Population Based Care

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A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self. Select the best outcome related to this diagnosis. Within 2 weeks, the patient will:

  • A. appropriately express angry feelings.
  • B. verbalize two positive things about self.
  • C. verbalize the importance of eating a balanced diet.
  • D. identify two alternative methods of coping with loneliness and isolation.
Correct Answer: D

Rationale: The correct answer is D because it directly addresses the nursing diagnosis of ineffective coping related to feelings of loneliness and isolation. By identifying two alternative methods of coping, the patient can develop healthier strategies to manage these emotions instead of resorting to overeating and vomiting. This outcome promotes long-term behavioral change and helps the patient build resilience.

Choice A is incorrect because expressing angry feelings may not necessarily address the underlying issues of loneliness and isolation. Choice B is incorrect as verbalizing positive things about oneself may be beneficial but does not directly address coping mechanisms for loneliness and isolation. Choice C is also incorrect because understanding the importance of a balanced diet does not directly address coping strategies for managing emotions like loneliness and isolation.

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What is the priority nursing intervention for a patient with bulimia nervosa who is engaging in purging behaviors?

  • A. Monitor electrolyte levels and cardiac function.
  • B. Encourage self-monitoring of food intake.
  • C. Provide emotional support and promote body image acceptance.
  • D. Focus on encouraging weight loss through diet control.
Correct Answer: A

Rationale: The correct answer is A. The priority nursing intervention for a patient with bulimia nervosa engaging in purging behaviors is to monitor electrolyte levels and cardiac function. This is crucial due to the potential electrolyte imbalances and cardiac complications resulting from purging behaviors. Monitoring these parameters helps prevent life-threatening conditions such as hypokalemia and arrhythmias.

Option B is incorrect as self-monitoring of food intake may not address the immediate health risks associated with purging behaviors. Option C is also incorrect as emotional support and body image acceptance are important but not the immediate priority in this case. Option D is incorrect as focusing on weight loss through diet control can exacerbate the patient's eating disorder behaviors and does not address the urgent medical concerns associated with purging.

Vascular dementia is more common in individuals living in:

  • A. The United States
  • B. Japan
  • C. France
  • D. Australia
Correct Answer: B

Rationale: The correct answer is B: Japan. Vascular dementia is more common in countries with a high prevalence of risk factors such as hypertension, diabetes, and cardiovascular diseases. Japan has a high prevalence of these risk factors due to lifestyle factors and aging population. The other choices (A, C, D) do not have the same level of risk factors or population demographics as Japan, making them less likely to have a higher incidence of vascular dementia.

The nurse is caring for a client who is being treated for comorbid eating or affective disorder. For which medication would the nurse expect to prepare a client teaching plan?

  • A. Fluoxetine (Prozac).
  • B. Diazepam (Valium).
  • C. Lorazepam (Ativan).
  • D. Lithium.
Correct Answer: A

Rationale: The correct answer is A: Fluoxetine (Prozac). Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat eating disorders and affective disorders like depression. The nurse would prepare a client teaching plan for fluoxetine to educate the client on its mechanism of action, potential side effects, proper dosing, and the importance of compliance. Diazepam and lorazepam are benzodiazepines used for anxiety and not typically indicated for eating or affective disorders. Lithium is primarily used for bipolar disorder and not specifically for eating or affective disorders.

Which statement by a patient with anorexia nervosa indicates a need for further education?

  • A. I understand that my weight loss is dangerous, and I want to regain weight.
  • B. I feel good about my body and don't need to gain weight.
  • C. I am willing to work with my healthcare team to restore my nutrition.
  • D. I know I need to eat more to improve my health.
Correct Answer: B

Rationale: The correct answer is B because feeling good about their body and not recognizing the need to gain weight is a common symptom of anorexia nervosa. This statement indicates a lack of insight into the seriousness of their condition and the necessity to restore a healthy weight. The other choices (A, C, D) demonstrate an understanding of the importance of weight gain, collaboration with healthcare professionals, and the need for increased food intake to improve health, indicating a willingness to engage in treatment and recovery.

What is the primary source of mental stimulation in early childhood?

  • A. Television
  • B. Parental interaction
  • C. Toys
  • D. School lessons
Correct Answer: B

Rationale: Parental interaction (B) provides responsive, tailored stimulation critical for early mental development. TV (A) and toys (C) are less interactive, and school lessons (D) come later.

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