Conversion disorder and hypochondriasis are classified as
- A. physio-mental disorders
- B. somatoform disorders
- C. psychosomatic disorders
- D. somatization disorders
Correct Answer: B
Rationale: Somatoform disorders involve physical symptoms without medical cause, like conversion and hypochondriasis.
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An older adult patient who lives with a daughter and attends the Alzheimer day hospital program exhibits bilateral bruising for the second time on both upper outer arms. When the nurse questions the patient about the bruising, the patient starts to cry and pleads, 'Please don't say anything. It's not my daughter's fault. I just bruise easily.' Which intervention reflects the best management of this situation?
- A. Call the daughter to discuss both the bruising and her parent's reaction.
- B. Report the elder abuse, and inform the patient and the daughter of your intention.
- C. Notify the patient's social worker of the bruising after a complete assessment has been completed.
- D. Inform the patient and the daughter of your intention to document the bruising and arrange for appropriate counseling.
Correct Answer: B
Rationale: The correct answer is B: Report the elder abuse and inform the patient and the daughter of your intention. This is the best intervention as it prioritizes the safety and well-being of the older adult. Here's the rationale:
1. The patient's repeated bruising and fear of disclosure indicate potential abuse.
2. Reporting elder abuse is mandatory to ensure protection for the patient.
3. Informing the patient and daughter shows transparency and involves them in the process.
4. It is crucial to address the situation promptly to prevent further harm.
Summary:
A: Calling the daughter may escalate the situation and compromise the patient's safety.
C: Notifying the social worker without addressing the abuse directly may delay necessary action.
D: Counseling may be beneficial, but addressing the abuse is a priority to ensure the patient's safety.
A patient with anorexia nervosa is at risk for refeeding syndrome. The nurse should be most concerned with:
- A. Hyperglycemia.
- B. Electrolyte imbalances, particularly hypophosphatemia.
- C. Increased hunger and overeating.
- D. Rapid weight gain and hypertension.
Correct Answer: B
Rationale: The correct answer is B: Electrolyte imbalances, particularly hypophosphatemia. Refeeding syndrome occurs when a malnourished individual receives nutrition too quickly, leading to shifts in electrolytes like phosphate, potassium, and magnesium. Hypophosphatemia is a key concern due to its potential to cause cardiac and respiratory failure. Hyperglycemia (A) may occur but is not the primary concern. Increased hunger and overeating (C) are common symptoms of anorexia nervosa but not directly related to refeeding syndrome. Rapid weight gain and hypertension (D) are potential consequences of refeeding but are not the immediate concern compared to electrolyte imbalances.
A person diagnosed with a serious mental illness (SMI) living in the community was punched, pushed to the ground, and robbed of 7 during the day on a public street. Which statements about violence and serious mental illness in general are accurate? Select one tha does not apply.
- A. Persons with SMI are more likely to be violent
- B. SMI persons experience higher rates of sexual assault and victimization than others
- C. Impaired judgment and social skills can provoke hostile or assaultive behavior
- D. Lower incomes force SMI persons to live in high-crime areas, increasing risk
Correct Answer: A
Rationale: Mentally ill persons are more likely to be victims of crime than perpetrators of criminal acts. They are often victims of criminal behavior, including sexual crimes, at a higher rate than others. When a mentally ill person commits a crime, it is usually nonviolent. Mental illnesses interfere with employment and are associated with poverty, limiting SMI persons to living in inexpensive areas that also tend to be higher-crime areas. SMI persons may inadvertently provoke others because of poor judgment or socially inappropriate behavior, or they may be victimized because they are perceived as passive, less likely to resist, and less likely to be believed as witnesses.
A patient with an eating disorder states, 'Now that I've gained 4 pounds, I can't wear shorts until I lose it again.' The nurse documents that the patient is exhibiting which cognitive distortion related to maladaptive eating regulation responses?
- A. Magnification
- B. Superstitious thinking
- C. Personalization
- D. Dichotomous thinking
Correct Answer: A
Rationale: The correct answer is A: Magnification. This cognitive distortion involves exaggerating the significance of a negative event, in this case, gaining 4 pounds. The patient's focus on this small weight gain as a major obstacle to wearing shorts reflects magnification. Superstitious thinking (B) involves believing in unrelated events causing outcomes, which is not evident here. Personalization (C) involves taking responsibility for events beyond one's control, which is not the case in this scenario. Dichotomous thinking (D) involves seeing things in black and white terms, which is not demonstrated in the patient's statement.
In an art therapy session, a client with anorexia nervosa was asked to draw a picture of herself. Which drawing would likely depict the client's view of herself?
- A. A tall, slim girl with obvious muscle definition.
- B. A malnourished teenager with thin, lanky extremities.
- C. A grossly obese figure lacking feminine characteristics.
- D. A shapely figure of a model who she admires.
Correct Answer: C
Rationale: The correct answer is C because individuals with anorexia nervosa often have a distorted body image and see themselves as larger than they actually are. Drawing a grossly obese figure lacking feminine characteristics reflects the distorted self-perception common in anorexia nervosa. Choice A is incorrect as it portrays a positive body image. Choice B may be close, but it focuses more on malnourishment rather than distorted body image. Choice D is incorrect as it reflects admiration for a shapely figure, which may not align with the client's self-perception.