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A nurse is planning care for a patient with bulimia nervosa. Which goal should be included in the care plan?
- A. The patient will engage in daily exercise to prevent weight gain.
- B. The patient will maintain a healthy, balanced diet without purging behaviors.
- C. The patient will gain 1-2 pounds per week.
- D. The patient will eliminate binge eating and purging behaviors entirely.
Correct Answer: B
Rationale: Step-by-step rationale:
1. Maintaining a healthy, balanced diet without purging behaviors is crucial for managing bulimia nervosa.
2. This goal promotes physical health and addresses the underlying disordered eating habits.
3. It focuses on establishing sustainable eating patterns to support overall well-being.
4. It helps prevent complications associated with bulimia, such as electrolyte imbalances.
Summary:
- Option A is incorrect as excessive exercise can be a compensatory behavior in eating disorders.
- Option C is incorrect as rapid weight gain is not recommended in the treatment of bulimia.
- Option D is incorrect as complete elimination of binge eating and purging may be unrealistic initially.
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Which of the following is a common physical sign in patients with bulimia nervosa?
- A. Hypotension and bradycardia.
- B. Dental erosion and swollen parotid glands.
- C. Rapid weight gain and increased appetite.
- D. Severe muscle wasting and low body temperature.
Correct Answer: B
Rationale: The correct answer is B: Dental erosion and swollen parotid glands are common physical signs in patients with bulimia nervosa. Dental erosion is caused by repeated exposure of teeth to stomach acid during purging. Swollen parotid glands result from repeated vomiting. Hypotension and bradycardia (A) are more common in anorexia nervosa. Rapid weight gain and increased appetite (C) are not typical in bulimia nervosa; rather, patients often maintain a normal weight. Severe muscle wasting and low body temperature (D) are not commonly associated with bulimia nervosa.
A patient with acute mania approaches the nurse, waves a newspaper, and says, "I want the phone right now. I need to call this store while their sale is going on. I need ten dresses and four pairs of shoes." Select the nurse's best intervention.
- A. Suggest the patient ask a friend do the shopping and bring purchases to the unit.
- B. Invite the patient to sit with the nurse and look at new fashion magazines.
- C. Tell the patient phone use is not allowed until self-control is improved.
- D. Ask whether the patient has enough money to pay for the purchases.
Correct Answer: C
Rationale: The correct answer is C because the patient's behavior is impulsive and reflects poor judgment, which are common symptoms of acute mania. By telling the patient that phone use is not allowed until self-control is improved, the nurse is setting a boundary to prevent further impulsive actions. This intervention prioritizes safety and helps maintain a therapeutic environment.
A: This option does not address the immediate need to manage the patient's impulsive behavior and may put the friend in a potentially risky situation.
B: Inviting the patient to look at fashion magazines does not address the impulsivity and may even reinforce the behavior.
D: Asking about the patient's financial situation is not the most appropriate intervention at this time.
The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating. He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. This information most likely suggests:
- A. medication nonadherence.
- B. a need for psychoeducation.
- C. the chronic nature of his illness.
- D. relapse of his schizophrenia.
Correct Answer: D
Rationale: The correct answer is D: relapse of his schizophrenia. The patient's symptoms of feeling tense, difficulty concentrating, poor sleep, and delusional beliefs about creatures at work indicate a worsening of his psychotic symptoms. This suggests a relapse of schizophrenia, a chronic mental illness characterized by periods of stability and exacerbation of symptoms. The patient's previous stability for a year makes medication nonadherence less likely. While psychoeducation may be beneficial, the patient's current symptoms require more immediate intervention for relapse management. The information provided does not directly indicate the chronic nature of his illness, but rather an acute exacerbation. Therefore, D is the most appropriate choice based on the presented symptoms and clinical understanding of schizophrenia.
The psychiatric-mental health nurse, who is teaching a patient's parents how to use positive reinforcement techniques with the patient, recommends:
- A. agreeing with the child's statements, whether negative or positive, and simply restating the child's statements without other comment
- B. controlling the child's behavior, so there is no chance of negative behavior
- C. removing adverse consequences to produce positive results
- D. rewarding positive behaviors to promote their recurrence
Correct Answer: D
Rationale: Positive reinforcement rewards desired behaviors, increasing their frequency, a core behavioral strategy.
Theories based on study of the brain and its activities are called:
- A. Social
- B. Biological
- C. Psychological
- D. Psychobiological
Correct Answer: B
Rationale: The correct answer is B: Biological. Theories based on the brain and its activities fall under the field of biological psychology, which focuses on how biological factors influence behavior and mental processes. This includes studying brain structures, neural pathways, neurotransmitters, and their impact on behavior. Social (A) theories focus on interactions between individuals, Psychological (C) theories relate to mental processes and behavior, and Psychobiological (D) is a term that could be used interchangeably with Biological but is less commonly used. Hence, the most specific and appropriate term for theories related to the brain is Biological.