Nokea
A patient with an eating disorder states, 'Now that I've gained 4 pounds, I can't wear shorts until I lose it again.' The nurse documents that the patient is exhibiting which cognitive distortion related to maladaptive eating regulation responses?
- A. Magnification
- B. Superstitious thinking
- C. Personalization
- D. Dichotomous thinking
Correct Answer: A
Rationale: The correct answer is A: Magnification. This cognitive distortion involves exaggerating the significance of a negative event, in this case, gaining 4 pounds. The patient's focus on this small weight gain as a major obstacle to wearing shorts reflects magnification. Superstitious thinking (B) involves believing in unrelated events causing outcomes, which is not evident here. Personalization (C) involves taking responsibility for events beyond one's control, which is not the case in this scenario. Dichotomous thinking (D) involves seeing things in black and white terms, which is not demonstrated in the patient's statement.
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The psychiatric-mental health nurse, who is teaching a patient's parents how to use positive reinforcement techniques with the patient, recommends:
- A. agreeing with the child's statements, whether negative or positive, and simply restating the child's statements without other comment
- B. controlling the child's behavior, so there is no chance of negative behavior
- C. removing adverse consequences to produce positive results
- D. rewarding positive behaviors to promote their recurrence
Correct Answer: D
Rationale: Positive reinforcement rewards desired behaviors, increasing their frequency, a core behavioral strategy.
In an art therapy session, a client with anorexia nervosa was asked to draw a picture of herself. Which drawing would likely depict the client's view of herself?
- A. A tall, slim girl with obvious muscle definition.
- B. A malnourished teenager with thin, lanky extremities.
- C. A grossly obese figure lacking feminine characteristics.
- D. A shapely figure of a model who she admires.
Correct Answer: C
Rationale: The correct answer is C because individuals with anorexia nervosa often have a distorted body image and see themselves as larger than they actually are. Drawing a grossly obese figure lacking feminine characteristics reflects the distorted self-perception common in anorexia nervosa. Choice A is incorrect as it portrays a positive body image. Choice B may be close, but it focuses more on malnourishment rather than distorted body image. Choice D is incorrect as it reflects admiration for a shapely figure, which may not align with the client's self-perception.
An older adult patient who lives with a daughter and attends the Alzheimer day hospital program exhibits bilateral bruising for the second time on both upper outer arms. When the nurse questions the patient about the bruising, the patient starts to cry and pleads, 'Please don't say anything. It's not my daughter's fault. I just bruise easily.' Which intervention reflects the best management of this situation?
- A. Call the daughter to discuss both the bruising and her parent's reaction.
- B. Report the elder abuse, and inform the patient and the daughter of your intention.
- C. Notify the patient's social worker of the bruising after a complete assessment has been completed.
- D. Inform the patient and the daughter of your intention to document the bruising and arrange for appropriate counseling.
Correct Answer: B
Rationale: The correct answer is B: Report the elder abuse and inform the patient and the daughter of your intention. This is the best intervention as it prioritizes the safety and well-being of the older adult. Here's the rationale:
1. The patient's repeated bruising and fear of disclosure indicate potential abuse.
2. Reporting elder abuse is mandatory to ensure protection for the patient.
3. Informing the patient and daughter shows transparency and involves them in the process.
4. It is crucial to address the situation promptly to prevent further harm.
Summary:
A: Calling the daughter may escalate the situation and compromise the patient's safety.
C: Notifying the social worker without addressing the abuse directly may delay necessary action.
D: Counseling may be beneficial, but addressing the abuse is a priority to ensure the patient's safety.
A patient who takes lithium phones the nurse at the clinic to say, "I've had diarrhea for 4 days. I feel weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?" Which instruction by the nurse is appropriate?
- A. Have someone bring you to the clinic immediately.
- B. Restrict food and fluids for 24 hours and stay in bed.
- C. Drink a large glass of water with 1 teaspoon of salt added.
- D. Take antidiarrheal medication hourly until the diarrhea subsides.
Correct Answer: A
Rationale: The correct answer is A: Have someone bring you to the clinic immediately. The patient is experiencing symptoms of lithium toxicity, including diarrhea, weakness, unsteadiness, and worsening hand tremor. These symptoms indicate a potential lithium overdose, which can be life-threatening. Bringing the patient to the clinic immediately is crucial for assessment, monitoring, and intervention.
Choice B is incorrect because restricting food and fluids can worsen dehydration and electrolyte imbalances. Choice C is incorrect as adding salt to water can exacerbate electrolyte abnormalities in lithium toxicity. Choice D is incorrect as taking antidiarrheal medication can further worsen the symptoms and delay appropriate medical treatment.
Which of the following options is not useful for reducing mental conflict?
- A. Stay away from the causes of conflict.
- B. Find out the exact causes of the conflict.
- C. Think about what's left out.
- D. Consult an adult.
Correct Answer: C
Rationale: Mental conflict refers to a state of inner turmoil or struggle that arises when an individual experiences opposing thoughts, desires, or emotions. Strategies useful for reducing mental conflict include avoiding triggers (A), understanding root causes (B), and seeking support (D). Thinking about what's left out (C) can lead to overthinking, increasing conflict rather than reducing it.