Age Specific Care Competency

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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 takes responsibility for events that are not entirely their fault. In this scenario, the patient is attributing the laughter of people in the check-out line to being about them and their weight gain, when in reality, the laughter may have had nothing to do with them. This distortion can contribute to feelings of guilt, shame, and self-blame.

A: Magnification involves exaggerating the importance or meaning of an event, which is not evident in the scenario.
C: Overgeneralization involves making broad negative conclusions based on a single event, which is not demonstrated here.
D: Dichotomous thinking is the tendency to view situations in black and white terms, with no middle ground, which is not present in the patient's statement.

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A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. The client occasionally curses or calls another client a 'jerk' without provocation. The nurse asks the client how he is feeling, and he responds, 'Everybody picks on me. They frobitz me.' The best response for the nurse to make would be:

  • A. That's really too bad.'
  • B. Who do you mean when you say 'everybody'?'
  • C. What difference does frobitzing make?'
  • D. Why do they frobitz?'
Correct Answer: B

Rationale: The correct answer is B: "Who do you mean when you say 'everybody'?" This response is the best because it acknowledges the client's feelings and seeks clarification. By asking for specifics, the nurse can gain a better understanding of the client's perceptions and experiences, which can help in providing appropriate care and support.

Choice A: "That's really too bad." This response lacks empathy and does not address the client's concerns directly.

Choice C: "What difference does frobitzing make?" This response is dismissive and does not focus on the client's feelings or experiences.

Choice D: "Why do they frobitz?" This response is confrontational and may make the client feel defensive, hindering effective communication and rapport-building.

Trends that have contributed to the recent increase in eating disorders in the United States include a(n):

  • A. more competitive workplace.
  • B. increase in the number of divorces.
  • C. focus on being thin as a measure of attractiveness.
  • D. increase in the number of nonnutritional foods consumed.
Correct Answer: C

Rationale: The correct answer is C: focus on being thin as a measure of attractiveness. This is because societal pressures and media influence have placed a strong emphasis on thinness as the ideal body type, leading to increased body dissatisfaction and disordered eating behaviors. Option A (more competitive workplace) and B (increase in the number of divorces) are not directly linked to eating disorders, while option D (increase in the number of nonnutritional foods consumed) may contribute to health issues but not specifically to eating disorders. In conclusion, the societal focus on thinness has a significant impact on the rise of eating disorders in the United States.

A frequent finding in clients with Paraphiliac sexual disorders is that they have:

  • A. Other covert or overt emotional
  • B. Gonadal and pituitary hormone deficiencies
  • C. An inadequate physical development of the sex organs
  • D. A poor adjustment due to association with society's fringe groups
Correct Answer: A

Rationale: Clients with paraphilic disorders often have coexisting emotional disorders, which may contribute to or result from their condition.

Which assessment findings would be expected for a patient diagnosed with bipolar I disorder?

  • A. Rapid cycling
  • B. Major depression and acute mania
  • C. Major depression and/or hypomania
  • D. Hypomania and/or minor depression
Correct Answer: B

Rationale: Step 1: Bipolar I disorder involves episodes of acute mania, which is characterized by elevated mood, increased energy, and impulsivity.
Step 2: Major depression can also occur in bipolar I, as patients may experience depressive episodes.
Step 3: Therefore, choice B (Major depression and acute mania) is the correct answer.
Summary: Choice A is incorrect because rapid cycling refers to frequent mood shifts, not specific to bipolar I. Choice C is incorrect as hypomania is characteristic of bipolar II, not bipolar I. Choice D is incorrect as minor depression is not a typical feature of bipolar I disorder.

A victim of spousal abuse comes to the emergency department for treatment of a broken arm. She appears hypervigilant and anxious and admits to sleep disturbance when the nurse questions the dark circles under her eyes. She reluctantly tells the nurse the abuse usually occurs when the husband has been drinking, although she concedes he is always jealous and controlling. She is a stay-at-home mother of two preschool children. The family has lived in this town for 1 month. The patient states she has fleetingly considered suicide but must stay alive to care for her children and work her way out of the abusive relationship. She denies any further suicidal thoughts. The nurse should document in the medical record that: (Select all that apply.)

  • A. Signs of high anxiety and chronic stress are present.
  • B. The patient relies on the perpetrator for basic needs.
  • C. The patient has a history of suicidal ideation.
  • D. None of the above.
Correct Answer: A

Rationale: The correct answer is A: Signs of high anxiety and chronic stress are present.
Rationale:
1. The patient displaying hypervigilance, anxiety, sleep disturbances, and dark circles under her eyes are indicators of high anxiety and chronic stress, common in victims of abuse.
2. Mentioning abuse occurring when the husband drinks, his jealousy, and control further support the presence of chronic stress and anxiety.
3. The patient's fleeting suicidal thoughts are a response to the abusive situation, not indicative of a history of suicidal ideation.

Summary:
B: The patient relying on the perpetrator for basic needs is not supported by the information provided.
C: There is no indication of a history of suicidal ideation, as the patient's thoughts are tied to her children and escaping the abusive relationship.

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