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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 is planning care for a patient with bulimia nervosa. Which goal should be included in the care plan?
- A. The patient will engage in daily exercise to prevent weight gain.
- B. The patient will maintain a healthy, balanced diet without purging behaviors.
- C. The patient will gain 1-2 pounds per week.
- D. The patient will eliminate binge eating and purging behaviors entirely.
Correct Answer: B
Rationale: Step-by-step rationale:
1. Maintaining a healthy, balanced diet without purging behaviors is crucial for managing bulimia nervosa.
2. This goal promotes physical health and addresses the underlying disordered eating habits.
3. It focuses on establishing sustainable eating patterns to support overall well-being.
4. It helps prevent complications associated with bulimia, such as electrolyte imbalances.
Summary:
- Option A is incorrect as excessive exercise can be a compensatory behavior in eating disorders.
- Option C is incorrect as rapid weight gain is not recommended in the treatment of bulimia.
- Option D is incorrect as complete elimination of binge eating and purging may be unrealistic initially.
The early stage of Alzheimer's disease is characterized by:
- A. Loss of recent memory
- B. Loss of remote memory
- C. Withdrawal from family
- D. Apraxia
Correct Answer: A
Rationale: The correct answer is A: Loss of recent memory. In the early stage of Alzheimer's disease, individuals typically experience difficulty remembering recent events, conversations, or information. This is due to the initial impact of the disease on the hippocampus and other brain regions responsible for forming new memories. Choices B, C, and D are incorrect because loss of remote memory (choice B) usually occurs in later stages, withdrawal from family (choice C) can be a result of various factors beyond memory loss, and apraxia (choice D) refers to the inability to perform coordinated movements and is not a primary symptom of early-stage Alzheimer's.
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.
A client with dementia was admitted to a dementia unit after she began persistently wandering away from home. The nursing staff should plan to:
- A. Provide unlimited freedom because the client has no place to go in the new neighborhood
- B. Provide one-to-one supervision when the client is ambulatory
- C. Place the client in a geriatric chair with a tray across the lap
- D. Provide the client with an electronic alarm that sounds when the client nears the exit door
Correct Answer: D
Rationale: The correct answer is D because providing the client with an electronic alarm that sounds when she nears the exit door is the best option to ensure her safety. This approach allows for monitoring without restricting her movement excessively. Choice A is incorrect as unlimited freedom poses risks. Choice B is not practical or feasible long-term. Choice C is not person-centered and may lead to discomfort and agitation. The electronic alarm in choice D is the most effective and least intrusive method to prevent wandering while respecting the client's autonomy.
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.