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A nurse is caring for a patient with bulimia nervosa. What is the most important aspect of the treatment plan?
- A. To encourage purging behaviors to eliminate binge episodes.
- B. To provide a structured meal plan and monitor food intake.
- C. To focus solely on achieving weight loss.
- D. To offer therapy focused on body image without addressing eating behaviors.
Correct Answer: B
Rationale: The correct answer is B: To provide a structured meal plan and monitor food intake. This is crucial in the treatment of bulimia nervosa as it helps establish regular eating patterns, prevent binge episodes, and promote healthy nutrition. Providing structure and monitoring food intake also helps in addressing underlying psychological issues related to disordered eating. Encouraging purging behaviors (choice A) can worsen the condition and lead to serious health complications. Focusing solely on weight loss (choice C) may reinforce unhealthy behaviors and neglect the holistic approach needed for recovery. Offering therapy focused only on body image (choice D) overlooks the critical component of addressing eating behaviors and nutritional needs.
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The nurse is aware, when developing a care plan, that the three major goals of care for the client in whom Alzheimer's disease has been diagnosed include providing for the client's safety and well-being, therapeutically managing the client's behaviors, and:
- A. Supporting the client during curative care.
- B. Providing support for family, relatives, and caregivers.
- C. Arranging for nursing home placement.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B. Providing support for family, relatives, and caregivers is crucial in the care of a client with Alzheimer's disease as it helps to ensure a holistic approach to care. Family members and caregivers often experience significant stress and burden in caring for someone with Alzheimer's, so providing support to them can improve the overall quality of care for the client. Additionally, involving family and caregivers in the care plan can help in maintaining continuity and consistency in the client's care.
Other choices are incorrect because:
A: Supporting the client during curative care is not applicable in Alzheimer's disease as there is currently no cure for the condition.
C: Arranging for nursing home placement may be necessary in some cases, but it is not one of the three major goals of care for a client with Alzheimer's disease.
D: None of the above is incorrect as providing support for family, relatives, and caregivers is a critical aspect of care for clients with Alzheimer's disease.
A patient with antisocial personality disorder tells Nurse A, 'You're a much better nurse than Nurse B said you were.' The patient tells Nurse B, 'Nurse A's upset with you for some reason.' To Nurse C the patient states, 'You'd like to think you're perfect, but I've seen three of your mistakes this morning.' These comments can best be assessed as:
- A. seductive.
- B. detached.
- C. guilt producing.
- D. manipulative.
Correct Answer: D
Rationale: The correct answer is D: manipulative. The patient is using different strategies to manipulate each nurse's emotions and behavior for personal gain. In the first scenario, the patient is attempting to create a divide between Nurse A and Nurse B by praising Nurse A and implying Nurse B's incompetence. In the second scenario, the patient is trying to instigate conflict between Nurse A and Nurse B by falsely suggesting Nurse A's negative feelings towards Nurse B. In the third scenario, the patient is employing a manipulative tactic by undermining Nurse C's confidence and competence. These behaviors demonstrate a pattern of manipulation aimed at controlling and influencing the nurses' perceptions and actions. Choices A, B, and C do not accurately capture the manipulative intent behind the patient's actions.
A health care provider writes these new prescriptions for a resident in a skilled nursing facility: 2 g sodium diet, restraint as needed, limit fluids to 1800 mL daily, continue antihypertensive medication, milk of magnesia 30 mL PO once if no bowel movement for 3 days. The nurse should
- A. question the fluid restriction.
- B. question the order for restraint.
- C. transcribe the prescriptions as written.
- D. assess the resident's bowel elimination.
Correct Answer: B
Rationale: The correct answer is B: question the order for restraint. Restraints should only be used as a last resort due to the potential risks and ethical considerations. In this scenario, the prescription of restraint seems unnecessary and should be questioned to ensure the resident's safety and well-being. The other choices are incorrect because questioning the fluid restriction (A) is not necessary as it aligns with the resident's needs, transcribing the prescriptions as written (C) would be inappropriate without considering the necessity of each order, and assessing the resident's bowel elimination (D) is important but not the immediate concern indicated by the order for restraint.
A 45-year-old patient shows marked cognitive impairment that has developed progressively over several months. A family member reports that the patient's father also had early-onset dementia. What research-based information can be given to the family in response to their concerns about the patient developing early-onset dementia?
- A. The risk for developing the condition is about 50% only if both parents were affected.
- B. The greatest risk exists for relatives of individuals diagnosed with Alzheimer disease before age 55 years.
- C. Added risk is present only for people with Down syndrome, so relatives without Down syndrome are essentially "safe."Â
- D. Results of the research on genetic predisposition and its effect on the development of early-onset dementia are still unclear.
Correct Answer: B
Rationale: The correct answer is B because individuals with a family history of early-onset dementia, particularly Alzheimer's disease before age 55, are at a higher risk of developing the condition themselves. This is supported by research showing a strong genetic component in the development of early-onset dementia. Choice A is incorrect because the risk is not solely dependent on both parents being affected. Choice C is incorrect as early-onset dementia is not limited to individuals with Down syndrome. Choice D is incorrect because research has shown a clear link between genetic predisposition and early-onset dementia.
What is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors?
- A. Monitor for signs of electrolyte imbalances and dehydration.
- B. Assess for any weight gain and increase exercise habits.
- C. Encourage the patient to express feelings about food and body image.
- D. Monitor for compulsive eating behaviors and binge episodes.
Correct Answer: A
Rationale: The correct answer is A: Monitor for signs of electrolyte imbalances and dehydration. This is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors because purging can lead to electrolyte imbalances and dehydration, which can result in serious health complications such as cardiac arrhythmias and renal issues. Monitoring electrolyte levels and hydration status is crucial for the patient's safety and well-being.
Summary:
- Choice B is incorrect because focusing on weight gain and exercise habits is not the priority when dealing with the immediate health risks of electrolyte imbalances and dehydration.
- Choice C is incorrect as expressing feelings about food and body image is important for therapy but not the priority in this acute situation.
- Choice D is incorrect as monitoring for compulsive eating behaviors and binge episodes is more relevant for patients with binge eating disorder rather than bulimia nervosa with frequent purging behaviors.