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A patient is being admitted to an inpatient unit for treatment of anorexia nervosa. Of the following assessment data, which should the nurse place as highest priority in the plan of care?
- A. Weight 24% below ideal body weight
- B. Distorted body image
- C. Feelings of inadequacy
- D. Frequent vomiting
Correct Answer: D
Rationale: According to Maslow's hierarchy, physiological needs like fluid and electrolyte balance, threatened by frequent vomiting, take priority over psychological issues like body image or self-esteem.
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Which of the following is most essential when planning care for a client who is experiencing a crisis?
- A. Explore previous coping strategies
- B. Explore underlying personality dynamics
- C. Focus on emotional deficits
- D. Offer a referral to a self-help group
Correct Answer: A
Rationale: Crisis intervention leverages the client's existing coping strategies and strengths to address the current situation, making this the most essential focus.
A patient is blaming his impending divorce on the fact that his wife goes out frequently with her girlfriends. If using reality therapy, the nurse would help the patient with which of the following responses?
- A. If you really love her, she should love you as well.
- B. What does being divorced mean for you?
- C. How do you feel about your marriage ending?
- D. What role do you think you have played in the end of your marriage?
Correct Answer: D
Rationale: Reality therapy encourages clients to examine their own behaviors and their impact on life goals, such as taking responsibility for their role in the divorce.
A teenaged client is playing a video game when the nurse says it is time to go to sleep. The teen says angrily, 'You sound just like my mother at home!' and continues to play the video game. The nurse understands that this statement likely indicates
- A. The need of firm limit-setting
- B. Transference
- C. Ineffective parenting
- D. A personality disorder
Correct Answer: B
Rationale: Transference occurs when a client projects attitudes or feelings from past relationships, such as those with a parent, onto the therapist. The teen's reaction reflects this dynamic, not necessarily ineffective parenting, a disorder, or the need for limit-setting.
The family members of a patient with bipolar disorder express frustration with the unpredictable behaviors of their loved one. Which group should the nurse suggest as most helpful to this family?
- A. Family therapy group
- B. Family education group
- C. Psychotherapy group
- D. Self-help support group
Correct Answer: B
Rationale: Family education groups provide knowledge and coping skills for families dealing with mental illness, addressing their frustration with unpredictable behaviors.
Which one of the following is an important characteristic of an effective therapist-client relationship in individual psychotherapy?
- A. Homogeneity between the client and the therapist.
- B. Mutual benefit for the client and the therapist.
- C. The client must adapt to the therapist's style of therapy and theoretical beliefs.
- D. Match between the theoretical beliefs and style of therapy and the client's needs and expectations of therapy.
Correct Answer: D
Rationale: Effective therapy requires compatibility between the therapist's approach and the client's needs and expectations, prioritizing the client's benefit over homogeneity or therapist gain.