Nokea
The first step in the creation of a therapeutic alliance between a nurse and a patient with a maladaptive response to eating regulation is:
- A. formulation of a nurse-patient contract.
- B. resolution of conflicts with family members.
- C. nurse and patient will agree on perception of patient's body.
- D. the means of stabilizing the patient's nutritional status will be specified.
Correct Answer: A
Rationale: The correct answer is A: formulation of a nurse-patient contract. This is because establishing a clear agreement outlining the roles, responsibilities, and boundaries between the nurse and patient is crucial in building trust and collaboration. It sets the foundation for a therapeutic alliance by promoting mutual understanding and shared goals.
Summary:
B: Resolving conflicts with family members may be important for overall well-being but is not the first step in creating a therapeutic alliance.
C: Agreeing on the patient's body perception is important but does not address the fundamental establishment of trust through a contract.
D: Specifying means of stabilizing nutritional status is essential but comes after the initial agreement on roles and responsibilities.
You may also like to solve these questions
Which of these is a sign of delayed mental development in toddlers?
- A. Limited speech
- B. Preference for solo play
- C. Not walking by 12 months
- D. Dislike of loud noises
Correct Answer: A
Rationale: Limited speech (A) by toddler age (e.g., few words by 2 years) may indicate delayed mental development, per milestones. Solo play (B) is normal, walking (C) is physical, and noise dislike (D) is sensory.
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.
Most individuals with Alzheimer's disease are cared for in:
- A. Nursing homes
- B. Their homes
- C. Mental health facilities
- D. Long-term care facilities specifically set up for clients with Alzheimer's
Correct Answer: B
Rationale: The correct answer is B: Their homes. Most individuals with Alzheimer's disease are cared for in their homes because it allows for familiar surroundings and routines, which can help reduce confusion and anxiety. Home care also promotes independence and maintains a sense of normalcy. Nursing homes (choice A) may be necessary for individuals with advanced Alzheimer's who require round-the-clock care. Mental health facilities (choice C) are not typically designed to provide specialized care for Alzheimer's. Long-term care facilities specifically for Alzheimer's clients (choice D) are a subset of nursing homes and may not be the most common setting for care.
What is the priority nursing intervention when caring for a patient with bulimia nervosa who has a history of purging?
- A. Provide emotional support and assist with stress management.
- B. Monitor vital signs and electrolyte levels closely.
- C. Encourage the patient to exercise regularly to prevent weight gain.
- D. Help the patient identify triggers for binge eating and purging behaviors.
Correct Answer: B
Rationale: The correct answer is B because monitoring vital signs and electrolyte levels closely is crucial in managing a patient with bulimia nervosa who has a history of purging. Purging can lead to electrolyte imbalances and dehydration, which can have serious consequences such as cardiac arrhythmias and electrolyte disturbances. By closely monitoring vital signs and electrolyte levels, nurses can quickly identify and intervene in case of any abnormalities, preventing potential life-threatening complications.
Choice A is incorrect because emotional support and stress management are important but not the priority when dealing with physical complications from purging. Choice C is incorrect because encouraging exercise may exacerbate the patient's unhealthy behaviors and should be approached cautiously. Choice D is incorrect because identifying triggers is important but not as immediate as monitoring vital signs and electrolyte levels in this situation.
A person who is the caregiver of a parent with early-to-middle-stage Alzheimer disease is concerned about possible episodes of incontinence. What strategy should the nurse suggest?
- A. Limiting the patient's fluid intake to 1000 ml daily
- B. Discussing the use of an indwelling catheter with the physician
- C. Putting plastic coverings on the beds, upholstered chairs, and sofas
- D. Taking the patient to the bathroom at least every 2 hours when the patient is awake
Correct Answer: D
Rationale: The correct answer is D: Taking the patient to the bathroom at least every 2 hours when the patient is awake. This strategy helps prevent episodes of incontinence by ensuring the patient has regular opportunities to void. It promotes continence through scheduled toileting, maintaining the patient's dignity and preventing accidents.
Choice A is incorrect as restricting fluid intake can lead to dehydration and other health issues. Choice B is incorrect because indwelling catheters are not recommended for managing incontinence in Alzheimer's patients due to the risk of urinary tract infections. Choice C is incorrect as it only addresses the aftermath of incontinence, not the prevention of it.