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The average age for onset of anorexia nervosa is:
- A. 13 years old.
- B. 17 years old.
- C. 33 years old.
- D. 40 years old.
Correct Answer: B
Rationale: The correct answer is B (17 years old) because anorexia nervosa typically manifests during adolescence, around ages 15-19. This age range coincides with the developmental stage where body image concerns and societal pressures are heightened. Choice A (13 years old) is too young for the typical onset. Choices C (33 years old) and D (40 years old) are too late for onset, as anorexia nervosa usually begins earlier in life.
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Which nursing strategy leads patients to respond more positively to limit setting?
- A. Confront the patient with the inappropriateness of the behavior.
- B. Explore with the patient the underlying dynamics of the behavior.
- C. Reflect back to the patient an understanding of the patient's distress.
- D. State clear disapproval of the behavior, and support its consequences.
Correct Answer: C
Rationale: The correct answer is C because reflecting back to the patient an understanding of their distress shows empathy and validation, which can help build a therapeutic relationship and lead to a more positive response to limit setting. This approach acknowledges the patient's feelings without judgment, fostering trust and cooperation.
Choice A is incorrect as confrontation may lead to defensiveness and resistance. Choice B is incorrect as exploring underlying dynamics may not address the immediate need for setting limits. Choice D is incorrect as clear disapproval and consequences may create a negative, punitive atmosphere rather than promoting understanding and collaboration.
A nurse is planning care for a patient with anorexia nervosa. What is the priority intervention?
- A. Encourage the patient to verbalize concerns about body image.
- B. Monitor the patient's weight and nutritional intake closely.
- C. Provide education on healthy eating and exercise.
- D. Offer emotional support to the patient regarding self-esteem.
Correct Answer: B
Rationale: The correct answer is B. Monitoring the patient's weight and nutritional intake closely is the priority intervention for a patient with anorexia nervosa as it directly addresses the immediate health risks associated with the disorder, such as malnutrition and weight loss. By closely monitoring these parameters, healthcare providers can assess the patient's progress and make necessary adjustments to prevent further complications.
Choice A is incorrect because while addressing body image concerns is important in the long term, it is not the priority intervention when the patient's physical health is at risk.
Choice C is incorrect as providing education on healthy eating and exercise may not be effective if the patient is not yet in a stable physical condition to absorb and apply the information.
Choice D is incorrect as offering emotional support is valuable, but it is not the priority intervention in this case where the patient's physical health needs immediate attention.
The nurse who assesses a patient previously diagnosed as having paranoid personality disorder is most likely to describe the patient as:
- A. superficially charming.
- B. intense and impulsive.
- C. guarded and distant.
- D. friendly and open.
Correct Answer: C
Rationale: The correct answer is C: guarded and distant. This is because individuals with paranoid personality disorder typically exhibit suspiciousness, mistrust, and a reluctance to confide in others. They tend to be hypervigilant and wary of others, leading them to appear guarded and distant.
A: Superficially charming is incorrect because individuals with paranoid personality disorder are more likely to be cautious and suspicious rather than charming.
B: Intense and impulsive is incorrect as this description is more characteristic of individuals with borderline personality disorder, not paranoid personality disorder.
D: Friendly and open is incorrect because individuals with paranoid personality disorder are more likely to be reserved and cautious in their interactions.
In summary, the correct answer is C because individuals with paranoid personality disorder typically exhibit guarded and distant behavior due to their suspicious and mistrustful nature.
The client lives so completely in a world of her own that she does not eat, drink, or bathe regularly. She is considered to be:
- A. Exotic
- B. Anorectic
- C. Neurotic
- D. Psychotic
Correct Answer: D
Rationale: The correct answer is D: Psychotic. The client's behavior of not eating, drinking, or bathing regularly indicates a severe detachment from reality, which is a hallmark of psychosis. Psychotic individuals may have delusions or hallucinations that distort their perception of the world, leading to extreme neglect of basic needs. Choices A, B, and C are incorrect because they do not specifically address the profound disconnect from reality exhibited by the client. Exotic refers to something unusual or rare, anorectic relates to an eating disorder, and neurotic typically involves anxiety and emotional instability, none of which fully capture the level of disconnection seen in psychosis.
A nurse works a rape telephone hotline. Communication should focus on:
- A. Explaining immediate steps victims should take;
- B. Providing callers with a sympathetic listener.
- C. Obtaining information for law enforcement.
- D. Arranging long-term counseling.
Correct Answer: A
Rationale: The correct answer is A because in cases of sexual assault, immediate steps such as seeking medical attention, preserving evidence, and contacting authorities are crucial. Providing sympathy (B) is important but secondary to ensuring victims' safety. Obtaining information for law enforcement (C) should only be done if victims consent, as their safety and well-being are the priority. Long-term counseling (D) is important but not the immediate focus on a hotline call.