Nokea
Appropriate teaching for a patient with bulimia nervosa who binges and purges is:
- A. Not to skip meals or restrict food.
- B. To eat a small meal after purging.
- C. To eat a large breakfast but no lunch.
- D. None of the above.
Correct Answer: A
Rationale: Step-by-step rationale:
1. A: Not skipping meals or restricting food promotes regular eating patterns, helps stabilize blood sugar levels, and reduces the urge to binge.
2. B: Eating a small meal after purging could reinforce the binge-purge cycle and is not a healthy approach.
3. C: Eating a large breakfast but skipping lunch can lead to imbalanced eating habits and is not recommended for treating bulimia nervosa.
4. D: None of the above options provide a comprehensive and effective approach to managing bulimia nervosa symptoms.
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After being raped, a woman was told by her aunt, 'I'm not surprised that happened to you. You were asking for it.' A few days later, a friend told her, 'Well after all, he took you to dinner. He expected something in return.' The victim states, 'I can't believe that people can think that way.' The rape crisis nurse correctly hypothesizes that the client is:
- A. Experiencing cognitive dissonance.
- B. In denial about the rape.
- C. Seeking validation from others.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Experiencing cognitive dissonance. Cognitive dissonance refers to the mental discomfort or conflict that occurs when a person's beliefs or attitudes are inconsistent with their actions or experiences. In this scenario, the woman is facing conflicting beliefs - she knows she did not ask for or deserve to be raped, yet the comments from her aunt and friend suggest otherwise. This leads to the woman feeling disbelief and distress.
Summary:
B: In denial about the rape - This choice does not address the conflicting beliefs the woman is experiencing.
C: Seeking validation from others - While seeking validation may be a natural response, it does not capture the essence of cognitive dissonance in this context.
The management of nausea as a side effect of lithium carbonate (Eskalith) includes instructing the patient to take the medication:
- A. after meals
- B. between meals
- C. with a carbonated beverage
- D. with a large glass of water
Correct Answer: A
Rationale: Taking lithium after meals reduces gastrointestinal irritation, including nausea, by buffering its absorption.
Which intervention would best address the nursing diagnosis of Imbalanced nutrition for elderly patients in stages 2 to 3 of Alzheimer's disease?
- A. Monitor the frequency and characteristics of bowel movements.
- B. Offer finger foods the patient can take away from the table.
- C. Monitor intake and output, and take patient weights each week.
- D. Provide protein-dense foods to provide for neurological regrowth.
Correct Answer: B
Rationale: The correct answer is B: Offer finger foods the patient can take away from the table. This intervention is best suited for elderly patients in stages 2 to 3 of Alzheimer's disease as it promotes independent eating, encourages increased food intake, and addresses potential behavioral issues related to Alzheimer's. By offering finger foods that the patient can take away from the table, it allows for easier access to food, enhances the patient's ability to feed themselves, and reduces frustration or confusion that may arise during meal times. This approach supports the patient's autonomy and dignity while also addressing the nursing diagnosis of Imbalanced nutrition.
Choice A is incorrect because monitoring bowel movements does not directly address the nutritional needs of the patient. Choice C focuses more on fluid balance rather than nutrition intake. Choice D is incorrect as providing protein-dense foods does not specifically target the challenges faced by elderly patients with Alzheimer's disease in stages 2 to 3.
Which of the following statements is true about the differences in mental health problems between children and adults?
- A. Children are affected by the same stressors as adults, but to different degrees and with different manifestations
- B. Childrens mental health disorders are generally much less severe and resolve more quickly than do those of adults
- C. Childrens mental health problems are different from those of adults because their brains are wired differently
- D. Children have better means of working off stresses than do adults
Correct Answer: A
Rationale: Mental health disorders in children have many similarities and differences from the same disorders in adults. The other responses are not correct.
An adult patient tells the case manager, 'I dont have bipolar disorder anymore, so I dont need medicine. After I was in the hospital last year, you helped me get an apartment and disability checks. Now Im bored and dont have any friends.' Where should the nurse refer the patient? Select one tha does not apply.
- A. Psychoeducational classes
- B. Vocational rehabilitation
- C. Social skills training
- D. A homeless shelter
Correct Answer: D
Rationale: The patient does not understand the illness and need for adherence to the medication regimen. Psychoeducation for the patient (and family) can address this lack of knowledge. The patient, who considers himself friendless, could also profit from social skills training to improve the quality of interpersonal relationships. Many patients with serious mental illness have such poor communication skills that others are uncomfortable interacting with them. Interactional skills can be effectively taught by breaking the skill down into smaller verbal and nonverbal components. Work gives meaning and purpose to life, so vocational rehabilitation can assist with this aspect of care. The nurse case manager will function in the role of crisis stabilizer, so no related referral is needed. The patient presently has a home and does not require a homeless shelter.