Nokea
A psychosis arising from an advanced stage of syphilis, in which the disease attacks brain cells, is called
- A. Korsakoff's syndrome
- B. delirium tremens
- C. schizotypical psychosis
- D. general paresis
Correct Answer: D
Rationale: General paresis results from neurosyphilis, causing psychotic symptoms due to brain damage.
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What is the primary nursing intervention for a patient with anorexia nervosa who is refusing to eat?
- A. Offer rewards for eating meals.
- B. Provide firm encouragement and offer small, frequent meals.
- C. Enforce strict diet control and limit food choices.
- D. Allow the patient to skip meals if they do not feel hungry.
Correct Answer: B
Rationale: The correct answer is B because providing firm encouragement and offering small, frequent meals is a supportive approach to help the patient with anorexia nervosa overcome their fear of eating. It helps in gradually reintroducing food, building trust, and establishing a healthier eating pattern. Offering rewards (A) may reinforce unhealthy eating behaviors. Enforcing strict diet control (C) can exacerbate control issues and worsen the patient's condition. Allowing the patient to skip meals (D) can perpetuate malnutrition and reinforce avoidance behaviors.
A history reveals that a patient virtually stopped eating 5 months ago and lost 25% of body weight. The nurse says, "Describe what you think about your present weight and how you look." Which response would be most consistent with anorexia nervosa?
- A. I'm fat and ugly.
- B. What I think about myself is my business.
- C. I'm grossly underweight, but I cover it well.
- D. I'm a few pounds overweight, but I can live with it.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. The patient's history of significant weight loss and refusal to eat align with symptoms of anorexia nervosa.
2. Choice A reflects negative body image common in anorexia nervosa, as patients often perceive themselves as overweight and unattractive.
3. Choices B, C, and D do not acknowledge the patient's actual physical condition or the psychological aspect of anorexia nervosa.
4. Choice B avoids the question and lacks insight into the patient's distorted body image.
5. Choice C acknowledges being underweight but does not address the negative self-perception associated with anorexia nervosa.
6. Choice D acknowledges being overweight, which contradicts the patient's actual weight loss history and is inconsistent with anorexia nervosa's symptoms.
A patient diagnosed with serious mental illness was living successfully in a group home but wanted an apartment. The prospective landlord said, 'People like you have trouble getting along and paying their rent.' The patient and nurse meet for a problem-solving session. Which options should the nurse endorse? Select one tha does not apply.
- A. Coach the patient in ways to control symptoms effectively
- B. Seek out landlords less affected by the stigma associated with mental illness
- C. Threaten the landlord with legal action because of the discriminatory actions
- D. Have the case manager meet with the landlord to provide education about mental illness
Correct Answer: C
Rationale: Managing symptoms so that they are less obvious or socially disruptive can reduce negative reactions and reduce rejection due to stigma. Seeking a more receptive landlord might be the most expeditious route to housing for this patient. Educating the landlord to reduce stigma might make him more receptive and give the case manager an opportunity to address some of his concerns (e.g., the case manager could arrange a payee to assure that the rent is paid each month). However, threatening a lawsuit would increase the landlords defensiveness and would likely be a long and expensive undertaking. Delaying the patients efforts to become more independent is not clinically necessary according to the data noted here; the problem is the landlords bias and response, not the patients illness. It would be unethical to encourage falsification and poor role modeling to do so; further, if falsification is discovered, it could permit the landlord to refuse or cancel her lease.
A patient was admitted in a semistuporous catatonic state. Family states that the patient has neither left the apartment nor attended to personal hygiene for several weeks. The patient's last 48 hours have been spent lying in bed, mute and motionless. The nursing diagnosis that should be considered the priority is:
- A. self-care deficit.
- B. situational low self-esteem.
- C. disturbed thought processes.
- D. impaired verbal communication.
Correct Answer: A
Rationale: The correct answer is A: self-care deficit. This nursing diagnosis should be considered the priority because the patient is unable to attend to personal hygiene and has been lying in bed motionless and mute for 48 hours, indicating a significant impairment in self-care abilities. This is a critical issue that needs immediate attention to prevent further deterioration in the patient's physical and mental health.
Choice B: situational low self-esteem is not the priority as the patient's current state is more indicative of physical neglect rather than a self-esteem issue.
Choice C: disturbed thought processes may be a contributing factor to the patient's presentation, but the priority at this moment is addressing the self-care deficit to ensure the patient's safety and well-being.
Choice D: impaired verbal communication, while important, is not the priority in this scenario as the patient's inability to communicate verbally is secondary to the urgent need for assistance with self-care.
What should the nurse do when a patient with anorexia nervosa expresses a fear of gaining weight?
- A. Minimize the patient's fears to avoid anxiety.
- B. Provide information about the importance of weight gain for health.
- C. Encourage weight loss to help the patient feel more in control.
- D. Agree with the patient's concerns and avoid discussing the topic.
Correct Answer: B
Rationale: The correct answer is B because providing information about the importance of weight gain for health helps educate the patient on the risks of anorexia nervosa. By doing so, the nurse can address the patient's fears in a supportive and informative manner, promoting a better understanding of the need for weight gain.
Choice A is incorrect because minimizing the patient's fears may invalidate their feelings and hinder therapeutic communication. Choice C is incorrect as encouraging weight loss can exacerbate the patient's condition and reinforce unhealthy behaviors. Choice D is incorrect because agreeing with the patient's concerns perpetuates the harmful beliefs associated with anorexia nervosa.