Age Specific Nursing Care

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A nurse is planning care for a patient with anorexia nervosa. What is the priority intervention?

  • A. Encourage the patient to verbalize concerns about body image.
  • B. Monitor the patient's weight and nutritional intake closely.
  • C. Provide education on healthy eating and exercise.
  • D. Offer emotional support to the patient regarding self-esteem.
Correct Answer: B

Rationale: The correct answer is B. Monitoring the patient's weight and nutritional intake closely is the priority intervention for a patient with anorexia nervosa as it directly addresses the immediate health risks associated with the disorder, such as malnutrition and weight loss. By closely monitoring these parameters, healthcare providers can assess the patient's progress and make necessary adjustments to prevent further complications.

Choice A is incorrect because while addressing body image concerns is important in the long term, it is not the priority intervention when the patient's physical health is at risk.

Choice C is incorrect as providing education on healthy eating and exercise may not be effective if the patient is not yet in a stable physical condition to absorb and apply the information.

Choice D is incorrect as offering emotional support is valuable, but it is not the priority intervention in this case where the patient's physical health needs immediate attention.

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The client has been taking lithium and fluoxetine (Prozac) for almost a week. During today's assessment, the nurse notes a temperature of 39°C, muscle rigidity, and confusion. The client's signs and symptoms suggest:

  • A. Dystonic reactions
  • B. Bradykinesic side effects
  • C. Extrapyramidal side effects
  • D. Neuroleptic malignant syndrome
Correct Answer: D

Rationale: The correct answer is D: Neuroleptic malignant syndrome (NMS). This is indicated by the client's elevated temperature, muscle rigidity, and confusion, which are classic symptoms of NMS. NMS is a serious, potentially life-threatening condition associated with the use of antipsychotic medications like lithium and fluoxetine. The onset of NMS is often rapid and can lead to severe complications if not treated promptly. Dystonic reactions (choice A) involve sudden and involuntary muscle contractions, which are not consistent with the client's symptoms. Bradykinesic side effects (choice B) refer to slowed movements, which are not present in this case. Extrapyramidal side effects (choice C) typically include symptoms like tremors, stiffness, and restlessness, but do not encompass the combination of symptoms seen in NMS.

A type of delusion in which a patient claims that her genitals have disappeared without her knowledge is called

  • A. Hypochondriacal
  • B. Amorous
  • C. Reference
  • D. Nihilistic
Correct Answer: D

Rationale: Nihilistic delusions involve beliefs that parts of the body or the self have ceased to exist or are destroyed.

A 14-year-old female comes into clinic for a medical certificate once a week for multiple complaints of chest pain and abdominal pain. The complaints are non-specific, and her physical examination is normal. She is quiet with poor eye contact. She states the pain is worse on school days. Her mother is concerned that her daughter is being bullied but won't talk to her. Her mother is also worried that her complaints represent an undiagnosed medical condition. The next best step in management is:

  • A. Referral to tertiary hospital to rule out organic cause
  • B. HEADSS or other psychosocial screening
  • C. Referral for counselling
  • D. Reassurance that nothing is wrong
Correct Answer: B

Rationale: HEADSS screening assesses psychosocial factors (e.g., bullying, stress) that may underlie somatic complaints, making it the best next step before referral or reassurance.

A nurse and social worker co-lead a reminiscence group for eight elite-old adults. Which activity is 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 todays newspaper
Correct Answer: B

Rationale: Elite-old adults (100+ years) were young during World War II. Singing a song from that era (B) aligns with reminiscence therapy by sharing relevant past memories. Other options (A, C, D) are less tied to their life experiences.

A client who is diagnosed with schizoid personality disorder is isolative, does not speak to her peers, and sits through the community meeting without speaking. Her mother describes her as shy and having few friends. Which would be an appropriate nursing diagnosis for this client?

  • A. Anxiety related to a new environment as evidenced by isolation and not talking with peers
  • B. Impaired social interaction related to unfamiliar environment as evidenced by isolation and not talking with peers
  • C. Ineffective coping related to new environment as evidenced by isolation and minimal interaction with others
  • D. Disturbed thought processes related to a new environment as evidenced by isolation and minimal interactions with others
Correct Answer: B

Rationale: The correct answer is B: Impaired social interaction related to unfamiliar environment as evidenced by isolation and not talking with peers. This is the most appropriate nursing diagnosis because schizoid personality disorder is characterized by a pattern of social detachment and limited emotional expression. The client's behavior of isolating herself and not engaging with peers aligns with impaired social interaction.

Choice A (Anxiety) is incorrect because the client's behavior is more indicative of social detachment rather than anxiety. Choice C (Ineffective coping) is incorrect as there is no evidence to suggest the client is using maladaptive coping strategies. Choice D (Disturbed thought processes) is incorrect as the client's presentation does not indicate any disturbances in thought processes, but rather a lack of social engagement.

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