Nokea
A short-term goal for a patient with Alzheimer disease is:
- A. Improved functioning in the least restrictive environment
- B. improved problem solving in activities of daily living
- C. increased self-esteem and improved self-concept
- D. regained sensory perception and cognitive function
Correct Answer: A
Rationale: Promoting function in a safe, least restrictive setting is realistic and achievable given Alzheimer's progressive nature.
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A student transfers from a hometown college to a university 200 miles away after breaking up with her boyfriend of 2 years. She was slow to make friends at the university. The history shows a close relationship with her mother and sister. She began eating large quantities when she felt sad, and then she induced vomiting. When the student's schoolwork declined, she sought help from the university health clinic. During the initial interview, what priority issue should the nurse address?
- A. Losses
- B. Sleep patterns
- C. School activities
- D. Menstrual flow
Correct Answer: A
Rationale: The correct answer is A: Losses. The priority issue the nurse should address is the student's recent breakup and difficulty making friends, which are significant losses impacting her emotional well-being. By addressing these losses, the nurse can help the student process her emotions and develop coping strategies.
B: Sleep patterns may be affected by the student's emotional distress, but it is a secondary concern compared to addressing the underlying losses.
C: School activities are important, but the root cause of the student's decline in schoolwork is likely related to her emotional state following the breakup.
D: Menstrual flow is not the priority issue at this time as it is not directly related to the student's emotional struggles and academic decline.
Which nursing diagnosis is more relevant for a patient with anorexia nervosa who restricts intake and is 20% below normal weight than for a 130-pound patient with bulimia nervosa who purges?
- A. Powerlessness
- B. Ineffective coping
- C. Disturbed body image
- D. Imbalanced nutrition: less than body requirements
Correct Answer: D
Rationale: The correct answer is D, Imbalanced nutrition: less than body requirements. For a patient with anorexia nervosa who restricts intake and is 20% below normal weight, this diagnosis is more relevant as it directly addresses the issue of inadequate food intake leading to weight loss. Powerlessness (A) may not be as directly related to the physical consequences of anorexia. Ineffective coping (B) and Disturbed body image (C) are more commonly associated with bulimia nervosa and do not address the primary concern of malnutrition in this case.
Which is the most appropriate response when a patient with bulimia nervosa expresses feelings of shame about their purging behaviors?
- A. Encourage the patient to avoid discussing their eating habits.
- B. Agree with the patient's feelings and offer reassurance.
- C. Focus on helping the patient identify triggers for purging behaviors.
- D. Provide education on the benefits of purging for weight management.
Correct Answer: C
Rationale: The correct answer is C because focusing on helping the patient identify triggers for purging behaviors is essential in addressing the underlying issues contributing to their behavior. By identifying triggers, the patient can develop coping strategies and alternative behaviors.
Choice A is incorrect as avoiding discussing eating habits can hinder progress in therapy. Choice B is incorrect as simply agreeing and offering reassurance without addressing the root cause may not lead to lasting change. Choice D is incorrect as it promotes the harmful behavior of purging for weight management, which goes against the goal of treating bulimia nervosa.
What is the most important aspect of nursing care for patients with anorexia nervosa during refeeding?
- A. Refeed the patient with high-calorie foods quickly to gain weight.
- B. Start with small, manageable portions and gradually increase caloric intake.
- C. Restrict food choices to healthy foods only.
- D. Encourage the patient to take food supplements in addition to meals.
Correct Answer: B
Rationale: The correct answer is B: Start with small, manageable portions and gradually increase caloric intake. This approach is essential because refeeding syndrome can occur in patients with anorexia nervosa, where rapid refeeding can lead to severe electrolyte imbalances and potentially life-threatening complications. Starting with small portions helps to prevent this syndrome by allowing the body to gradually adjust to increased caloric intake. Additionally, it helps in preventing overwhelming the patient with large amounts of food, which can trigger anxiety and resistance to eating.
Incorrect choices:
A: Refeed the patient with high-calorie foods quickly to gain weight - This can lead to refeeding syndrome and is not a safe approach.
C: Restrict food choices to healthy foods only - Restricting food choices can exacerbate disordered eating behaviors and does not address the need for gradual refeeding.
D: Encourage the patient to take food supplements in addition to meals - While supplements can be helpful, they should not be a primary focus over balanced
CT scans of the brains of some young schizophrenics show than normal
- A. wider ventricles
- B. smaller fissures
- C. smaller ventricles
- D. fewer fissures
Correct Answer: A
Rationale: Enlarged ventricles in schizophrenics suggest brain abnormalities linked to the disorder.