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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Select the best comment for a nurse to begin an interview with an elderly patient.
- A. I am a nurse. Are you familiar with what nurses do?'
- B. Hello. I am going to ask you some questions to get to know you better.'
- C. You look comfortable and ready to participate in an admission interview. Shall we get started?'
- D. Hello. My name is and I am a nurse. How you would like to be addressed by staff?'
Correct Answer: D
Rationale: The correct opening identifies the nurses role and politely seeks direction for addressing the patient in a way that will make him or her comfortable. This is particularly important when a considerable age difference exists between the nurse and the patient. The nurse should address patients by name and not assume patients want to be called by a first name. The nurse should always introduce self.
A nursing colleague says, 'This patient was admitted claiming to have been raped by her boyfriend, but just look at the sexy clothes she's wearing.' Which response reflects an understanding of the most likely source of the colleague's comment?
- A. Have you ever cared for other sexual assault victims?'
- B. Your sister was raped when she was in college, wasn't she?'
- C. You have three unmarried brothers about the patient's age, don't you?'
- D. Do you think that wearing sexy clothes caused her to be sexually assaulted?'
Correct Answer: D
Rationale: The correct answer is D because it addresses the underlying misconception that a person's clothing choices can justify or provoke sexual assault. By asking if the colleague believes the victim's clothing caused the assault, it challenges victim-blaming and highlights the importance of understanding consent and boundaries.
Option A does not directly address the colleague's potentially victim-blaming statement. Option B brings up the colleague's personal experience, which is irrelevant and may not effectively challenge the problematic comment. Option C makes assumptions about the colleague's personal life, which is not relevant to the situation at hand.
A 17-year-old patient with anorexia nervosa has just been released from the hospital. To facilitate recovery at home, the psychiatric-mental health nurse instructs the family to:
- A. discourage the patient from sneaking food between meals, by unobtrusively reducing access to the kitchen
- B. encourage the patient's interest in menu planning, food magazines, and cooking lessons, by leaving information and materials around the house
- C. permit the patient to eat her meals privately to discourage family preoccupation with meals
- D. recommend that the patient joins in routine family meals and clears the dishes after dinner, even if they do not eat
Correct Answer: D
Rationale: Involving the patient in family meals normalizes eating behavior and provides structure, supporting recovery without enabling secrecy or avoidance.
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.
An acutely psychotic individual diagnosed with schizophreniaform disorder at admission is immediately placed on daily doses of risperidone. A hospitalization of 8 days' duration has been authorized by the HMO. By what hospital day would the nurse expect to note that client was demonstrating beginning trust in the nurse and reduction in hallucinations and delusions?
- A. Day of admission
- B. Day 3 of hospitalization
- C. Day 5 of hospitalization
- D. Day 7 of hospitalization
Correct Answer: B
Rationale: The correct answer is B: Day 3 of hospitalization. Typically, antipsychotic medications like risperidone take a few days to start showing noticeable effects in reducing hallucinations and delusions. By day 3, the medication would have had enough time to begin its therapeutic effect. Building trust with a psychotic patient also takes time, so by day 3, the patient may start showing signs of trust in the nurse. Day of admission (Choice A) is too early for the medication to take effect. Day 5 (Choice C) and Day 7 (Choice D) are too late as the medication usually shows noticeable improvement within the first few days.
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