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A patient with antisocial personality disorder tells Nurse A, 'You're a much better nurse than Nurse B said you were.' The patient tells Nurse B, 'Nurse A's upset with you for some reason.' To Nurse C the patient states, 'You'd like to think you're perfect, but I've seen three of your mistakes this morning.' These comments can best be assessed as:

  • A. seductive.
  • B. detached.
  • C. guilt producing.
  • D. manipulative.
Correct Answer: D

Rationale: The correct answer is D: manipulative. The patient's behavior demonstrates manipulation by attempting to create discord and control the relationships between the nurses. The patient uses different tactics to manipulate each nurse's emotions and perceptions for personal gain. Seductive (choice A) implies enticing or charming behavior, which is not evident in the scenario. Detached (choice B) suggests a lack of emotional connection, which is not the focus here. Guilt producing (choice C) involves inducing guilt, which the patient is not directly doing in this situation. Manipulative (choice D) best captures the patient's intent to influence others through deceptive and controlling tactics.

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Behavioral problems in which the person exhibits symptoms suggesting physical disease or injury, but for which there is no identifiable cause, are called

  • A. mood disorders
  • B. schizophrenia
  • C. organic brain pathologies
  • D. somatoform disorders
Correct Answer: D

Rationale: Somatoform disorders feature physical complaints without medical explanation.

Which regions have the lowest rates of death due to poor air quality?

  • A. The United States
  • B. Greenland
  • C. Eastern Europe (Poland, Slovakia, the Czech Republic)
  • D. India
Correct Answer: B

Rationale: Greenland, with its sparse population and minimal industry, has low air pollution-related deaths.

Retreat from reality by hallucinations and delusions and by social withdrawal typically characterizes

  • A. somatoform disorders
  • B. anxiety disorders
  • C. psychotic disorders
  • D. personality disorders
Correct Answer: C

Rationale: Psychotic disorders, like schizophrenia, involve hallucinations, delusions, and withdrawal, distinguishing them from other categories.

What is an appropriate goal for a nurse working with a patient with anorexia nervosa?

  • A. The patient will gain weight rapidly to restore nutritional balance.
  • B. The patient will express satisfaction with their body image by the end of treatment.
  • C. The patient will eat three meals daily and demonstrate healthy eating behaviors.
  • D. The patient will be able to resume normal physical activities without fatigue.
Correct Answer: C

Rationale: The correct answer is C because setting a goal for the patient to eat three meals daily and demonstrate healthy eating behaviors is a more realistic and achievable target for someone with anorexia nervosa. This goal focuses on establishing regular eating habits and promoting a healthy relationship with food, which are crucial in the treatment of anorexia nervosa. Choices A and D are incorrect as rapid weight gain and resuming normal physical activities may not be safe or sustainable goals for someone with anorexia nervosa. Choice B is also incorrect because body image satisfaction is a complex issue that may not be directly addressed solely through treatment for anorexia nervosa.

A patient with bulimia nervosa expresses that they feel better after purging. How should the nurse respond?

  • A. Encourage the patient to continue purging to maintain weight.
  • B. Explain that purging has long-term harmful effects on the body.
  • C. Agree that purging can help with weight control and self-esteem.
  • D. Tell the patient that purging is an effective method to prevent weight gain.
Correct Answer: B

Rationale: The correct answer is B because purging in bulimia nervosa is a maladaptive behavior with severe health consequences. The nurse should educate the patient about the long-term harmful effects of purging, such as electrolyte imbalances, dental issues, and organ damage. Encouraging the patient to continue purging (A) reinforces the harmful behavior. Agreeing with the patient (C) or suggesting purging as an effective weight management method (D) further perpetuates the unhealthy behavior and fails to address the underlying issues. Overall, educating the patient about the risks of purging is essential in promoting recovery and better health outcomes.

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