Population Based Care

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A patient with an eating disorder states, 'I heard people laughing behind me in the check-out line at the department store. I bet they thought it was hysterically funny that I gained a pound in the last few days.' The nurse documents that the patient is exhibiting which cognitive distortion related to maladaptive eating regulation responses?

  • A. Magnification
  • B. Personalization
  • C. Overgeneralization
  • D. Dichotomous thinking
Correct Answer: B

Rationale: The correct answer is B: Personalization. Personalization is a cognitive distortion where an individual attributes external events to themselves without any evidence. In this case, the patient is assuming that people laughing were directed at them and related to their weight gain, which is a distorted belief.

A: Magnification involves blowing things out of proportion, which is not evident in this scenario.
C: Overgeneralization involves drawing broad conclusions based on a single incident, which is not happening here.
D: Dichotomous thinking involves seeing things in black and white terms, which is not demonstrated in the patient's statement.

In summary, the patient's attribution of others' laughter to their weight gain without evidence aligns with the cognitive distortion of personalization, making it the correct choice.

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A patient diagnosed with dementia associated with excessive alcohol use tells a nurse, "Last week I had to take my baby to the hospital for major surgery. That's why I've been so nervous and needed to come here." The nurse is aware that the patient has never parented any children. The symptom described can be assessed as:

  • A. akathisia.
  • B. confabulation.
  • C. intellectualization.
  • D. magical thinking.
Correct Answer: B

Rationale: The correct answer is B: confabulation. Confabulation is the production of fabricated or distorted memories without the conscious intention to deceive. In this case, the patient is creating a false memory about having a baby and needing to take it to the hospital, which is not based on reality. Akathisia (A) is a movement disorder associated with restlessness, not memory distortion. Intellectualization (C) is a defense mechanism involving excessive focus on facts to avoid uncomfortable emotions, not memory fabrication. Magical thinking (D) involves believing that one's thoughts can influence events, not creating false memories.

Which symptom is most closely associated with the onset of anorexia nervosa?

  • A. Excessive eating followed by purging.
  • B. Obsession with calorie intake and extreme weight loss.
  • C. Compulsive exercising to burn calories.
  • D. Binge eating episodes with a lack of control.
Correct Answer: B

Rationale: The correct answer is B because an obsession with calorie intake and extreme weight loss is a hallmark symptom of anorexia nervosa. Individuals with anorexia nervosa typically have a distorted body image and an intense fear of gaining weight. This leads them to restrict their food intake severely, leading to extreme weight loss.

Choice A is incorrect because excessive eating followed by purging is more characteristic of bulimia nervosa, not anorexia nervosa. Choice C is incorrect as compulsive exercising is more commonly associated with another eating disorder called orthorexia nervosa. Choice D is incorrect as binge eating episodes with a lack of control are symptoms of binge eating disorder, not anorexia nervosa.

The drug of choice for treating Tourette syndrome?

  • A. Fluoxetine
  • B. Fluvoxamine
  • C. Haloperidol
  • D. Paroxetine
Correct Answer: C

Rationale: Haloperidol is a typical antipsychotic commonly used to reduce tics in Tourette syndrome by modulating dopamine activity.

Older adults have reached Erikson's developmental stage of ego integrity when they:

  • A. acknowledge that one cannot get everything one wants in life
  • B. assess their lives and identify actions that had value and purpose
  • C. express a wish that life could be relived differently
  • D. feel that they are being punished for things they did not do
Correct Answer: B

Rationale: Ego integrity involves reflecting on life with acceptance and finding meaning, per Erikson's theory.

The nurse in the emergency department tells the daughter of a patient that her 86-year-old mother has had a stroke. The daughter tearfully asks the nurse, 'Who will take care of me now?' When the nurse explores this query, the daughter mentions that her mother always tells her what job to take, what clothes to buy and wear, and what to have for lunch. The daughter states that she needs someone to direct her and reassure her when she gets anxious. With which personality disorder is this presentation most consistent?

  • A. Histrionic
  • B. Dependent
  • C. Narcissistic
  • D. Borderline
Correct Answer: B

Rationale: The correct answer is B: Dependent. This presentation is most consistent with dependent personality disorder because the daughter is displaying excessive need for someone to take care of her and make decisions for her, as well as seeking reassurance and guidance when anxious. Individuals with dependent personality disorder often lack self-confidence and rely heavily on others for emotional and physical needs.

Choice A: Histrionic personality disorder is characterized by attention-seeking behavior and excessive emotions, which do not match the daughter's presentation.

Choice C: Narcissistic personality disorder involves a grandiose sense of self-importance and a lack of empathy for others, which is not evident in the daughter's behavior.

Choice D: Borderline personality disorder is characterized by unstable relationships, self-image, and emotions, as well as impulsive behaviors, which are not reflected in the daughter's need for constant direction and reassurance.

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