Age Specific Patient Care

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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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Features of schizoid personality include.

  • A. Hyper-vigilant ready for real or imagines threat
  • B. Inability to respond to others, hyper-vigilant
  • C. Social withdrawal, inability to respond to others
  • D. Ready for real or imagined threat, social withdrawal
Correct Answer: C

Rationale: Schizoid personality disorder is characterized by social withdrawal and emotional detachment, with little interest in relationships.

An emergency department nurse prepares to assist with evidence collection for a sexual assault victim. Prior to photographs and pelvic examination, what documentation is important?

  • A. The patient's vital signs
  • B. Consent signed by the patient
  • C. Supervision and credentials of the examiner
  • D. Storage location of the patient's personal effects
Correct Answer: B

Rationale: The correct answer is B: Consent signed by the patient. This is crucial as it ensures the patient's autonomy and willingness to undergo evidence collection. Without proper consent, the procedure would be unethical and potentially illegal. Vital signs (A) may be important for overall assessment but are not directly related to evidence collection. Supervision and credentials of the examiner (C) are necessary but not the most important documentation. The storage location of personal effects (D) is relevant for patient safety but not essential for evidence collection.

A patient with anorexia nervosa is being treated with refeeding. Which complication should the nurse monitor for during this phase?

  • A. Hyperkalemia and hyperglycemia.
  • B. Hypophosphatemia and cardiac arrhythmias.
  • C. Increased appetite and food cravings.
  • D. Dehydration and hypotension.
Correct Answer: B

Rationale: The correct answer is B: Hypophosphatemia and cardiac arrhythmias. During refeeding in anorexia nervosa, there is a risk of rapid shifts in electrolytes, particularly phosphorus, leading to hypophosphatemia which can cause cardiac arrhythmias. This is a critical complication that the nurse should monitor for. Hyperkalemia and hyperglycemia (choice A) are less common in refeeding syndrome. Increased appetite and food cravings (choice C) are expected outcomes of refeeding, not complications. Dehydration and hypotension (choice D) are potential issues but are not specific to refeeding in anorexia nervosa.

A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self. Select the best outcome related to this diagnosis. Within 2 weeks, the patient will:

  • A. Appropriately express angry feelings.
  • B. Verbalize two positive things about self.
  • C. Verbalize the importance of eating a balanced diet.
  • D. None of the above.
Correct Answer: D

Rationale: Rationale:
1. Patient's diagnosis indicates coping issues, not anger expression or self-esteem.
2. Patient's coping mechanism involves overeating and vomiting, not diet.
3. Outcome should focus on coping skills improvement, not unrelated goals.
4. None of the choices address the root issue of coping with loneliness and isolation.
5. Thus, the correct answer is D, as none of the options directly address the patient's ineffective coping mechanism.

What is the primary goal for a nurse treating a patient with anorexia nervosa?

  • A. To help the patient achieve optimal body weight quickly.
  • B. To restore the patient's nutritional balance and weight.
  • C. To involve the patient in daily exercise routines to improve physical health.
  • D. To encourage the patient to undergo intensive psychotherapy.
Correct Answer: B

Rationale: The primary goal for a nurse treating a patient with anorexia nervosa is to restore the patient's nutritional balance and weight. This is because individuals with anorexia nervosa often have severe malnutrition and weight loss, which can lead to serious health complications. By focusing on restoring nutritional balance and weight, the nurse can help improve the patient's physical health and overall well-being. Encouraging the patient to achieve optimal body weight quickly (choice A) may not be realistic or safe, as rapid weight gain can have negative consequences. Involving the patient in daily exercise routines (choice C) may exacerbate the patient's compulsive behaviors around food and exercise. Encouraging the patient to undergo intensive psychotherapy (choice D) is important, but it is not the primary goal in the initial treatment of anorexia nervosa.

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