Nokea
The coping mechanism that patients with anorexia nervosa use maladaptively is:
- A. denial.
- B. projection.
- C. introjection.
- D. rationalization.
Correct Answer: A
Rationale: The correct answer is A: denial. Patients with anorexia nervosa often deny the seriousness of their low weight, distorted body image, or the potential health consequences of their eating behaviors. This denial helps them avoid facing their underlying issues and enables them to continue harmful behaviors. Choice B (projection) involves attributing one's own thoughts or feelings onto others, not relevant to anorexia. Choice C (introjection) involves internalizing external beliefs or values, not a common maladaptive coping mechanism in anorexia. Choice D (rationalization) involves creating logical explanations to justify inappropriate behaviors, not the primary defense mechanism in anorexia.
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An 18-year-old referred to the mental health center often cooks gourmet meals but eats only tiny portions. The patient wears layers of loose clothing saying, "I like the style."Â The patient's weight dropped from 130 to 95 pounds. She has amenorrhea. Which diagnosis is most likely?
- A. Eating disorder not otherwise specified
- B. Anorexia nervosa
- C. Bulimia nervosa
- D. Binge eating
Correct Answer: B
Rationale: The correct answer is B: Anorexia nervosa. This diagnosis fits the patient's symptoms of restrictive eating, significant weight loss, amenorrhea, and denial of the severity of the situation. The patient's behavior of cooking gourmet meals but eating tiny portions and wearing layers of clothes to hide weight loss are classic signs of anorexia nervosa. The other choices are incorrect because:
A: Eating disorder not otherwise specified does not fully capture the severity and specific symptoms exhibited by the patient.
C: Bulimia nervosa involves binge-eating followed by compensatory behaviors, which are not described in the scenario.
D: Binge eating disorder involves recurrent episodes of binge eating without compensatory behaviors, which is not indicated.
The nurse is aware, when developing a care plan, that the three major goals of care for the client in whom Alzheimer's disease has been diagnosed include providing for the client's safety and well-being, therapeutically managing the client's behaviors, and:
- A. Supporting the client during curative care
- B. Providing support for family, relatives, and caregivers
- C. Arranging for nursing home placement
- D. Tracking the progress of medical, legal, and financial records
Correct Answer: B
Rationale: The correct answer is B: Providing support for family, relatives, and caregivers. This is because Alzheimer's disease not only affects the individual but also has a significant impact on their family and caregivers. Providing support to them is crucial for maintaining the overall well-being of the client. Choice A is incorrect as Alzheimer's disease does not have a curative treatment. Choice C is incorrect as nursing home placement is not always necessary and should be considered as a last resort. Choice D is incorrect as tracking medical, legal, and financial records is important but not a major goal in the care plan for Alzheimer's clients. Supporting the family and caregivers helps in creating a supportive environment for the client and ensures holistic care.
In Avoidant/Restrictive Food Intake Disorder (ARFID), which of the following is a characteristic clinical feature?
- A. Do not prefer foods with strong smells
- B. Do not prefer bland foods
- C. Do not have weight concerns
- D. Do not prefer solid foods
Correct Answer: C
Rationale: ARFID involves food avoidance without body image concerns, unlike AN; lack of weight concerns is a key feature per DSM-5.
A 72-year-old female patient has the medical diagnosis of delirium secondary to anticholinergic medication toxicity. A nurse planning discharge care must consider the need to teach the family to be alert for maladaptive cognitive symptoms because:
- A. delirium is a hypersensitivity reaction.
- B. the elderly often deny changes in cognition.
- C. elderly females are more prone to delirium than elderly males.
- D. slower metabolism in the elderly predisposes to medication toxicity.
Correct Answer: D
Rationale: The correct answer is D because slower metabolism in the elderly can lead to medication toxicity, including anticholinergic toxicity causing delirium. As people age, their metabolism slows down, making them more susceptible to drug accumulation and toxicity. This can result in cognitive symptoms like delirium.
A: Delirium is not a hypersensitivity reaction; it is an acute state of confusion.
B: Denial of cognitive changes is not directly related to the risk of medication toxicity in the elderly.
C: Gender is not a significant factor in medication toxicity leading to delirium; it is more related to individual metabolism and drug interactions.
A patient tells the nurse, "My doctor prescribed Paxil (paroxetine) for my depression. I assume I'll have side effects like I had when I was taking Tofranil (imipramine)." The nurse's reply should be based on the knowledge that paroxetine is a:
- A. Selective norepinephrine reuptake inhibitor.
- B. Tricyclic antidepressant.
- C. MAO inhibitor.
- D. SSRI
Correct Answer: D
Rationale: The correct answer is D: SSRI. Paroxetine belongs to the class of selective serotonin reuptake inhibitors (SSRIs), which work by primarily increasing the levels of serotonin in the brain. This mechanism differs from tricyclic antidepressants like Tofranil (imipramine) and MAO inhibitors. SSRIs are known for having fewer side effects compared to tricyclic antidepressants and MAO inhibitors. Therefore, the nurse should inform the patient that the side effects experienced with Tofranil are not necessarily indicative of what they will experience with Paxil due to the different drug classes.