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A patient with anorexia nervosa is resistant to weight gain. What is the rationale for establishing a contract with the patient to participate in measures to produce a specified weekly weight gain?
- A. Severe anxiety concerning eating is expected, so objective and subjective data are needed.
- B. Patient involvement in decision-making increases sense of control and promotes collaboration.
- C. The patient's family is not supportive of the treatment plan.
- D. None of the above.
Correct Answer: B
Rationale: Correct Answer: B - Patient involvement in decision-making increases sense of control and promotes collaboration.
Rationale:
1. Involving the patient in decision-making empowers them and increases their sense of control over their treatment.
2. Collaborating with the patient fosters a positive therapeutic relationship.
3. This approach is more likely to lead to better treatment adherence and outcomes.
Summary:
A: While objective and subjective data are important, this choice does not address the need for patient involvement in decision-making and collaboration.
C: The lack of family support is not directly related to the rationale for establishing a contract with the patient.
D: This choice is incorrect as patient involvement is crucial in promoting successful treatment outcomes.
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A nurse and social worker co-lead a reminiscence group for eight old-old and centenarian adults. Which activity is appropriate to include in the group?
- A. Mild aerobic exercise
- B. Singing a song from World War II
- C. Discussing national leadership during the Vietnam War
- D. Identifying the most troubling story in today's newspaper
Correct Answer: B
Rationale: The correct answer is B: Singing a song from World War II. This activity is appropriate because reminiscence therapy involves recalling past memories to enhance well-being in older adults. Singing a song from that era can help trigger positive emotions and memories for the participants.
A: Mild aerobic exercise may not be suitable for all participants due to physical limitations.
C: Discussing national leadership during the Vietnam War might evoke negative emotions or political disagreements.
D: Identifying the most troubling story in today's newspaper could lead to distress and is not conducive to the therapeutic nature of reminiscence therapy.
The mother of a teenager diagnosed with an eating disorder asks, 'How long will my daughter have this problem?' The nurse answers with the knowledge that:
- A. recovery is usual after one severe episode.
- B. less than 30% show improvement after 5 years.
- C. weight restoration is sufficient for recovery.
- D. long-term therapy combined with medication results in the best outcomes.
Correct Answer: D
Rationale: The correct answer is D because long-term therapy combined with medication results in the best outcomes for individuals with eating disorders. Therapy helps address underlying psychological issues, while medication can help manage symptoms. Recovery is a complex process that often requires ongoing support. Choice A is incorrect as recovery is not always guaranteed after one severe episode. Choice B is incorrect as many individuals do show improvement over time. Choice C is incorrect as weight restoration alone may not address all aspects of the disorder.
A patient reports, 'My brain is tapped by government agents who can trace my whereabouts and listen to my thoughts.' An appropriate nursing response to this information would be:
- A. Your story is very strange and too bizarre for me to believe.'
- B. Tell me why you think your brain is being tapped.'
- C. What was happening in your life just before you began to think your brain was tapped?'
- D. Are you feeling frightened or angry about the government violating your body?'
Correct Answer: C
Rationale: The correct response is C because it focuses on exploring the underlying reasons for the patient's belief, which can help uncover any triggers or stressors leading to the delusion. This approach shows empathy, builds rapport, and encourages the patient to share more about their experiences. Choice A is dismissive and may cause the patient to feel invalidated. Choice B only focuses on the belief itself without delving deeper into the context. Choice D jumps to assumptions about the patient's emotions without addressing the core issue of the delusion. Overall, choice C promotes therapeutic communication and understanding of the patient's perspective.
A victim of a sexual assault sits in the emergency department rocking back and forth and repeatedly saying, "I can't believe I've been raped."Â This behavior is characteristic of:
- A. The acute phase reaction.
- B. The angry stage of rape-trauma syndrome.
- C. A delayed reaction to rape-trauma syndrome.
- D. The long-term phase of rape-trauma syndrome.
Correct Answer: A
Rationale: The correct answer is A: The acute phase reaction. This behavior is characteristic of the immediate emotional response following a traumatic event like sexual assault. The victim may exhibit shock, disbelief, and emotional distress. In this scenario, the victim's reaction of disbelief and repetitive statements align with the acute phase reaction. The other options are incorrect because the angry stage (B) and delayed reaction (C) occur later in the trauma response process, while the long-term phase (D) reflects a more prolonged period of adjustment and coping.
A 35-year-old woman is being assessed related to suspected battering. In interviewing this patient, it is important for the nurse to keep in mind that: (Select all that apply.)
- A. The nurse's demeanor should be one of concern and caring.
- B. Professional terminology should be used and taught to the patient.
- C. All noted injuries should be thoroughly and explicitly documented.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A because when assessing a patient related to suspected battering, the nurse should demonstrate concern and caring to establish trust and encourage the patient to open up. This approach helps build rapport and facilitates communication, leading to a more accurate assessment and better support for the patient. Choice B is incorrect because using professional terminology might intimidate the patient and hinder effective communication. Choice C is incorrect because documenting injuries without sensitivity and consideration for the patient's emotional well-being can further traumatize the individual. Choice D is incorrect as the nurse's demeanor and approach are crucial in addressing cases of suspected battering.