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A nurse is working with a patient with bulimia nervosa. Which outcome would indicate successful intervention?
- A. The patient eats three full meals daily without purging.
- B. The patient agrees to begin psychotherapy without resistance.
- C. The patient loses 5% of their body weight over 3 months.
- D. The patient expresses improved body image but still purges occasionally.
Correct Answer: A
Rationale: The correct answer is A because it indicates successful intervention in bulimia nervosa by demonstrating healthy eating behavior without purging. This outcome reflects improved control over binge-purge cycles and supports physical health. Choices B and D show progress but do not directly address the core issue of purging behavior. Choice C, losing weight, can be a misleading indicator and may not necessarily reflect improved psychological and behavioral outcomes associated with recovery from bulimia nervosa.
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An elderly patient brings a bag of medications to the clinic. The nurse finds a bottle labeled Ativan and one labeled lorazepam, both of which are to be taken BID. There are also bottles labeled hydrochlorothiazide, Inderal, and rofecoxib, each to be taken once daily. Which conclusion is accurate?
- A. Rofecoxib should not be taken with Ativan.
- B. Lorazepam interferes with the action of Inderal.
- C. The patient should not self-administer medication.
- D. Lorazepam and Ativan are the same drug, so the dose is excessive.
Correct Answer: D
Rationale: Lorazepam and Ativan are generic and trade names for the same drug (D), creating an accidental misuse situation with an excessive dose. The patient needs medication education and help with proper labeling; there is no evidence they cannot self-administer (C). Options A and B are not factually supported.
True paranoids are rarely treated or admitted to hospitals because
- A. they are potentially harmful and dangerous to others
- B. they resist the attempts of others to offer help
- C. their severe hallucinations make reasoning with them impossible
- D. psychiatric hospitals are primarily for psychotics
Correct Answer: B
Rationale: Paranoid individuals' mistrust leads them to resist help, reducing treatment rates.
A patient was abducted and raped at gunpoint by an unknown assailant. Which nursing interventions are appropriate while caring for the patient in the emergency department? Select all that apply.
- A. Allow the patient to talk at a comfortable pace.
- B. Place the patient in a private room with a caregiver.
- C. Pose questions in nonjudgmental, empathetic ways.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Allow the patient to talk at a comfortable pace. This intervention is appropriate because it promotes the patient's autonomy and empowerment in sharing their experience, which can be therapeutic. It also helps establish trust and rapport, facilitating effective communication and assessment.
Incorrect choices:
B: Placing the patient in a private room with a caregiver can be important for privacy and support but may not be the immediate priority.
C: Posing questions in nonjudgmental, empathetic ways is crucial but may not be as important as allowing the patient to talk at their own pace initially.
D: None of the above is incorrect as allowing the patient to talk is a crucial step in providing appropriate care for a patient who has experienced trauma.
Which finding is most indicative of refeeding syndrome in a patient with anorexia nervosa?
- A. Increased energy and mental clarity after eating.
- B. Electrolyte imbalances, particularly hypophosphatemia.
- C. A sudden increase in appetite and food cravings.
- D. Rapid weight gain and hypertension.
Correct Answer: B
Rationale: The correct answer is B because refeeding syndrome is characterized by electrolyte imbalances, especially hypophosphatemia, due to rapid reintroduction of nutrition. This can lead to serious complications like cardiac arrhythmias and respiratory failure. Increased energy and mental clarity (A) are not specific to refeeding syndrome. A sudden increase in appetite and food cravings (C) may occur but are not indicative of refeeding syndrome. Rapid weight gain and hypertension (D) are not typically seen in refeeding syndrome.
A client with undifferentiated schizophrenia is readmitted for an acute exacerbation of the disorder. The goal of hospitalization is symptom stabilization. The nurse has documented that, in addition to experiencing auditory hallucinations, the client seems uninterested in activities, has difficulty completing tasks, seems forgetful, and seems puzzled by information and directions given by staff. The nurse's plans for intervention will be effective if these behaviors are attributed to:
- A. Social isolation
- B. Deficient knowledge
- C. Situational low self-esteem
- D. Problems in cognitive functioning
Correct Answer: D
Rationale: The correct answer is D: Problems in cognitive functioning. In undifferentiated schizophrenia, cognitive deficits are common, leading to difficulties in memory, attention, problem-solving, and executive functioning. The client's symptoms of forgetfulness, difficulty completing tasks, being puzzled by information, and auditory hallucinations are indicative of cognitive impairment. Interventions should focus on addressing these cognitive deficits to improve the client's ability to function.
Incorrect choices:
A: Social isolation - This choice does not address the cognitive deficits and symptoms described by the client, such as forgetfulness and difficulty completing tasks.
B: Deficient knowledge - While cognitive deficits may contribute to deficient knowledge, the primary concern in this scenario is the client's cognitive functioning impairments.
C: Situational low self-esteem - This choice does not explain the cognitive deficits and symptoms experienced by the client, which are more indicative of problems in cognitive functioning.