Nokea
Psychological dependence on mood- or behavior-altering drugs is known as
- A. drug psychosis
- B. a substance related disorder
- C. an orthopsychosis
- D. a psychotropic disorder
Correct Answer: B
Rationale: Substance-related disorders encompass psychological dependence on drugs altering mood or behavior.
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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 Parkinsons 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: Advance directives are invoked when patients are unable to make their own health care decisions. The correct response is the most global answer. A diagnosis of cancer or Parkinsons disease does not mean the patient is unable to make a decision. For a patient with amyotrophic lateral sclerosis, there are other ways to communicate beyond speaking.
What is the correct assessment for a patient with bulimia nervosa who frequently engages in purging behaviors?
- A. Observe for parotid gland enlargement and dehydration.
- B. Assess for fluid retention and leg swelling.
- C. Perform regular weight checks to assess for weight loss.
- D. Evaluate for signs of hyperactivity and poor sleep.
Correct Answer: A
Rationale: The correct assessment for a patient with bulimia nervosa who frequently engages in purging behaviors is to observe for parotid gland enlargement and dehydration. Parotid gland enlargement is a common physical manifestation due to repeated vomiting, and dehydration can result from purging behaviors. This assessment is crucial in monitoring the patient's physical health and identifying potential complications. Assessing for fluid retention and leg swelling (Choice B) is more typical in conditions like heart failure. Performing weight checks (Choice C) may not accurately reflect the patient's health status due to fluid shifts. Evaluating for signs of hyperactivity and poor sleep (Choice D) are not directly related to the immediate physical consequences of purging behaviors.
A patient reports an intense, overwhelming fear of driving a car. The fear has disrupted all elements of the patient's life. The patient does not go to the grocery store unless driven by someone else, has relinquished their job, and has few social contacts. The patient's treatment plan includes:
- A. assertiveness training
- B. biofeedback
- C. stress management assistance
- D. systematic desensitization
Correct Answer: D
Rationale: Systematic desensitization gradually exposes the patient to driving-related stimuli, reducing phobia through controlled steps.
Therapeutic nutrition begins for a patient with anorexia nervosa who is 70% of ideal body weight. Which nursing intervention is most important to add to the plan of care?
- A. Communicate empathy for the patient's feelings.
- B. Observe for adverse effects associated with refeeding.
- C. Teach patient about psychological origins of the disorder.
- D. Direct the patient to balance energy expenditure and caloric intake.
Correct Answer: B
Rationale: The correct answer is B: Observe for adverse effects associated with refeeding. This is important because refeeding syndrome can occur when a severely malnourished individual is reintroduced to nutrition too quickly, leading to potentially life-threatening electrolyte imbalances. Monitoring for signs such as fluid retention, electrolyte abnormalities, and changes in vital signs is crucial in preventing these complications.
Choice A: Communicating empathy is important in building trust and rapport with the patient, but it is not the most critical intervention in this scenario.
Choice C: Teaching the patient about the psychological origins of the disorder is important for long-term treatment, but it is not the most immediate concern when starting therapeutic nutrition.
Choice D: Directing the patient to balance energy expenditure and caloric intake is important for overall health, but it is not the priority when the patient is severely malnourished and at risk for refeeding syndrome.
Which nursing action should occur first regarding a patient who has a problem of sexual dysfunction or sexual disorder? The nurse should
- A. develop an understanding of human sexual response.
- B. assess the patient's sexual functioning and needs.
- C. acquire knowledge of the patient's sexual roles.
- D. clarify own personal values about sexuality.
Correct Answer: D
Rationale: The correct answer is D because clarifying the nurse's own personal values about sexuality is crucial before addressing a patient's sexual dysfunction. By understanding personal biases or judgments, the nurse can provide unbiased care. Assessing the patient's needs (B) should follow, as it directly addresses the patient's concerns. Developing an understanding of human sexual response (A) is important, but not as urgent as addressing personal values. Acquiring knowledge of the patient's sexual roles (C) is less relevant and should come after understanding the patient's needs.