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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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Which assessment finding is most associated with bulimia nervosa?
- A. Prominent parotid glands
- B. Peripheral edema
- C. Thin, brittle hair
- D. Amenorrhea
Correct Answer: A
Rationale: The correct answer is A: Prominent parotid glands. This is associated with bulimia nervosa due to repeated vomiting, which can lead to enlargement of the parotid glands. This is known as parotid gland hypertrophy. The other choices (B: Peripheral edema, C: Thin, brittle hair, D: Amenorrhea) are more commonly associated with anorexia nervosa rather than bulimia nervosa. Edema is a sign of malnutrition in anorexia, while thin, brittle hair and amenorrhea are also common in anorexia due to severe weight loss and hormonal disturbances.
A nurse leads a staff development session about ageism among health care workers. What information should the nurse include about the consequences of ageism? Select one tha does not apply.
- A. Failure of the elderly to receive necessary medical information
- B. Development of public policy that discriminates against the elderly
- C. Staff shortages because caregivers prefer working with younger adults
- D. The perception that elderly consume a smaller share of medical resources
Correct Answer: D
Rationale: Because of society's negative stereotyping, elderly patients often receive less information (A) and fewer treatment options, public policy discriminates against them (B), and staff shortages occur as some prefer younger patients (C). The elderly are seen to consume more resources (not D), and discrimination spans all staff (not E).
In clinical supervision, the nurse caring for the patient with a paranoid personality disorder tells the advanced practice nurse, 'I tried being caring and empathetic, but the patient just kept telling me to stay away.' Which response by the advanced practice nurse would be best?
- A. Acting somewhat cynical and aloof, like they do, will make it easier for paranoid persons to bond with you over time. That, plus humor.'
- B. You may be trying too hard too soon. Back off, give him some time to get used to you, then try your caring and empathetic approach again.'
- C. Mistrustful people do not bond as others do, so first it's important to be realistic. Second, a neutral yet courteous approach will work better.'
- D. You are on the right track, but give it more time. Actively conveying empathy and care will work, but paranoid persons respond more slowly.'
Correct Answer: C
Rationale: The correct answer is C because it acknowledges the unique challenges of working with individuals with paranoid personality disorder. The response emphasizes the importance of being realistic about the patient's mistrust and suggests a neutral yet courteous approach. This approach recognizes the need to build trust gradually and not rush into being overly caring or empathetic, which could further trigger the patient's paranoia.
Choice A is incorrect because adopting a cynical and aloof attitude is not conducive to building rapport with individuals with paranoid personality disorder. Humor may also be perceived as mocking or dismissive.
Choice B is incorrect because it suggests backing off completely before trying a caring and empathetic approach again. This approach may not effectively address the patient's needs for support and may reinforce their feelings of isolation.
Choice D is incorrect because it suggests continuing with the caring and empathetic approach without acknowledging the need for a more cautious and neutral approach with individuals who are mistrustful. This approach may not effectively address the patient's specific needs and could potentially worsen the
Which symptom of Alzheimer's disease is associated with disorientation to time and place?
- A. Forgetting in what order to put clothes on
- B. Forgetting simple words
- C. Forgetting where he or she lives
- D. Becoming suspicious of others
Correct Answer: C
Rationale: The correct answer is C: Forgetting where he or she lives. In Alzheimer's disease, disorientation to time and place is a common symptom due to memory loss and cognitive decline. Forgetting where one lives directly relates to disorientation, as the individual may not recognize their home or surroundings. Choice A is related to sequencing and executive function, not specific to time and place. Choice B is more associated with language and communication difficulties. Choice D relates to paranoia or mistrust, not specifically related to disorientation to time and place. In summary, the correct answer directly reflects the symptom of disorientation in Alzheimer's disease, while the other choices are related to different cognitive functions.
An example of a Developmental Disorder is:
- A. ADHD
- B. Dyslexia
- C. Mental Retardation
- D. Autistic spectrum disorders
Correct Answer: D
Rationale: Autistic Spectrum Disorder (ASD): An umbrella term that refers to all disorders that display autistic style symptoms across a wide range of severity and disability.