Nokea
A person diagnosed with serious mental illness has frequent relapses, usually precipitated by situational stressors such as running out of money or the absence of key staff at the mental health center. Which interventions would the nurse suggest to reduce the risk of stressors to cause relapse? Select one tha does not apply.
- A. Discourage potentially stressful activities such as groups or volunteer work
- B. Develop written plans that will help the patient remember what to do in a crisis
- C. Help the patient identify and anticipate events that are likely to be overwhelming
- D. Encourage health-promoting activities such as exercise and getting adequate rest
Correct Answer: A
Rationale: Basic interventions for coping with crises involve anticipating crises where possible and then developing a plan with specific actions to take when faced with an overwhelming stressor. Written plans are helpful; it can be difficult for anyone, especially a person with cognitive or memory impairments, to develop or remember steps to take when under overwhelming stress. Health-promoting activities enhance a persons ability to cope with stress. As the name suggests, support groups help a person develop a support system, and they provide practical guidance from peers who learned from experience how to deal with issues the patient may be facing. Groups and volunteer work may involve a measure of stress but also provide benefits that help persons cope and should not be discouraged unless they are being done to excess.
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What is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors?
- A. Monitor for signs of electrolyte imbalances and dehydration.
- B. Assess for any weight gain and increase exercise habits.
- C. Encourage the patient to express feelings about food and body image.
- D. Monitor for compulsive eating behaviors and binge episodes.
Correct Answer: A
Rationale: The correct answer is A: Monitor for signs of electrolyte imbalances and dehydration. This is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors because purging can lead to electrolyte imbalances and dehydration, which can result in serious health complications such as cardiac arrhythmias and renal issues. Monitoring electrolyte levels and hydration status is crucial for the patient's safety and well-being.
Summary:
- Choice B is incorrect because focusing on weight gain and exercise habits is not the priority when dealing with the immediate health risks of electrolyte imbalances and dehydration.
- Choice C is incorrect as expressing feelings about food and body image is important for therapy but not the priority in this acute situation.
- Choice D is incorrect as monitoring for compulsive eating behaviors and binge episodes is more relevant for patients with binge eating disorder rather than bulimia nervosa with frequent purging behaviors.
The daughter of an 84-year-old client with dementia tearfully tells the nurse that she doesn't know what's wrong with her mother, who has begun accusing the family of stealing her lingerie and holding her prisoner. The nurse identifies which of the following nursing diagnosis for the client?
- A. Disturbed thought processes
- B. Powerlessness
- C. Ineffective coping
- D. Defensive coping
Correct Answer: A
Rationale: The correct answer is A: Disturbed thought processes. This nursing diagnosis is appropriate because the client's symptoms suggest cognitive impairment and delusions, which are common in dementia. The client's accusations of theft and imprisonment indicate a distortion in reality perception, reflecting disturbed thought processes. Powerlessness (B) relates more to lack of control over circumstances, not cognitive issues. Ineffective coping (C) and Defensive coping (D) focus on emotional responses rather than cognitive impairment.
A nurse assesses that which of the following individuals is most likely to engage in binge-eating behaviors characteristic of bulimia?
- A. A person who weighs 225 pounds and is 5 feet 4 inches tall.
- B. A person who is 5 pounds overweight and cannot stick to a diet.
- C. A person who lost up 40 pounds but gained it back within 1 year.
- D. A person who monitors caloric intake in order to fit into a small suit.
Correct Answer: B
Rationale: The correct answer is B because binge-eating behaviors are often associated with individuals who struggle to control their eating, leading to episodes of excessive food consumption. Being unable to stick to a diet indicates a lack of control, which is a key characteristic of binge-eating. Choice A focuses more on weight and height, which are not direct indicators of binge-eating. Choice C describes weight fluctuations, which may not necessarily be linked to binge-eating. Choice D emphasizes monitoring caloric intake for a specific goal, which does not necessarily indicate a loss of control over eating behavior.
Which of these nursing communications would be most effective in teaching a patient about abusive behavior?
- A. So when your husband says he needs other women because you aren't sexually satisfying his needs, do you believe what he is telling you is true?'
- B. You say that your son has been pulling the neighbor's pigtails and you are worried he's becoming violent and abusive like your brother?'
- C. You say that you placed your son on an allowance but that you also want to regulate everything he spends and saves?'
- D. I noticed that when your mother paid you a compliment about your new hairstyle, you seemed skeptical.'
Correct Answer: A
Rationale: The correct answer is A because it directly addresses the issue of abusive behavior in a clear and non-judgmental manner. By framing the question around a specific scenario of abusive behavior and asking for the patient's perspective, it encourages self-reflection and critical thinking. This approach empowers the patient to recognize and acknowledge the abusive behavior, which is crucial for initiating change.
Choices B, C, and D are incorrect because they do not specifically address abusive behavior. Choice B focuses on a different type of behavior (childhood aggression), Choice C addresses financial control rather than abuse, and Choice D discusses skepticism in response to a compliment, which is unrelated to abusive behavior. These choices do not effectively target the issue at hand and may lead to confusion or misinterpretation.
Which of these nursing communications best reflects the nurse's use of an empowerment model with an individual who has been abused?
- A. Let me share with you my knowledge of what happens psychologically to individuals who have been abused.'
- B. I know you feel that your partner will change, but the current research does not validate your thinking.'
- C. It's up to you to end the violence. You are the only one who can set limits on how your partner is allowed to treat you.'
- D. Let's consider what you believe your options are in terms of your relationship with your partner in light of the behavior toward you.'
Correct Answer: D
Rationale: The correct answer, D, reflects the nurse's use of an empowerment model because it focuses on exploring the individual's beliefs and options, empowering them to make informed decisions. The nurse is not imposing their own knowledge or opinions but instead facilitating the individual's self-reflection and decision-making process. This approach respects the individual's autonomy and promotes empowerment by helping them identify and evaluate their own choices.
Choice A focuses on the nurse sharing knowledge, which may come across as patronizing and disempowering. Choice B dismisses the individual's feelings and relies on research rather than empowering the individual to make their own decisions. Choice C places the responsibility solely on the individual to end the violence, which may feel overwhelming and lacking in support or guidance.