Nokea
A nurse is working with a patient diagnosed with bulimia nervosa. Which of the following would be considered an appropriate outcome for this patient?
- A. The patient will engage in purging behavior once a week.
- B. The patient will eat three meals a day without purging behaviors.
- C. The patient will maintain a BMI of 18.5.
- D. The patient will avoid emotional support to prevent dependence.
Correct Answer: B
Rationale: The correct answer is B because it reflects a positive outcome for a patient with bulimia nervosa. Eating three meals a day without purging behaviors indicates improved eating habits and reduced harmful behaviors. This outcome promotes physical health and addresses the underlying issues of the disorder.
Choice A is incorrect as engaging in purging behavior is not a desirable outcome for a patient with bulimia nervosa. Choice C is incorrect because focusing solely on maintaining a specific BMI does not address the psychological and behavioral aspects of the disorder. Choice D is incorrect as emotional support is essential in the treatment of eating disorders and should not be avoided to prevent dependence.
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Which information is most important to obtain during assessment of an older adult diagnosed with a mental disorder?
- A. Functional ability and emotional status
- B. Chronological age and sexual function
- C. Economic status and sources of income
- D. Developmental history, interests, and activities
Correct Answer: A
Rationale: Information related to functional ability and emotional status provides an overview of patient problems and abilities. It guides selection of interventions and services to meet identified needs. The distracters reflect information of relevance, but are not of highest priority.
The wife of a client who is being seen in the sleep clinic states that her husband snores terribly at night and that she has to shake him to get him to stop. The client complains of a headache upon wakening and often falls asleep during the day when he sits for long periods. This client is exhibiting signs and symptoms characteristic of:
- A. narcolepsy.
- B. parasomnia.
- C. sleep apnea.
- D. primary hypersomnia.
Correct Answer: C
Rationale: The correct answer is C: sleep apnea. The client's symptoms of loud snoring, need to be shaken to stop snoring, morning headache, daytime sleepiness, and falling asleep during the day are all classic signs of sleep apnea. Sleep apnea is a disorder characterized by pauses in breathing or shallow breathing during sleep, leading to poor sleep quality and daytime symptoms. Narcolepsy (choice A) involves excessive daytime sleepiness and sudden muscle weakness, which are not mentioned here. Parasomnia (choice B) refers to abnormal behaviors during sleep, such as sleepwalking or night terrors, which are not described in the scenario. Primary hypersomnia (choice D) is characterized by excessive daytime sleepiness without a clear cause, which is not consistent with the client's symptoms.
A woman consults the nurse practitioner because she has not achieved orgasm for 2 years, despite having been sexually active. This is an example of
- A. Paraphilic disorder.
- B. Female orgasmic disorder.
- C. Genito-pelvic pain/penetration disorder.
- D. Female sexual interest/arousal disorder.
Correct Answer: B
Rationale: The correct answer is B: Female orgasmic disorder. This woman's inability to achieve orgasm despite being sexually active aligns with the diagnostic criteria for Female Orgasmic Disorder in the DSM-5. This disorder is characterized by a marked delay, absence, or decreased intensity of orgasm, which causes distress or interpersonal difficulty. Other choices are incorrect because Paraphilic Disorder refers to atypical sexual interests, Genito-pelvic pain/penetration disorder involves pain during intercourse, and Female Sexual Interest/Arousal Disorder pertains to lack of interest in or arousal during sexual activity.
Which intervention would be appropriate for a patient with a nursing diagnosis of Ineffective coping as evidenced by manipulation of others?
- A. Refer patient requests and questions about care to the primary nurse.
- B. Provide negative reinforcement for any acting-out behavior.
- C. Ignore rather than confront inappropriate interpersonal behavior.
- D. Encourage the patient to discuss feelings of fear and inferiority.
Correct Answer: A
Rationale: The correct answer is A because referring patient requests and questions about care to the primary nurse promotes patient independence and helps establish boundaries. This intervention empowers the patient to take responsibility for their care and reduces the reliance on manipulation of others.
Choice B is incorrect because negative reinforcement may exacerbate the behavior and lead to further manipulation.
Choice C is incorrect because ignoring inappropriate behavior does not address the underlying issue of ineffective coping and may reinforce the behavior.
Choice D is incorrect because encouraging the patient to discuss feelings of fear and inferiority may be helpful, but it does not directly address the manipulation of others, which is the main concern in this nursing diagnosis.
A woman was bound, taken to a remote location, and raped at gunpoint. When found, she was examined and treated in the emergency department. Which aspect of this crisis produced the greatest amount of psychological trauma?
- A. The threat to her life
- B. Collection of evidence
- C. Physical pain experienced
- D. Being in a remote location
Correct Answer: A
Rationale: The correct answer is A: The threat to her life. This aspect produced the greatest psychological trauma as the fear of losing one's life triggers intense emotional distress and long-lasting psychological effects such as anxiety and PTSD. The threat of death during a traumatic event can lead to profound feelings of helplessness and vulnerability. In comparison, while the other aspects (B: Collection of evidence, C: Physical pain experienced, D: Being in a remote location) also contribute to the trauma experienced, they do not elicit the same level of fear and existential threat as the possibility of losing one's life.