A nurse is caring for a patient with bulimia nervosa. What is a priority assessment for this patient?
- A. Electrolyte imbalances and cardiac function.
- B. Body image issues and mental health status.
- C. Nutritional status and hydration levels.
- D. Weight changes and exercise patterns.
Correct Answer: A
Rationale: The correct answer is A: Electrolyte imbalances and cardiac function. This is because patients with bulimia nervosa often engage in purging behaviors which can lead to electrolyte imbalances and cardiac complications. Assessing electrolyte levels and cardiac function is crucial to prevent life-threatening complications.
Choice B is incorrect because while body image and mental health are important considerations, they are not the priority assessment in this case. Choice C is also incorrect as nutritional status and hydration levels can be affected, but not as immediately life-threatening as electrolyte imbalances and cardiac issues. Choice D is incorrect as weight changes and exercise patterns may be important, but they are not the priority assessment for a patient with bulimia nervosa.
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A 27-year-old woman diagnosed with borderline personality disorder displays a labile affect, impulsivity, frequent angry outbursts, and difficulty tolerating her angry feelings without self-injury. A priority nursing diagnosis for this client is:
- A. Anxiety
- B. Risk for self-mutilation
- C. Risk for other-directed violence
- D. Ineffective coping
Correct Answer: B
Rationale: The correct answer is B: Risk for self-mutilation. This is the priority nursing diagnosis because the client is displaying behaviors such as self-injury due to difficulty tolerating angry feelings. Self-mutilation poses an immediate risk to the client's safety and requires immediate intervention. The other choices are incorrect because anxiety (A) is a common symptom of borderline personality disorder but not the priority in this case. Risk for other-directed violence (C) is not indicated as the client is primarily harming themselves. Ineffective coping (D) is a broad diagnosis that does not address the immediate risk of self-mutilation.
What is the most important aspect of refeeding for a patient with anorexia nervosa?
- A. Refeeding should begin slowly to avoid complications.
- B. Rapid weight gain is essential to restore health.
- C. The patient should be encouraged to make independent food choices.
- D. Fluid intake should be restricted to avoid water retention.
Correct Answer: A
Rationale: The correct answer is A because refeeding should start slowly to prevent refeeding syndrome, a potentially life-threatening condition caused by rapid electrolyte shifts. Gradually increasing caloric intake allows the body to adjust and reduces the risk of complications. Rapid weight gain (B) is not recommended as it can lead to medical complications. Encouraging independent food choices (C) may not be suitable initially as structured meal plans are often necessary. Restricting fluid intake (D) is not advisable as adequate hydration is crucial during refeeding.
A novice nurse tells the assigned mentor, 'I admitted a patient today who has several bizarre delusions. I wanted to tell the patient that the ideas and conclusions simply are not logical. What do you think will happen if I do?' Which reply by the mentor is best?
- A. I think you'll give the patient something to think about.'
- B. The patient will probably incorporate you into the delusions as a persecutor.'
- C. Develop trust using empathy and calmness before pointing out discrepancies.'
- D. Initially, it would be better to go along with the patient's thinking to gain cooperation.'
Correct Answer: C
Rationale: Step 1: Establish trust - Developing trust with the patient is crucial in building a therapeutic relationship.
Step 2: Use empathy and calmness - Showing empathy helps the patient feel understood and valued.
Step 3: Point out discrepancies - Once trust is established, gently pointing out discrepancies in a non-confrontational manner can help the patient reflect on their delusions.
Summary: Choice C is the best because it emphasizes the importance of building trust and rapport before addressing the patient's delusions. Choices A, B, and D are incorrect because they do not prioritize the therapeutic relationship or show empathy towards the patient's experiences.
The antisocial personality
- A. avoids other people as much as possible
- B. is relatively easy to treat effectively by psychotherapy
- C. tends to be selfish and lacking remorse
- D. usually gives a bad first impression
Correct Answer: C
Rationale: Antisocial personality involves selfishness and lack of remorse, often masked by initial charm.
The persistent eating of nonfood items such as clay, laundry starch, insects, leaves, or pebbles that lasts for longer than 1 month is called:
- A. pica.
- B. bulimia.
- C. rumination.
- D. regurgitation.
Correct Answer: A
Rationale: Sure! The correct answer is A: pica. Pica is the persistent consumption of nonfood items lasting longer than 1 month. This condition is characterized by cravings for non-nutritive, nonfood substances. Bulimia (B) is a different eating disorder involving binge eating followed by purging behaviors. Rumination (C) is the repeated regurgitation and rechewing of food. Regurgitation (D) is the act of bringing swallowed food back to the mouth without nausea or retching.