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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 goal has priority for a patient with anorexia nervosa undergoing nutritional stabilization?
- A. Schedules meals appropriately
- B. Eats 100% of each meal served
- C. Selects food items from a menu
- D. Prepares food under supervision
Correct Answer: B
Rationale: The correct answer is B because ensuring the patient eats 100% of each meal served is crucial for nutritional rehabilitation in anorexia nervosa. This goal helps the patient meet their caloric needs and address malnutrition. It is essential to monitor and support the patient in consuming all the food provided to promote weight restoration and overall health. The other options are less critical: A focuses on timing rather than full intake, C involves choice rather than completion, and D emphasizes supervision but not necessarily full consumption.
Attention Deficit Hyperactivity Disorder (ADHD) is equally common in boys and girls
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: ADHD is more commonly diagnosed in boys than girls, though it affects both genders.
A 17-year-old client is admitted to the ED after being alternately hyperalert and difficult to arouse. His symptoms all started within the last few hours, during which time he became agitated and restless, and his memory was impaired, especially for recent events. The client displayed some delusions and misinterpretations of his surroundings. The nurse knows she needs to assess the client further for:
- A. Drug use.
- B. Infection.
- C. Metabolic disorder.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Drug use. Given the client's sudden onset of symptoms, including altered mental status, agitation, memory impairment, delusions, and misinterpretations of surroundings, drug use is the most likely cause. Step 1: Consider the timeline - symptoms started within a few hours. Step 2: Review the symptoms - agitation, memory impairment, delusions, altered mental status. Step 3: Think of common causes for acute onset of these symptoms - drug use can lead to these manifestations. Step 4: Rule out other potential causes - infection and metabolic disorders typically present with different symptomatology and are less likely in this acute scenario. Step 5: Therefore, the nurse should prioritize assessing the client for drug use to provide appropriate interventions.
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.
Joey is a 5-year-old who is causing his parents a lot of concern. His mother reports that he bounces off the walls all the time and cant focus on any one thing for very long. He is impulsive and has recently ran right out into the street in front of the familys home. His teacher has told his parents that he has done similar things at school. The nurse understands that:
- A. Joey shows all the signs of having ADHD and should probably be placed on Ritalin as soon as possible
- B. Joey is just an active, healthy child who needs to be disciplined more effectively
- C. Joey could be autistic, and additional testing will have to be done to confirm the diagnosis
- D. Joey shows signs of having ADHD, but is too young for that diagnosis to be made definitively now
Correct Answer: D
Rationale: Definitive diagnosis of ADHD should not be made before age 7 because developmentally the child has a shorter attention span.