A patient is diagnosed with anorexia nervosa. A nurse who is assessing for co-morbid psychiatric disorders should begin by looking for signs of which common, concurrent diagnosis?
- A. Phobias.
- B. Depression.
- C. Schizophrenia.
- D. Personality disorder.
Correct Answer: B
Rationale: The correct answer is B: Depression. Anorexia nervosa commonly co-occurs with depression due to shared risk factors and biological mechanisms. Depression is often a primary trigger or consequence of anorexia nervosa, making it a crucial diagnosis to assess for. Phobias (choice A) may be present but are less commonly associated with anorexia nervosa. Schizophrenia (choice C) and personality disorders (choice D) are less likely to co-occur with anorexia nervosa compared to depression. Identifying and addressing depression in a patient with anorexia nervosa is essential for comprehensive treatment and improved outcomes.
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An 83-year-old man becomes lost while driving. He pulls into a driveway to turn around and cannot figure out how to put his car in reverse, so he drives into the yard, makes a circle, and drives back out of the driveway. He is stopped by police, who take him to the emergency department. The physician diagnoses him with Alzheimer's disease and refers him to the neurology clinic for follow-up. Given this diagnosis, which behaviors should the clinic nurse anticipate?
- A. Does not know today's date.
- B. Unable to shower without help.
- C. Denial of mental impairment.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Does not know today's date. This behavior is commonly associated with Alzheimer's disease due to memory impairment. The inability to recall the current date is a key symptom of cognitive decline. In this case, the man's difficulty with reversing his car and getting lost are indicative of cognitive impairment.
Choice B, Unable to shower without help, is a functional impairment and not specific to Alzheimer's disease. Choice C, Denial of mental impairment, may occur in some individuals with Alzheimer's but is not a consistent behavior. Choice D, None of the above, is incorrect as memory deficits, such as not knowing the date, are commonly seen in Alzheimer's disease.
A nurse is working with a family with an elderly family member who is in the predisgnostic phase of Alzheimer disease. The most important nursing intervention at this time would be to provide:
- A. family consultation to facilitate communication.
- B. information about support groups and counseling.
- C. options directed toward the reduction of caregiver stress.
- D. educational materials that help them understand their situation.
Correct Answer: D
Rationale: The correct answer is D because educating the family about Alzheimer's disease in the predisgnostic phase helps them understand what to expect and how to cope effectively. This empowers them to make informed decisions and provide appropriate care. Option A focuses on communication, which is important but not the most critical intervention at this stage. Option B is helpful but may not address the family's immediate needs. Option C addresses caregiver stress, which is important but may not be the priority in the predisgnostic phase. Therefore, providing educational materials is the most important intervention to support the family during this phase.
The daughter of an 84-year-old client with dementia tearfully tells the nurse that she doesn't know what's wrong with her mother, who has begun accusing the family of stealing her lingerie and holding her prisoner. The nurse assesses the client's stage of Alzheimer's disease as stage:
- A. 1
- B. 2
- C. 3
- D. 4
Correct Answer: B
Rationale: The correct answer is B (stage 2) because the client is exhibiting symptoms of moderate Alzheimer's disease, such as paranoia and delusions. In stage 2, cognitive decline becomes more noticeable, leading to memory loss, confusion, and behavioral changes. The client's accusations and false beliefs indicate a decline in reality orientation, which is characteristic of stage 2. Choices A, C, and D are incorrect because stage 1 is characterized by mild cognitive decline, stage 3 by severe cognitive decline, and stage 4 by very severe cognitive decline.
A nurse conducts group therapy on the eating disorders unit. Sessions are scheduled immediately after meals. What is the rationale?
- A. Provide a forum for journaling about foods eaten.
- B. Shift the patients' focus from food to psychotherapy.
- C. Promote processing of anxiety associated with eating.
- D. Focus on weight control mechanisms and food preparation.
Correct Answer: C
Rationale: The correct answer is C because scheduling group therapy sessions immediately after meals can help promote processing of anxiety associated with eating. This timing allows patients to address their feelings and thoughts about food in a supportive environment, leading to better understanding and management of their anxieties. Choice A is incorrect because journaling about foods eaten is not the primary purpose of group therapy sessions. Choice B is incorrect as the main focus is on addressing anxiety related to eating disorders, not shifting focus to psychotherapy. Choice D is incorrect as weight control mechanisms and food preparation are not the main objectives of group therapy for eating disorders.
Which aspect of assessment has priority when a nurse interviews a rape victim?
- A. Coping mechanisms the patient is using
- B. The patient's previous sexual experiences
- C. Adequacy of the patient's interpersonal relationships
- D. Whether the patient has ever had a sexually transmitted disease
Correct Answer: A
Rationale: The correct answer is A: Coping mechanisms the patient is using. This aspect has priority because it helps the nurse assess the immediate emotional and psychological impact of the trauma on the victim. Understanding coping mechanisms can guide the nurse in providing appropriate support and interventions. Choice B is incorrect as past sexual experiences are not as pertinent during the immediate assessment of a rape victim. Choice C is incorrect as assessing interpersonal relationships may not be a priority during the initial interview. Choice D is incorrect as the presence of a sexually transmitted disease is not the primary concern when assessing a rape victim.