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An advance directive gives legally binding direction for health care interventions when a patient
- A. has a new diagnosis of cancer.
- B. is diagnosed with Parkinson's disease.
- C. is unable to make decisions for self because of illness.
- D. diagnosed with amyotrophic lateral sclerosis is unable to speak.
Correct Answer: C
Rationale: The correct answer is C because an advance directive is a legal document that specifies a person's wishes for healthcare decisions if they are unable to make decisions for themselves due to illness. This ensures their preferences are followed. Choices A and B are specific diagnoses and do not address decision-making capacity. Choice D focuses on the inability to speak, which is just one aspect of decision-making ability, but not comprehensive enough for an advance directive.
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Which of the following interventions is most appropriate for a patient with bulimia nervosa?
- A. Encourage regular weight monitoring and restriction of food intake.
- B. Offer emotional support and focus on healthy coping mechanisms.
- C. Provide medications to induce vomiting after meals.
- D. Focus on achieving weight loss and reducing food intake.
Correct Answer: B
Rationale: The correct answer is B because offering emotional support and focusing on healthy coping mechanisms are crucial in treating bulimia nervosa. This approach addresses the psychological aspects of the disorder and helps the patient develop healthier behaviors. Regular weight monitoring and food restriction (choice A) can exacerbate the disorder by reinforcing a focus on weight and food. Medications to induce vomiting (choice C) can be harmful and do not address the underlying issues. Focusing on weight loss and reducing food intake (choice D) may worsen the patient's disordered eating behaviors and contribute to a cycle of restriction and bingeing.
The extreme reaction known as fugue refers to
- A. physical flight to escape conflict
- B. severe depression
- C. hallucinations
- D. obsessive behavior
Correct Answer: A
Rationale: Fugue is a dissociative state involving sudden travel or flight, often to escape stress.
In Singapore, MSF-funded disability services for preschool children:
- A. Serve those with congenital, physical, sensory, developmental, and behavioural disorders
- B. Are all centre-based
- C. Provided by charity and public hospitals only
- D. Are overseen by the Early Childhood Developmental Agency (EDCA)
Correct Answer: A
Rationale: MSF-funded services cover a broad range of disabilities in preschoolers, aligning with Singapore's inclusive disability framework.
Schizophrenia is usually diagnosed in:
- A. Infancy
- B. Childhood
- C. Early adulthood
- D. Old age
Correct Answer: C
Rationale: Schizophrenia typically emerges in early adulthood (late teens to early 20s), though symptoms may appear earlier or later in rare cases.
What is the priority intervention for a nurse caring for a patient with bulimia nervosa?
- A. Assist the patient to identify triggers to binge eating.
- B. Provide remedial consequences for weight loss.
- C. Assess for signs of impulsive eating.
- D. Explore needs for health teaching.
Correct Answer: A
Rationale: The correct answer is A: Assist the patient to identify triggers to binge eating. This intervention is crucial for managing bulimia nervosa as it helps address the root cause of the behavior. By identifying triggers, the patient can develop strategies to avoid or cope with them, ultimately reducing the frequency of binge eating episodes. Choices B, C, and D are incorrect because providing consequences for weight loss may reinforce unhealthy behaviors, assessing for impulsive eating is not addressing the underlying triggers, and exploring needs for health teaching is not as immediate and targeted as identifying triggers for binge eating.