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Many clients with eating disorders have difficulty translating their pain into words. Which approach may be used to promote getting in touch with feelings and greater self-disclosure?
- A. Personality inventory testing.
- B. Dance and movement therapy.
- C. Letter writing.
- D. Cooking and meal-planning classes.
Correct Answer: B
Rationale: The correct answer is B: Dance and movement therapy. This approach can help clients with eating disorders express emotions non-verbally, promoting self-awareness and self-disclosure. Movement therapy encourages embodied expression of feelings, facilitating a deeper connection to internal experiences. It allows clients to explore and release emotions through physical movement, aiding in the processing of emotional pain. Personality inventory testing (A) may not directly address emotional expression. Letter writing (C) can help, but may not be as effective as movement in promoting non-verbal expression. Cooking and meal-planning classes (D) focus on practical skills rather than emotional expression.
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Which intervention is appropriate for a patient who has anorexia nervosa and is resisting weight gain?
- 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 because assisting the patient to identify triggers to binge eating is crucial in addressing the resistance to weight gain in anorexia nervosa. By understanding the triggers, the patient can work on overcoming them and develop healthier eating habits. Option B is incorrect as providing remedial consequences for weight loss may exacerbate the issue. Option C is incorrect as impulsive eating is not the main concern in anorexia nervosa. Option D is incorrect as exploring needs for health teaching does not directly address the resistance to weight gain in anorexia nervosa.
The client is describing her trip to town. She tells the nurse, 'I cold town yellow water girl outside below ground.' This speech disturbance is called:
- A. Neologism
- B. Word salad
- C. Flight of ideas
- D. Verbigeration
Correct Answer: B
Rationale: The correct answer is B: Word salad. This speech disturbance is characterized by a jumble of words that lack coherent meaning or connection. In this case, the client's words are disorganized and nonsensical. Neologism (A) is the creation of new words, not a jumble of existing words. Flight of ideas (C) involves rapid shifts in thoughts without a clear connection, not a jumble of words. Verbigeration (D) is the constant repetition of words or phrases, not a jumble of unrelated words.
A newly admitted client has the diagnosis of catatonic schizophrenia. The nurse would expect to assess:
- A. Psychomotor symptoms
- B. Intense suspiciousness
- C. Inappropriate affect
- D. Clanging communication
Correct Answer: A
Rationale: Rationale:
A: Psychomotor symptoms are characteristic of catatonic schizophrenia, such as stupor or excessive motor activity.
B: Intense suspiciousness is more indicative of paranoid schizophrenia, not catatonic schizophrenia.
C: Inappropriate affect is a symptom seen in other types of schizophrenia but not specific to catatonic schizophrenia.
D: Clanging communication is associated with disorganized schizophrenia, not catatonic schizophrenia.
In catatonic schizophrenia, psychomotor symptoms like stupor, rigidity, or excitement are prominent.
A nurse is working with a perpetrator of family violence who has a long history of violent rages when frustrated, with periods of remorse after each outburst. The nurse is most likely to establish the nursing diagnosis of:
- A. Risk for injury related to victim reprisal.
- B. Risk for other-directed violence related to stress.
- C. Ineffective coping related to poor anger management.
- D. Caregiver role strain related to feelings of being overwhelmed.
Correct Answer: C
Rationale: The correct answer is C: Ineffective coping related to poor anger management. This nursing diagnosis is appropriate because it addresses the perpetrator's inability to manage their anger effectively, leading to violent outbursts. The perpetrator's history of violent rages and subsequent remorse suggest a pattern of maladaptive coping mechanisms. This diagnosis focuses on the underlying issue of poor anger management, which is essential to address in order to prevent future acts of violence.
Choices A, B, and D are incorrect:
A: Risk for injury related to victim reprisal - This choice places the focus on potential harm to the victim as a result of retaliation, which is not the primary issue in this scenario.
B: Risk for other-directed violence related to stress - While stress may contribute to the perpetrator's behavior, the primary issue lies in their poor anger management rather than just stress.
D: Caregiver role strain related to feelings of being overwhelmed - This choice is not appropriate as it does not address the core issue of poor
Which of the following is a common physical sign of anorexia nervosa?
- A. Hypoglycemia and tachycardia.
- B. Severe weight loss and dry skin.
- C. Increased appetite and excessive weight gain.
- D. High blood pressure and rapid heart rate.
Correct Answer: B
Rationale: The correct answer is B: Severe weight loss and dry skin. In anorexia nervosa, individuals typically experience significant weight loss due to severe restriction of food intake. This leads to a low body weight, which is a key physical sign of the disorder. Dry skin is also common in anorexia nervosa due to malnutrition.
Rationale:
A: Hypoglycemia and tachycardia are not specific physical signs of anorexia nervosa. While tachycardia (rapid heart rate) can occur due to the stress on the body, it is not as specific as severe weight loss.
C: Increased appetite and excessive weight gain are not characteristic of anorexia nervosa, as individuals with this disorder typically have a distorted body image and fear gaining weight.
D: High blood pressure and rapid heart rate are not typical physical signs of anorexia nervosa. Anorexia nervosa is more commonly associated with low blood pressure due to mal