Nokea
Adolescents often cite barriers for discussing psychosocial issues with their physician. If confidentiality is addressed, which of the following do adolescents NOT cite as a barrier:
- A. Non-judgemental approach of physician
- B. Personal embarrassment towards discussing sensitive topics
- C. Physician seems rushed
- D. Physician did not ask about sensitive topics
Correct Answer: A
Rationale: A non-judgmental approach facilitates discussion and is not a barrier, unlike embarrassment, time constraints, or perceived lack of understanding.
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Which assessment findings would alert the nurse that an older patient may have an increased risk for development of geriatric alcohol abuse? Select one tha does not apply.
- A. Mild recent memory impairment
- B. Eighth grade education
- C. Death of spouse
- D. Retirement
Correct Answer: A
Rationale: Geriatric problem drinking often begins in response to stressors like retirement (D), loss of spouse (C), and loneliness (E), with risk factors including less than high school education (B). Mild memory impairment (A) is not a predisposing factor.
A patient with anorexia nervosa is resistant to weight gain. What is the rationale for establishing a contract with the patient to participate in measures to produce a specified weekly weight gain?
- A. Severe anxiety concerning eating is expected, so objective and subjective data are needed.
- B. Patient involvement in decision-making increases sense of control and promotes collaboration.
- C. The patient's family is not supportive of the treatment plan.
- D. None of the above.
Correct Answer: B
Rationale: Correct Answer: B - Patient involvement in decision-making increases sense of control and promotes collaboration.
Rationale:
1. Involving the patient in decision-making empowers them and increases their sense of control over their treatment.
2. Collaborating with the patient fosters a positive therapeutic relationship.
3. This approach is more likely to lead to better treatment adherence and outcomes.
Summary:
A: While objective and subjective data are important, this choice does not address the need for patient involvement in decision-making and collaboration.
C: The lack of family support is not directly related to the rationale for establishing a contract with the patient.
D: This choice is incorrect as patient involvement is crucial in promoting successful treatment outcomes.
Which of the following is a common physical sign in patients with bulimia nervosa?
- A. Hypotension and bradycardia.
- B. Dental erosion and swollen parotid glands.
- C. Rapid weight gain and increased appetite.
- D. Severe muscle wasting and low body temperature.
Correct Answer: B
Rationale: The correct answer is B: Dental erosion and swollen parotid glands are common physical signs in patients with bulimia nervosa. Dental erosion is caused by repeated exposure of teeth to stomach acid during purging. Swollen parotid glands result from repeated vomiting. Hypotension and bradycardia (A) are more common in anorexia nervosa. Rapid weight gain and increased appetite (C) are not typical in bulimia nervosa; rather, patients often maintain a normal weight. Severe muscle wasting and low body temperature (D) are not commonly associated with bulimia nervosa.
When thinking about alcohol and drug abuse the clinical officer should be aware that
- A. Most alcoholics become poly drug abusers
- B. Addictive individuals tend to use hostile, abusive behavior
- C. An unhappy childhood is a causative factor in many addictions
- D. Most poly drug abusers also abuse alcohol
Correct Answer: D
Rationale: Most poly drug abusers also abuse alcohol, as it is a commonly available and socially accepted substance often combined with other drugs.
A client with dementia was admitted to a dementia unit after she began persistently wandering away from home. The nursing staff should plan to:
- A. Provide unlimited freedom because the client has no place to go in the new neighborhood
- B. Provide one-to-one supervision when the client is ambulatory
- C. Place the client in a geriatric chair with a tray across the lap
- D. Provide the client with an electronic alarm that sounds when the client nears the exit door
Correct Answer: D
Rationale: The correct answer is D because providing the client with an electronic alarm that sounds when she nears the exit door is the best option to ensure her safety. This approach allows for monitoring without restricting her movement excessively. Choice A is incorrect as unlimited freedom poses risks. Choice B is not practical or feasible long-term. Choice C is not person-centered and may lead to discomfort and agitation. The electronic alarm in choice D is the most effective and least intrusive method to prevent wandering while respecting the client's autonomy.