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In most anxiety disorders, the person's distress is
- A. focused on a specific situation
- B. related to ordinary life stresses
- C. greatly out of proportion to the situation
- D. based on a physical cause
Correct Answer: C
Rationale: Anxiety disorders feature exaggerated distress disproportionate to the trigger, unlike normal stress.
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Which of the following is a priority nursing intervention for a patient with anorexia nervosa during the refeeding process?
- A. Encourage the patient to engage in physical activity to stimulate appetite.
- B. Monitor vital signs and electrolyte levels to avoid refeeding syndrome.
- C. Offer high-calorie snacks to speed up weight gain.
- D. Focus on the patient's body image concerns before addressing nutrition.
Correct Answer: B
Rationale: The correct answer is B because monitoring vital signs and electrolyte levels is crucial during the refeeding process to prevent refeeding syndrome, a potentially life-threatening complication. This intervention ensures early detection of any electrolyte imbalances or cardiac complications that may arise as the body readjusts to increased food intake. Encouraging physical activity (A) can be harmful due to the patient's compromised state. Offering high-calorie snacks (C) may lead to rapid weight gain and increase the risk of refeeding syndrome. Focusing on body image concerns (D) is important but should not take precedence over addressing the patient's immediate medical needs.
An 11-year-old boy stays home from school to care for his siblings while his mother works, because the family cannot afford a babysitter. During the community mental health nurse's visit, he reveals that he thinks his father does not like him because he calls him 'stupid' all the time. He states he is too dumb to learn much and has no friends at school because he does not deserve them. Which nursing diagnosis should be the priority for the child?
- A. Helplessness
- B. Knowledge deficit
- C. Ineffective coping
- D. Chronic low self-esteem
Correct Answer: D
Rationale: The correct answer is D: Chronic low self-esteem. This diagnosis is appropriate because the child displays a negative self-concept, feeling unworthy, lacking confidence, and believing he is "stupid" and undeserving of friends. This impacts his self-worth and psychological well-being. Chronic low self-esteem is the priority to address as it affects various aspects of his life.
Choice A: Helplessness may seem relevant due to the family situation, but the child's core issue is more about self-worth than feeling helpless in his situation.
Choice B: Knowledge deficit is not the priority as the child's issue lies more in his emotional well-being rather than lack of information.
Choice C: Ineffective coping might be a concern, but the root of his struggles is his self-esteem, making chronic low self-esteem the primary focus.
A client with a borderline personality disorder tells the nurse, 'My doctor tells me there's something wrong with the hard wiring of my brain, and that's why I'm so impulsive and get so many mood swings. He said he's going to prescribe some medication.' Being aware of current practice guidelines, the nurse will prepare a teaching plan for:
- A. Lithium
- B. Fluoxetine
- C. Lorazepam
- D. Haloperidol
Correct Answer: B
Rationale: The correct answer is B: Fluoxetine. In the context of borderline personality disorder, fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is often used to manage symptoms such as mood swings and impulsivity. SSRIs help regulate serotonin levels in the brain, which can improve mood stability and reduce impulsive behaviors.
- A: Lithium is typically used for bipolar disorder, not borderline personality disorder.
- C: Lorazepam is a benzodiazepine used for anxiety or panic disorders, not specific to treating symptoms of borderline personality disorder.
- D: Haloperidol is an antipsychotic medication used for psychosis, not typically indicated for managing impulsivity or mood swings in borderline personality disorder.
Which remarks by a 72-year-old patient should prompt the nurse to assess for depression? Select one tha does not apply.
- A. Lately I have had a lot of aches and pains and just havent felt very well.
- B. People are in and out of my room all day and all night taking my things.
- C. Dont ask me to eat. I cant because my stomach is upset all the time.
- D. Im eating more than usual, and I am sleeping about 6 hours a night.
Correct Answer: D
Rationale: Somatic symptoms (A), delusions of persecution (B), and nihilistic delusions (C) are common in late-onset depression, warranting assessment. Increased appetite and contentment (D, E) do not suggest depression.
The Freudian explanation of anxiety disorders emphasizes
- A. the avoidance paradox
- B. learned habits of self-defeating behavior
- C. forbidden impulses that threaten a loss of control
- D. the development of a faulty or inaccurate self-image and distorted self-perceptions
Correct Answer: C
Rationale: Freud viewed anxiety as stemming from repressed impulses threatening to surface, disrupting control.