Nokea
A patient with anorexia nervosa begins to refuse food. The nurse should first:
- A. Speak with the patient's family about the refusal.
- B. Focus on the patient's emotional distress and discuss it.
- C. Redirect the patient to a different activity to distract them.
- D. Encourage the patient to eat a small, manageable portion of food.
Correct Answer: D
Rationale: The correct answer is D because encouraging the patient to eat a small, manageable portion of food is the most immediate and vital intervention in addressing the patient's refusal to eat. This step is crucial in preventing further complications associated with anorexia nervosa, such as malnutrition and dehydration. By starting with a small portion, the patient can gradually reintroduce food and begin the process of recovery.
A: Speaking with the family may be important but not the first step in addressing the patient's refusal to eat.
B: Focusing on emotional distress is important but addressing the physical need for food should take priority.
C: Redirecting the patient to a different activity may temporarily distract them but does not address the underlying issue of malnutrition.
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A 45-year-old man develops weakness and wasting of the right hand. Which one of the following is least likely to be the cause?
- A. Old injury to the elbow joint.
- B. Bronchogenic carcinoma of the right upper lobe.
- C. Multiple sclerosis.
- D. Syringomyelia.
Correct Answer: C
Rationale: Multiple sclerosis (C) typically causes sensory and motor symptoms but rarely isolated hand wasting, which is more characteristic of peripheral nerve or motor neuron issues. Old injury (A), lung cancer (B, via brachial plexus), syringomyelia (D), and motor neurone disease (E) are more directly linked to such symptoms.
Which information should the nurse include when teaching a client with a personality disorder?
- A. Journal writing will help you recognize feeling states.'
- B. Try problem solving independently to help with difficult relationships.'
- C. Identify people and circumstances that create conflict; then avoid them.'
- D. Try to alleviate behaviors that cause problems relating with others.'
Correct Answer: A
Rationale: The correct answer is A because journal writing can help individuals with personality disorders recognize and better understand their emotions, leading to improved self-awareness and emotional regulation. This can be a useful tool in therapy and self-management.
Choice B is incorrect because individuals with personality disorders often struggle with interpersonal relationships and might benefit from seeking support or guidance rather than attempting to solve problems independently.
Choice C is incorrect because avoidance does not address the underlying issues and can lead to isolation and maladaptive coping mechanisms.
Choice D is incorrect because simply trying to alleviate problematic behaviors without addressing the underlying emotional issues may not lead to long-term improvement in relationships.
A widowed patient tells a nurse that the door should be left unlocked because her husband will be coming home soon. Which response by the nurse would be most therapeutic?
- A. "You've forgotten that your husband's dead, haven't you?"Â
- B. "Just try to sleep. He won't be home for a long time yet."Â
- C. "You must miss him a lot. It almost seems he's here with you."Â
- D. "Your husband died 10 years ago. He won't be coming here."Â
Correct Answer: C
Rationale: The correct answer is C because it validates the patient's feelings without directly confronting or contradicting her belief. By acknowledging the patient's emotions and creating a sense of empathy, the nurse establishes a therapeutic rapport. Choice A is incorrect as it may be perceived as confrontational and insensitive. Choice B dismisses the patient's feelings and can be invalidating. Choice D is direct and may cause distress or confusion to the patient. In summary, option C is the best choice as it shows empathy and understanding towards the patient's emotional state.
Anorexia nervosa is very common in teenage girls
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Anorexia nervosa is prevalent among teenage girls due to societal pressures and developmental factors.
Consider these three drugs: divalproex (Depakote), carbamazepine (Tegretol), gabapentin (Neurontin). Which drug also belongs with this group?
- A. Clonazepam (Klonopin)
- B. Lamotrigine (Lamictal)
- C. Risperidone (Risperdal)
- D. Aripiprazole (Abilify)
Correct Answer: B
Rationale: The correct answer is B: Lamotrigine (Lamictal). All the drugs listed are commonly used in the treatment of epilepsy and mood disorders. Lamotrigine is often prescribed alongside divalproex, carbamazepine, and gabapentin as a mood stabilizer and antiepileptic medication. It works by stabilizing electrical activity in the brain and preventing seizures. Clonazepam (A) is a benzodiazepine used for anxiety and seizures, not in the same class as the other drugs. Risperidone (C) and Aripiprazole (D) are antipsychotics used for schizophrenia and bipolar disorder, not primarily for epilepsy.